title: A phenomenographic study of students' conception of learning for a written examination.
abstract: OBJECTIVE
  We investigated students' conception of learning for an examination in internal medicine, infectious diseases and dermatology-venereology, in three separate examinations versus a single integrated one.
  
  
  METHODS
  The study was carried out during a curricular change, with one cohort belonging to a new integrated examination and the other to the former non-integrated examination. Forty-eight interviews were carried out among medical undergraduates regarding the role of the examination in the learning process. The interviews were analyzed according to the phenomenographic approach to identify the students' conception of learning.
  
  
  RESULTS
  The learning approaches could be categorized in 47 of the 48 students into 4 major groups: application directed, holistic, comprehensive and tactical memorizing learning. The result indicated that comprehensive learning was the most common approach among students following either examination-form; tactical memorizing learning was more prevalent among students following the non-integrated examination and holistic learning was applied more frequently among students following the integrated examination. Nine of the 47 students changed their approaches over time, the majority switching to a comprehensive approach. No significant gender difference was observed.
  
  
  CONCLUSIONS
  Comprehensive learning was the most common strategy employed and students who changed during the course most often switched to this. However, only a minor change in approach was observed after a switching to an integrated examination, i.e. it takes more than just an integrated examination to change the student's conception of learning.
authors.affiliation: Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Sweden.
authors.forename: Desiree W
authors.initials: DW
authors.lastname: Edström
authors.affiliation: Department of Otorhinolaryngology, Karolinska University Hospital, Sweden.
authors.forename: Niklas
authors.initials: N
authors.lastname: Wilhemsson-Macleod
authors.affiliation: Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Sweden.
authors.forename: Michel
authors.initials: M
authors.lastname: Berggren
authors.affiliation: Department of Neuroscience, Karolinska Institutet, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Josephson
authors.affiliation: Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Sweden.
authors.forename: Carl-Fredrik
authors.initials: CF
authors.lastname: Wahlgren
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004501:Education, Medical; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D010465:Perception; D018794:Problem-Based Learning / Q000379:methods; D013337:Students, Medical / Q000523:psychology*; D013548:Sweden; D014956:Writing; D055815:Young Adult
keywords: Assessment; curriculum change; integration; phenomenography
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