The Analysis of Teaching of Medical Schools (AToMS) survey: an analysis of 47,258 timetabled teaching events in 25 UK medical schools relating to timing, duration, teaching formats, teaching content, and problem-based learning

Abstract

Background: What subjects UK medical schools teach, what ways they teach subjects, and how much they teach those subjects is unclear. Whether teaching differences matter is a separate, important question. This study provides a detailed picture of timetabled undergraduate teaching activity at 25 UK medical schools, particularly in relation to problem-based learning (PBL). Method: The Analysis of Teaching of Medical Schools (AToMS) survey used detailed timetables provided by 25 schools with standard 5-year courses. Timetabled teaching events were coded in terms of course year, duration, teaching format, and teaching content. Ten schools used PBL. Teaching times from timetables were validated against two other studies that had assessed GP teaching and lecture, seminar, and tutorial times. Results: A total of 47,258 timetabled teaching events in the academic year 2014/2015 were analysed, including SSCs (student-selected components) and elective studies. A typical UK medical student receives 3960 timetabled hours of teaching during their 5-year course. There was a clear difference between the initial 2 years which mostly contained basic medical science content and the later 3 years which mostly consisted of clinical teaching, although some clinical teaching occurs in the first 2 years. Medical schools differed in duration, format, and content of teaching. Two main factors underlay most of the variation between schools, Traditional vs PBL teaching and Structured vs Unstructured teaching. A curriculum map comparing medical schools was constructed using those factors. PBL schools differed on a number of measures, having more PBL teaching time, fewer lectures, more GP teaching, less surgery, less formal teaching of basic science, and more sessions with unspecified content. Discussion: UK medical schools differ in both format and content of teaching. PBL and non-PBL schools clearly differ, albeit with substantial variation within groups, and overlap in the middle. The important question of whether differences in teaching matter in terms of outcomes is analysed in a companion study (MedDifs) which examines how teaching differences relate to university infrastructure, entry requirements, student perceptions, and outcomes in Foundation Programme and postgraduate training.

Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise

“…While systematic data on medical school outcomes have been rare until recently, data on the detailed processes of medical school teaching, and how they differ, have been almost non-existent. The Analysis of Teaching of Medical Schools (AToMS) study [22], which is a companion to the present paper, addresses that issue directly and provides detailed data on timetabled teaching events across the 5 years of the undergraduate course in 25 UK medical schools. PBL and non-PBL schools differed on a range of teaching measures.…”

“…Teaching, learning and assessment (10 measures). Schools differ in their teaching, as seen in the two main factors in the AToMS study [22], which assess a more traditional approach to teaching as opposed to newer methods such as PBL or CBL (case-based learning), and the extent to which a course is structured or unstructured. There are also differences in the teaching of particular specialties, as well as in the amount of summative assessment [23], and of self-regulated learning, based on data from two other studies [39,50], described elsewhere [22].…”

“…Scores on the second factor describing differences in medical school teaching, positive scores indicating teaching is more structured rather than unstructured. From the AToMS study [22] for 2014-2015.…”

“…n/a n/a SelfRegLearn Self-regulated learning. Overall combined estimate of hours of selfregulated learning from survey of self-regulated learning [39] and HEPI data [22].…”

“…The issue is discussed in detail in the "Method" section, but care has to be taken because of multiple comparisons, with a Bonferroni correction being overly conservative. Our analysis will firstly describe the correlations between the various measures and then address three key questions: (1) the differences between PBL and non-PBL schools (which we have also assessed in the AToMS study in relation to the details of teaching [22]), (2) the extent to which teaching influences career choice and (3) the causal relations across measures at the ten different levels briefly in part described earlier.…”