What is it like to study under a lecture-based curriculum?

As you may be aware if you have read my previous blog post I have just completed year 1 of medicine at Cardiff university, which is a predominantly CBL based course style in the pre-clinical years. So you may now be wondering how on earth I am going to be able to tell you what a lecture based curriculum is like because I haven’t witnessed one, but this is where it gets a little complex.

Most universities for medicine will brand their course structure with a single title such as CBL/PBL/lecture-based, but just because the main style of teaching on the course falls under the 1 method doesn’t mean you will not experience another method also. At Cardiff during the autumn semester of year 1 all medical students undergo a programme of 3 modules named ‘Platform for clinical sciences’ which is not in CBL format, it is in fact a lecture based style of teaching. So for 3 months of my year 1 study I did experience a lecture based course style, and this post is going to be my reflection on that experience as well as guide to what it is really like studying under this type of curriculum.

What does a lecture based curriculum even mean?

I have covered in a previous post the many different types of course structures across the medical schools in the UK. As a brief summary, a lecture based curriculum is exactly what it says on the tin. Medical students will spend the majority of their pre-clinical years learning the pre-clinical sciences through all year lectures, small group tutorials, seminars and lab teachings. This course style requires much less independant study and self inquiry and relies much more on the students engaging and taking in the material delivered to them in these structured classes.

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Teaching delivered through lab sessions. 

As stated in my previous post sometimes this course style can mean a lack of patient contact and clinical exposure in pre-clinical years, but for me this was not the case as clinical skills and some very early patient contact sessions were timetabled into our week to help us prepare for clinical practice early on.

My experience of a lecture-based curriculum.

As I only witnessed this method of teaching for 3 months It was like a whirlwind to me, I was new to medical school, freshers was in full swing and I was also having a tough time adjusting to life without my family around me, so I apologise if the details are lacking here.

PCS as it was known by students is the rigorous programme of 3 modules undertaken in autumn term of year 1 at Cardiff medical school. From my understanding its aim seems to be to bring all students from various different backgrounds and education systems together and up to speed as well as give us a very good grounding in the basics (but it didnt seem very basic at the time) of the pre-clinical sciences so we could apply our knowledge and build on it further during case based learning. The 3 module programme was neither systems based nor science based to me, but this may have been because it was very fast paced and we moved from topic to topic very quickly. Each module did have a theme though so it wasn’t all that crazy.

A typical week in the life of a lecture based student can be seen below, I have modified one of my timetables to show you the average contact hours as well as the variety of learning methods encompassed into one week. What may be different to many other courses is that Cardiff cover the majority of the core anatomy teaching within PCS, hence it may seem like we have a lot of anatomy sessions, this may not be the case at other medical schools who do not aim to give students the majority of the core anatomical teaching within a short space of time.

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A general overview of a lecture based medical students week.

Above was an average timetable for me during my first term at medical school, if you have counted it clocks up 26 hours of timetabled study which is broken down into lectures (6 hours), anatomy lab (6 hours), physiology labs (3 hours), small group tutorials (9 hours) and clinical skills teaching (2 hours). Obviously this is not at all representative of every lecture based curriculum, especially if your thinking of heading to oxbridge where supervisions are scheduled into the week, but it is a good idea of the kind of things you will be doing if you chose this curriculum style.

What was this like as a learning environment?

From a personal standpoint after a whole year of trying to make it work, lectures just are not the right learning environment for me. I struggle to focus on listening for long periods of time and I find my focus is much greater when I am actively studying. Saying this I found that attending the lectures and recording them as well as listening and trying to take notes made the information much easier to study, but it didn’t necessarily stick the first time. I took much better to the small groups, lab teaching and anatomy teaching. The small group teaching was particularly great because it allowed me to build on the information from lectures and solve the problems surrounding these in smaller groups with close guidance from an academic in this field. I did find that at the end of the day I had to review a lot of the material from lectures and groups to truly understand it all, hence this made the days very long and tiring, but it was worth it when it all finally clicked.

