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This paper explores doctoral students' experiences of their scholarly communities in terms of socio-psychological well-being. Further, the study examines how experiences were related to study engagement and to self-reported stress, exhaustion, and anxiety. Altogether 669 doctoral students from the University of Helsinki, Finland, responded a survey. The answers to an open-ended question were content analysed and then statistically compared to well-being and study engagement items. The results showed that there was variation in students' experiences of the scholarly community regarding socio-psychological well-being. More than half of the answers, where students had explicitly described their experience (n = 383), emphasised the scholarly community as source of burden (56%), but experiences of inspiration and empowerment were also frequently reported in the answers (44%). Feelings of empowerment were positively related to study engagement and negatively related to stress, exhaustion, and anxiety. (Contains 6 tables.)

Computer-based systems have great potential for delivering learning material. Here, a Web-based learning management system is employed by a medical university to support undergraduate courses. The objective was to help the university's staff to understand the readiness and attitudes of students to the use of information technology, their orientation to new learning environments, and the functionality of the system. The participants were a cohort of first-year medical students enrolled in an introductory microbiology course. Students' attitudes to information technology and learning styles were measured by a rearranged questionnaire, and a principal component analysis identified the students' orientations to information technology and the learning environment. The results of the study revealed that students showed readiness to and positive attitudes towards information technology in education and exposed a possible benefit from its use in the long run. However, they also conveyed negative opinions of the learning management system used in their coursework, suggesting a need for change of the technology. This study provides evidence that in order for computer-based system to be effective they must be designed and implemented with care, otherwise they may risk to lower students' interests and activation.

CONTEXT: Interprofessional learning activities in health care are being gradually introduced on an international basis and therefore cross-cultural and internationally collaborative research into the outcomes of these activities is needed. Hence, it is necessary not only to translate research instruments into the language of the culture in which they are to be used, but also to adapt them culturally if they are to fulfil the testing purposes for which they are intended. It is also necessary to test a translated instrument in order to ensure that it retains its intended psychometric properties. METHODS: In the present study, the Readiness for Interprofessional Learning Scale (RIPLS) was adapted for use in a Swedish student population. Cross-cultural adaptation was performed according to recommended guidelines. The Swedish version was tested on a group of students from various health care professions (n = 214). Cronbach's alpha coefficient was adopted to ensure internal consistency. RESULTS: Minor discrepancies during the different translation processes were identified and corrected. Confirmatory factor analysis suggests that the model had an acceptable fit, implying that the factor structure of the scale did not undergo any significant changes by being subjected to translation. The psychometric qualities of the instrument were comparable with those of the English-language version. CONCLUSIONS: This study presents the cross-cultural adaptation of the RIPLS and demonstrates that its subscale Teamwork and Collaboration is the only reliable subscale. The other 2 subscales (Professional Identity, and Roles and Responsibilities) probably require further scrutiny and development, at least in the Swedish population. [ABSTRACT FROM AUTHOR]

ContextThe aim of the national 'IT Culture in Medical Education' project in Finland is to enhance the opportunities new technology may provide for medical education. The project focuses on attitudes towards information technology (IT) and on its current use among teachers and students. MethodThis survey was part of a Finnish nationwide project in medical education. Data were collected by means of a questionnaire designed to gather information about IT use in medical education, sent to teachers and students. The questions were 5-point Likert-type. The participants were medical teachers (n=196) and medical students (n=392) at two medical schools. ResultsIn both universities, it appeared that medical teachers and students had a very positive attitude toward the advances in modern technology. In addition to the favourable attitudes, computer-related technology was also widely applied. Teachers, however, used information technology more in their research work than in teaching. ConclusionsThe results pose challenges to medical education and underline the importance of educational and psychological knowledge in combination with new technical skills. [ABSTRACT FROM AUTHOR]

This study examines advanced medical students' perceptions of assessment practices and their ways of studying for examinations as related to their approaches to learning. This study further validates a cluster model obtained in a previous study through medical students' interviews. In this cluster model students were divided into four groups on the basis of their approaches to learning. The subjects (N = 35) were advanced medical students who volunteered to be interviewed. The interviews focused on learning strategies, study behaviour and perceptions of the learning environment. The results indicated that there were no differences in students' perceptions of the examination procedures. Students in all four groups criticised quite similarly the examination practices. However, the results showed that students in the four groups reported different ways of preparing for examinations and, furthermore, had different views of the most functional ways to study for them. This study brought into light problems that arise in a traditional medical curriculum, particularly concerning traditional assessment practices. [ABSTRACT FROM AUTHOR]

