title: A comparison of medical students' learning approaches between the first and fourth years.
abstract: OBJECTIVE
  We hypothesized that medical students exposed to a case-based curriculum in years 1 and 2 and clinical cases in the year 3 clerkship would demonstrate a longitudinal increase in the deep approach to learning and a decrease in the surface apathetic approach.
  
  
  METHODS
  A cohort of first-year medical students completed the Approaches and Study Skills Inventory for Students at the beginning of their first term and again at the beginning of their fourth year. Approaches and Study Skills Inventory for Students scores were aggregated into three main learning approach scales: deep, strategic, and surface apathetic.
  
  
  RESULTS
  On average, deep and strategic scores did not significantly change between years 1 and 4, but the surface apathetic mean score decreased as a result of lower syllabus boundness and fear of failure subscale scores. Effect sizes were small (d = 0.30, 0.34, respectively).
  
  
  CONCLUSIONS
  The deep approach to learning is a complex process and did not change in our students after 3 years of medical school, even though a case-based curriculum was believed to foster deeper learning. By the end of year 3, our students were, on average, less bound to syllabi and feared failure less.
authors: From the Department of Medical Education, Keck School of Medicine, University of Southern California, Los Angeles, and the Department of Medical Education, Chonnam National University Medical School, Gwangiu, South Korea.
authors: Eun-Kyung
authors: EK
authors: Chung
authors: From the Department of Medical Education, Keck School of Medicine, University of Southern California, Los Angeles, and the Department of Medical Education, Chonnam National University Medical School, Gwangiu, South Korea.
authors: Donna
authors: D
authors: Elliott
authors: From the Department of Medical Education, Keck School of Medicine, University of Southern California, Los Angeles, and the Department of Medical Education, Chonnam National University Medical School, Gwangiu, South Korea.
authors: Dixie
authors: D
authors: Fisher
authors: From the Department of Medical Education, Keck School of Medicine, University of Southern California, Los Angeles, and the Department of Medical Education, Chonnam National University Medical School, Gwangiu, South Korea.
authors: Win
authors: W
authors: May
mesh_terms: D000328:Adult; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods; D005260:Female; D006801:Humans; D007858:Learning; D008137:Longitudinal Studies; D008297:Male; D018794:Problem-Based Learning / Q000379:methods; D011446:Prospective Studies; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*; D055815:Young Adult