This style of curriculum is incredibly full on, hefty contact hours as well as little time scheduled for independant study meant I was always behind in terms of where I wanted my understanding to be, and I can definetly say this course style did not suit me at all. A lot of information was covered in a very short amount of time and I was always running to catch up.

Looking back on this style of learning now though having been through CBL, it providing me with a great foundation knowledge bank of pre-clinical science and has made my life so much easier in case group as the content we are covering is just building on things we have already covered. Hence in reflection whilst it was such a slog going through the long hours and lack of sleep, it was worth it to have that solid basis for further study.

How do you cope with the workload and full timetable?

I am not going to lie, the timetable and workload I witnessed whilst following this curriculum was very intense, and hence it required a lot of forward thinking and planning.

It is really important to plan out your days with your timetable in mind to be able to review your lecture material and other resources as well as study and frankly for myself just keep up. I found it best to plan my week in advance, giving myself slots for study, review and also FREE TIME! I cannot stress the importance of balance when following this curriculum, it is so easy to end up locked away in your room/library drowning in books, but you need to make time for yourself and know your limits.

Looking back now I approached this term with the wrong mindset of trying to make notes on absolutely everything, and whilst this did benefit me during CBL, it was impossible to keep up with alongside this very full timetable. Hence to cope with the workload of this curriculum I advise you annotate your lectures during the actual lecture and only make brief notes to consolidate things you dont know. This also frees some time up to do things you enjoy as well as study when exams are around the corner.

The workload was very straining, particularly because one single 50 minute lecture would cover a whole chapters worth of information in a textbook, and with multiple of these a week it can often feel slightly suffocating upon review. My best advice here is stop panicking and just try your best to take notes during the lectures and then on the weekend spend a good couple of hours reviewing it all and making sure you understand everything.

Is a lecture based course for me?

Before coming to medical school I thought I would really enjoy a lecture based course, but having experienced it I would have to say I do prefer a more self inquiry based CBL /PBL structure. For me people who enjoy being given information directly to learn rather than having to motivate themselves and search for the information themselves would be more suited to this style of course. Also if you have a deep interest in the pre-clinical sciences then a lecture based course may cover more of this in greater detail, and hence it may appeal to you. My advice as always is check out every single universities course at an open day or via a prospectus before you apply and find out what you like the sound of and what interests you.

 

This is my experience of a lecture based curriculum. Although it was brief and will differ from other medical schools which adopt this technique throughout their entire curriculum, I hope it was a useful insight into a more traditional course style. It didn’t personally work for me, but hopefully from above you can get a sense of what its like and whether you personally would suit this course style.

Nat x

What is it like to study under a CBL curriculum?

As you may already know I have just completed year 1 at Cardiff University Medical school, and the curriculum here follows a case based learning (CBL) approach from January of year 1, and for anyone who is interested it is an integrated CBL style course with a systems based approach.

Just as a side note, Term 1 at Cardiff goes by the name of platform for clinical sciences and this is delivered in a lecture based traditional format, so I will be doing a separate post on what it is like to follow a lecture based curriculum for those interested in medical schools which follow that method.

This blog post is going to be a complete run down of what its like to follow a CBL course structure, and I will address many aspects which I feel applicants often ask questions on or feel daunted by when starting the course or looking to apply.

What is CBL?

I have already addressed this topic in a previous blog post but this was on more general terms, instead here I will be describing the CBL style course I have personally witnessed at Cardiff medical school.

Case based learning at Cardiff university runs on a 2 week timetable and follows a given clinical case on one of the body systems. The case itself is split into two parts over the two weeks, the first part often addresses a patients complaint to the GP and the second part shows a development of the patients condition as part of the case. For example the first weeks case may see an middle aged gentleman who is suffering with chest pain, and this could escalate the following week to the gentleman being rushed into A&E with a heart attack. The aim of CBL is to discuss in a small group (10 people) the case, devise learning outcomes and brainstorm ideas to learn about the anatomy, physiology, pathology, histology, sociology and psychology linked to the case in question, and be able to apply this to our practice during placements.