New learning environments such as distance education and computer-aided instruction promise to bring a change in today's learning environments by adjusting the relationship between the learner, the educational content and the organization of education. In this study, we explored whether students' approaches to learning related to their perception of a particular virtual learning environment. Scales of the ASSIST questionnaire were loaded in a two-principal component solution, surface and deep-strategic. We found statistically significant correlations between the approaches to learning and the student's attitudes towards ICT. Early identification of approaches to learning and attitudes towards ICT may prove to be important in order to provide assistance to aid the transition of students with diverse individual characteristics and to the design of new learning environments. [ABSTRACT FROM AUTHOR]

Abstract Background In medical education, feedback from students is helpful in course evaluation. However, the impact of medical students' feedback on long-term course development is seldom reported. In this project we studied the correspondence between medical students' descriptive evaluations and key features of course development over five years. Methods Qualitative content analysis was used. The context was consultation skills courses in the middle of the Göteborg undergraduate curriculum during five years. An analysis of 158 students' descriptive evaluations was brought together with an analysis of key features of course development; learning objectives, course records, protocols from teachers' evaluations and field notes. Credibility of data was tested by two colleagues and by presenting themes at seminars and conferences. Authors' experiences of evaluating the course over many years were also used. Results A corresponding pattern was found in students' descriptive evaluations and key features of course development, indicating the impact of students' open-ended feed-back. Support to facilitators and a curriculum reform also contributed. Students' descriptive feedback was both initiating and validating longitudinal course implementation. During five years, students' descriptive evaluations and teachers' course records were crucial sources in a learner-centred knowledge-building process of course development. Conclusion Students' descriptive evaluations and course records can be seen as important instruments in developing both courses and students' learning. Continuity and endurance in the evaluation process must be emphasized for achieving relevant and useful results.

Background: This study explored the physiological correlates of students' self-reported emotions in ecologically valid settings by combining biosignal data (on physical and cardiac activity) and experience sampling method (ESM) data., Aims: The aim was to examine the concurrent associations between self-reported excitement, calmness, anxiety, and boredom (adopted from the dimensional model of emotions) and students' heart rate (HR) and heart rate variability (HRV) (indicators of physiological arousal and the activation of the autonomous nervous system). Students' physical activity was controlled in the models via the metabolic equivalent of task (MET) values (actigraphy data). A second objective was to explore how to combine the information stored by these three sources of ambulatory assessment., Sample: The study comprised 136 high school students with multiple repetitive data points., Methods: For three consecutive days, students wore biometric sensors and wristbands collecting their HR, HRV, and MET signals, and answered the ESM questionnaires five times a day on smartphones., Results: When MET values were controlled for, self-reported excitement was related to higher HR as well as lower HRV during a specific moment, indicating stronger sympathetic activity (i.e., physiological arousal/activation). Self-reported boredom was related to lower HR but was unrelated to HRV. Self-reported calmness and anxiety were unrelated to HR and HRV after controlling for MET., Conclusions: A 5-min time window with a Gaussian weighted mean seemed to be an appropriate data processing method for capturing the physiological arousal (or abate) of self-reported excitement and boredom. The findings suggest that the physiological stimulus of elevated HR could be interpreted by students as an adaptive state of excitement. Combining the experience sampling approach and the physiological measures revealed how the mind and body function in interplay and can therefore provide objective evidence of emotional and motivational processes as they unfold in students' daily lives., (© 2022 The Authors. British Journal of Educational Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Previous studies have examined the neural correlates of receiving negative feedback from peers during virtual social interaction in young people. However, there is a lack of studies applying platforms adolescents use in daily life. In the present study, 92 late-adolescent participants performed a task that involved receiving positive and negative feedback to their opinions from peers in a Facebook-like platform, while brain activity was measured using functional magnetic resonance imaging (fMRI). Peer feedback was shown to activate clusters in the ventrolateral prefrontal cortex (VLPFC), medial prefrontal cortex (MPFC), superior temporal gyrus and sulcus (STG/STS), and occipital cortex (OC). Negative feedback was related to greater activity in the VLPFC, MPFC, and anterior insula than positive feedback, replicating previous findings on peer feedback and social rejection. Real-life habits of social media use did not correlate with brain responses to negative feedback., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wikman, Moisala, Ylinen, Lindblom, Leikas, Salmela-Aro, Lonka, Güroğlu and Alho.)

Current educational reforms concerning curricula and digitalization challenge educators to meet new demands for learning and schooling. What is common for current educational reforms is that they tend to emphasize competencies that are not related to the traditional subject-matters and reflect a stance which presents learning as a naturally reflective and collaborative act. It is often assumed that teachers are automatically ready to implement ideas of this kind in practice. In this study, we propose that teachers' theories about knowledge, knowing and learning, particularly their epistemic theories, may be related to how teachers approach these reforms which challenge their previous ways of working and how they perceive their wellbeing at work. To examine these matters, we explored the dynamic interrelations between teachers' epistemic theories, conformity with the novel curricular and digital reforms (ideas behind the new curriculum and digitalization program), perceptions of the school leadership, work engagement and burnout. Participants (Study 1 n = 228; Study 2 n = 200) were Finnish class teachers and subject-matter teachers. Both data sets were collected before the COVID-19 pandemic. For data analysis, we plotted correlation network figures. Results showed that if teachers' epistemic theory was in harmony with the curricular or digital reforms, there is a positive association with work engagement and negative association with burnout. In sum, results of this provided a hint of the phenomenon suggesting that teachers' epistemic theories may be a factor which buffers teachers to meet the current epistemic and developmental challenges of teachers' profession, and furthermore, serve as grounds for a positive association for teachers to feel adequate and satisfied in their work., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lammassaari, Hietajärvi, Salmela-Aro, Hakkarainen and Lonka.)

Introduction: The majority of adolescents engage with others online, and using social media is one of their top activities. However, there is little longitudinal evidence addressing whether active social media use is associated with study-related emotional exhaustion or delayed bedtime at the individual level of development during adolescence., Method: A 6-year longitudinal survey study (N = 426, female, 65.7%) was conducted (2014-2019) in Finland when the participants were 13-19 years old. Utilizing a Random Intercept Cross-Lagged Panel Model, this study focused specifically on longitudinal within-person effects., Results: No clear patterns between increased active social media use, increased emotional exhaustion, and delayed bedtime were found; however, the associations varied across the years of adolescence: active social media use and delayed bedtime were only associated in early adolescence; active social media use and emotional exhaustion were associated in both middle and late adolescence., Conclusions: Intraindividual relations between adolescents' reported active social media use, emotional exhaustion, and sleeping habits are small, inconsistent, and vary according to age. Therefore, future research should focus on additional longitudinal studies to examine the specific practices of social media use during the different developmental stages of at-risk individuals., (© 2022 The Authors. Journal of Adolescence published by Wiley Periodicals LLC on behalf of Foundation for Professionals in Services to Adolescents.)

In recent years, the school curricula in many European countries have introduced social and emotional learning (SEL). This calls for the teachers to have SEL competencies. The present study evaluates teachers' and their students' readiness for SEL during an intervention in five European countries. The participants were teachers ( n = 402) in five European countries; Italy, Latvia, Lithuania, Slovenia, and Spain. The pre- and post-measuring points for both the intervention and the comparison group were at approximately the same time before and after the intervention. Comparison data consisted of 159 teachers in the same countries. The training for the intervention group lasted 16 h for the teachers and a maximum of 16 h for the principles and headmasters. An additional 9 h of further monitoring took place. There were two student groups participating in the study: the age group of 8-11 years (pre puberty) and the age group of 12-15-years (adolescents). Students, whose teachers had participated in the intervention, formed the intervention group ( n = 2,552). Those students, whose teachers did not participate in the intervention, formed the comparison group ( n = 1,730). The questionnaire data were collected at the beginning and at the end of the school year for both age groups. The results indicated that there was a favorable development in the intervention group in some of the measured skills among students, but the effects were different for the two age groups. This study adds to both theoretical and practical development of continuing teacher training about SEL and its possible role in reducing problem behavior among the students., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Berg, Talvio, Hietajärvi, Benítez, Cavioni, Conte, Cuadrado, Ferreira, Košir, Martinsone, Ornaghi, Raudiene, Šukyte, Talić and Lonka.)