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CBL case structure from a students perspective

As you can see above, there is a clear outline of what CBL entails (this is specific to Cardiff but I’ve heart it is similar at a lot of universities, and even similar to some PBL courses).

What is case group like as a learning environment?

At my university case groups comprise of 10 students and one academic staff member who is named the facilitator. During each CBL session (we have 3 over the 2 weeks), one person of the 10 will be a chair to keep the session organised and one person will scribe everything that we are discussing. The facilitators role is to keep us on track, prevent us from going on tangents and point out some useful topics of discussion if we are struggling, their main aim is to ensure our learning outcomes cover all the learning points we are supposed to cover during this case, so they do guide us when needed (i think this is where CBL differs from PBL).

For me case group was a brilliant environment to learn in, it allowed us a great safe and supportive place to share our ideas, and it allowed people who did not particularly understand one topic or learning outcome to listen to the findings from others who did, hence sharing ideas really does add to your knowledge and means your very unlikely to miss something important.

The cons for me of case group were the lack of formality, this meant that often people showed up without completing the learning outcomes and this meant some individuals in the group were not pulling their weight and piggybacking if you will off the hard work of others. Also if your not a particularly confident person case group can put you in the spotlight which may be slightly uncomfortable until your used to it.

Overall for me it is a great way to learn, and a very supportive and encouraging environment.

How do you cope with the large amount of self directed learning?

Coming from A-levels where all the information needed to pass the exams was handed to me on a plate, CBL was initially incredibly daunting. I remember leaving the first case group session with a load of learning outcomes and thinking “how am I ever going to find the answers to these on my own”, but trust me when I say its really not like that at all!

I found that the lecture material and lab material which we undertook during the 2 week case answered a lot of my learning outcomes without the need for extra reading in great amounts. Yes there were learning outcomes which weren’t covered at all by timetabled teaching, but I did in the end enjoy going to the library or back to my room and opening up my textbook to find the answers. I am a very motivated studier and this probably helped me as I enjoyed the self-directed aspect of CBL a lot more than I expected I would. SD learning is a key skill to have in medicine, and something which you will rely on heavily during the clinical years, so CBL was a great asset for me.

The main struggle is the transition to this style of learning, but over time if you work at it you will perfect the method best for you. Its also about studying smart, not every learning outcome developed by your group will be important, so make sure you spend less time on those.

For me the one big plus at Cardiff was that we received learning outcomes at the end of the 2 weeks, so even if I missed something out I could use the weekend between cases to fill in the blanks and work out what is important and what is less so.

What is integrated clinical placements like during pre-clinical years?

anyone attending a medical school with an integrated curriculum will know placements are a staple in years 1 and 2. At Cardiff we did 1 full day (8-5) of placement with half a day spent seeing real patients in the community/GP clinics who have the same issues as discussed in the case, and the other half spent learning the relevant clinical skills needed to practice on the wards in clinical years (as well as pass the ISCE and OSCE examinations).

I found clinical placements linked very well to the case, and allowed me to develop my clinical knowledge and patient communication early on. It was also really great to see the clinical issues we are learning about on real patients and to develop the key evidence based approach to medicine. I would definetly recommend any medical school with early clinical contact.

FAQs:

  • Do you ever feel like you are having to teach yourself? 

No not at all, yes self directed learning means sitting down with a textbook and learning the relevant information, but if I am ever stuck I can ask my facilitator, email a lecturer or ask any of the academics overseeing my course to point me in the right direction. Also a lot of our learning outcomes are addressed in timetabled teaching, it really isn’t as self-directed as many people think.

  • Do you feel unprepared for exams?

The short answer is no, if you put the work in during the CBL sessions and in your own revision time, you will be able to learn all the relevant information needed for the exams, especially considering we have learning outcomes to follow. Yes there is a lot of content in the course, so its practically impossible to know every last detail like at A2 level, but if you revise smart you will walk into the exams feeling prepared.

 

Above is my experience with Cardiff’s CBL style course, and hopefully is an insight into anyone who is looking at studying a course with a similar structure.  I am so glad I chose this course style because it really does work for me!

Nat x