The focus of the current study was to examine teachers' well-being in terms of work engagement and burnout by using a person-oriented approach. The participants ( n = 149, 70.5% female) were subject-matter teachers from 22 schools from metropolitan Helsinki area in Finland. The first aim was to examine the kinds of profiles we can identify based on work burnout and engagement among teachers. The second aim was to study how the identified profiles differed in job-related demands and resources and personal resources in terms of resilience. Based on the demands-resources model, we expected to find profiles that differ in terms of key resources and demands. The sample was acquired as a convenience sample and the data was collected using online self-report questionnaires. The measures were work engagement, work burnout, work demands/resources (workload and control) and resilience as the personal resource. In addition, changes and effects of the economic circumstances were accounted for with two binary variables assessing the effect on class sizes and material resources. We identified two profiles among teachers: engaged (30%) and engaged-burnout (70%) profiles. We found that those in the engaged profile group had more job and personal resources, such as control and resilience, whereas those in the engaged-burnout profile group experienced more work demands, such as workload., (Copyright © 2019 Salmela-Aro, Hietajärvi and Lonka.)

Background: Adolescence is a time of ongoing neural maturation and cognitive development, especially regarding executive functions. In the current study, age-related differences in the neural correlates of different executive functions were tracked by comparing three age groups consisting of adolescents and young adults., Methods: Brain activity was measured with functional magnetic resonance imaging (fMRI) from 167 human participants (13- to 14-year-old middle adolescents, 16- to 17-year-old late adolescents and 20- to 24-year-old young adults; 80 female, 87 male) while they performed attention and working memory tasks. The tasks were designed to tap into four putative sub-processes of executive function: division of attention, inhibition of distractors, working memory, and attention switching., Results: Behaviorally, our results demonstrated superior task performance in older participants across all task types. When brain activity was examined, young adult participants demonstrated a greater degree of overlap between brain regions recruited by the different executive tasks than adolescent participants. Similarly, functional connectivity between frontoparietal cortical regions was less task specific in the young adult participants than in adolescent participants., Conclusions: Together, these results demonstrate that the similarity between different executive processes in terms of both neural recruitment and functional connectivity increases with age from middle adolescence to early adulthood, possibly contributing to age-related behavioral improvements in executive functioning. These developmental changes in brain recruitment may reflect a more homogenous morphological organization between process-specific neural networks, increased reliance on a more domain-general network involved in executive processing, or developmental changes in cognitive strategy., (© 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.)

Recent research shows an increased concern with well-being at school and potential problems associated with students' use of socio-digital technologies, i.e., the mobile devices, computers, social media, and the Internet. Simultaneously with supporting creative social activities, socio-digital participation may also lead to compulsive and addictive behavioral patterns affecting both general and school-related mental health problems. Using two longitudinal data waves gathered among 1702 (53 % female) early (age 12-14) and 1636 (64 % female) late (age 16-18) Finnish adolescents, we examined cross-lagged paths between excessive internet use, school engagement and burnout, and depressive symptoms. Structural equation modeling revealed reciprocal cross-lagged paths between excessive internet use and school burnout among both adolescent groups: school burnout predicted later excessive internet use and excessive internet use predicted later school burnout. Reciprocal paths between school burnout and depressive symptoms were also found. Girls typically suffered more than boys from depressive symptoms and, in late adolescence, school burnout. Boys, in turn, more typically suffered from excessive internet use. These results show that, among adolescents, excessive internet use can be a cause of school burnout that can later spill over to depressive symptoms.

Rational and Objectives: To assess the effects of a tailored and activating educational intervention, based on a three-stage modified Prochaska model of readiness-to-change, on the performance of general physicians in primary care (GPs) regarding management of depressive disorders., Methods: Parallel group, randomized control trial. Primary hypothesis was that performance would improve by 20 percentage units in the intervention arm. The setting was primary care in southern Tehran. The participants were 192 GPs stratified on stage of readiness-to-change, sex, age and work experience. The intervention was a 2-day interactive workshop for a small group of GPs' at a higher stage of readiness-to-change ('intention') and a 2-day interactive large group meeting for those with lower propensity to change ('attitude') at the pre-assessment. GPs in the control arm participated in a standard educational programme on the same topic. The main outcome measures were validated tools to assess GPs' performance by unannounced standardized patients, regarding diagnosis and treatment of depressive disorders. The assessments were made 2 months before and 2 months after the intervention., Results: GPs in the intervention arm significantly improved their overall mean scores for performance regarding both diagnosis, with an intervention effect of 14 percentage units (P = 0.007), and treatment and referral, with an intervention effect of 20 percentage units (P < 0.0001). The largest improvement after the intervention appeared in the small group: 30 percentage units for diagnosis (P = 0.027) and 29 percentage units for treatment and referral (P < 0.0001)., Conclusions: Activating learning methods, tailored according to the participants' readiness to change, improved clinical performance of GPs in continuing medical education and can be recommended for continuing professional development., (© 2011 Blackwell Publishing Ltd.)

Background: Health care professionals are supposed to work in teams. Students in health care need to learn how to collaborate during their undergraduate education. Interprofessional learning environments, where collaboration is necessary, may be differently accepted by students depending on their approach to learning., Aim: We investigated health care students' evaluations of interprofessional clinical training in relation to their study orientations., Methods: The participants were 369 students (40 occupational therapy-, 85 medical-, 52 physiotherapy-, and 192 nursing students) attending an IPE course at a Swedish University Hospital. Data were collected by questionnaires measuring orientations to studying and attitudes towards the clinical training and the IPE concept before and after the training. The response rate was 77 %. Study groups were formed by a cluster analysis on the basis of the students' learning orientations., Results: Three clusters were found: Low collaboration-, Collaborative Constructivist-, and Cookbook groups. These clusters were related to different professions and how students perceived their interprofessional learning environment., Conclusions: Study orientations appear to play a role in the way students evaluate interprofessional training. This should be taken into account in instruction. Students with a 'Cookbook' approach to learning showed an increased understanding of interprofessional collaboration after the course.

The experience of clinical teachers as well as research results about senior medical students' understanding of basic science concepts has much been debated. To gain a better understanding about how this knowledge-transformation is managed by medical students, this work aims at investigating their ways of setting about learning anatomy. Second-year medical students were interviewed with a focus on their approach to learning and their way of organizing their studies in anatomy. Phenomenographic analysis of the interviews was performed in 2007 to explore the complex field of learning anatomy. Subjects were found to hold conceptions of a dual notion of the field of anatomy and the interplay between details and wholes permeated their ways of studying with an obvious endeavor of understanding anatomy in terms of connectedness and meaning. The students' ways of approaching the learning task was characterized by three categories of description; the subjects experienced their anatomy studies as memorizing, contextualizing or experiencing. The study reveals aspects of learning anatomy indicating a deficit in meaningfulness. Variation in approach to learning and contextualization of anatomy are suggested as key-elements in how the students arrive at understanding. This should be acknowledged through careful variation of the integration of anatomy in future design of medical curricula.

Objective: To assess the impact on knowledge and attitudes of a tailored educational intervention on depression using a modified version of the Prochaska stages of change model, compared with standard continuing medical education, for general practitioners (GPs) in primary care in Iran., Method: Using a randomized controlled trial, a total of 192 GPs were evenly randomized to intervention or control arm. The topic for the educational intervention was depressive disorders. The participants were divided in to small and large groups, depending on their initial stage of change. The GPs' knowledge and skills regarding management of depressive disorders were assessed through a questionnaire with 7 multiple choice questions, 11 Likert statements, 3 case vignettes, and 1 essay question. Attitudes toward management of depressive disorders were also assessed. Both questionnaires were validated., Results: There was a significant improvement in knowledge mean scores regarding multiple choice and Likert questions (intervention effect 6%; P = 0.002), as well as for the case vignettes and essay question (intervention effect 12%; P = 0.011) in the intervention arm, in comparison with the control arm. There were significant changes in mean attitude scores in both study arms, but no difference between them., Conclusions: A theoretical model of medical learning and behavioural change can be used to devise educational formats that suit different stages of learning. Such tailored educational formats can improve GPs' knowledge and skills regarding management of depressive disorders.

Clinical teachers often complain that medical students have forgotten or somehow "lost" knowledge that has been taught at pre-clinical levels at the time of entering the clinical part of education. The purpose of this qualitative study was to explore, whether transfer of knowledge was identified as a problem by the teaching staff of anatomy and surgery, and if so, what strategies they used to overcome it. Semi-structured interviews were conducted with ten medical teachers in anatomy and surgery. Most teachers recognised that there was a problem of transfer and some individuals had adopted strategies to address this. However, there was no formal educational strategy suggested to overcome the problem of transfer. The conclusion is that transfer needs to be addressed both by basic science teachers and clinical teachers. There is a need for a mutual educational discourse of the contexts students will face.

Objective: To obtain an understanding of basic science medical teachers' conceptions of learning and their ideas for facilitation of learning., Methods: Teaching staff at a biomedical centre (n = 62) were asked to describe their definitions of learning, their suggestions for how to solve an applied educational problem and their intended activities when teaching students. The research was carried out using a questionnaire consisting of open-ended and fixed-choice questions., Results: Although 1 in 4 teachers endorsed constructivist conceptions of learning, only 1 in 8 actually reported using activating teaching strategies. Conceptions of learning did not co-vary with teaching practice., Conclusions: The assumption that conceptions of learning and teaching practice are aligned was challenged. The current questionnaire could be used as an intervention tool for educational development to map whether or not there is a match between teachers' conceptions and their practice.

The aim of the study was to examine do health care students, who study at different programs, value similar expert qualities. To investigate this issue, a questionnaire was administered among health care students in a Finnish polytechnic (two cohorts, total n = 466), consisting of a scale for rating the importance of different expert qualities. The questionnaire resulted in the following dimensions of the conceptions of expertise: (1) social skills, (2) scientific skills, (3) innovativeness, (4) continuing self-development, and (5) problem-solving skills. Also the Inventory of General Study Orientations (IGSO) was applied to analyse possible motivational explanations for different conceptions of expertise. In addition to the scales, an open-ended writing task was used to explore in depth students' conceptions of expertise. It appeared that study orientations were a minor factor in the study, while study environment (study programs) clearly differentiated students' conceptions of expertise. Thus, the study argues that health care students' conceptions of expertise are constituted mainly on domain-specific bases and that students who graduate from different programs may possess very diverse ideas about their profession. Consequently, different conceptions captured during the education form a major challenge for inter-professional care later in work-life. This phenomenon should be taken into account when organising health care education.

Background: Advocates of the project method claim that project-based learning inspires student learning. However, it has been claimed that project-based learning environments demand quite a bit of self-regulation on the part of the learner., Aims: Consequently, it was tested whether students scoring low in self-regulation of learning experienced 'friction', an incompatibility between student self-regulation and the demands posed by the learning environment. This would be manifest in cognitive processing and motivation., Samples: The target group consisted of 58 mainly third-year Finnish university students taking a mandatory project course in information systems design. During the project course, student teams completed a commissioned assignment. The study also included a matched nonequivalent comparison group composed of computer science students attending study programmes without a project-based component., Methods: Data were gathered by means of a questionnaire administered at the beginning and end of the project course and it was analysed by between-groups repeated measures ANOVA. In addition, the students on the course were interviewed., Results: Results suggest that the work-based project model in question may indeed have a substantial motivational impact, interestingly benefitting especially those students who scored low in self-regulation., Conclusions: It is argued that we tend to view learning environments too simplistically. In particular, a basic distinction should be made between individual and collaborative learning contexts, since peer scaffolding, group grading and choice of group roles may explain why students scoring low in self-regulation of learning did not encounter friction as expected.

Background: In medical education, feedback from students is helpful in course evaluation. However, the impact of medical students' feedback on long-term course development is seldom reported. In this project we studied the correspondence between medical students' descriptive evaluations and key features of course development over five years., Methods: Qualitative content analysis was used. The context was consultation skills courses in the middle of the Göteborg undergraduate curriculum during five years. An analysis of 158 students' descriptive evaluations was brought together with an analysis of key features of course development; learning objectives, course records, protocols from teachers' evaluations and field notes. Credibility of data was tested by two colleagues and by presenting themes at seminars and conferences. Authors' experiences of evaluating the course over many years were also used., Results: A corresponding pattern was found in students' descriptive evaluations and key features of course development, indicating the impact of students' open-ended feed-back. Support to facilitators and a curriculum reform also contributed. Students' descriptive feedback was both initiating and validating longitudinal course implementation. During five years, students' descriptive evaluations and teachers' course records were crucial sources in a learner-centred knowledge-building process of course development., Conclusion: Students' descriptive evaluations and course records can be seen as important instruments in developing both courses and students' learning. Continuity and endurance in the evaluation process must be emphasized for achieving relevant and useful results.

Introduction: In problem-based learning (PBL), discussion in the tutorial group plays a central role in stimulating student learning. Problems are the principal input for stimulating discussion. The quality of discussion is assumed to influence student learning and, in the end, study success., Aims: To investigate the relationships between aspects of group functioning and study success., Methods: First-year medical students (n = 116), forming 12 PBL groups, completed a 21-item questionnaire on various aspects of a PBL session. At the end of the unit, a course examination was administered. Scales were constructed and reliability analyses conducted., Results: Group functioning and case quality were strongly correlated with students' grades in a course examination. Further, students' perceptions of group functioning, case quality and the quality of their own contribution were linked strongly with each other., Conclusions: Group functioning, case quality and study success are associated with each other in PBL. The interaction between these aspects of PBL in promoting learning calls for further investigation.

Aims: This paper describes the context of interprofessional training on clinical education wards (CEWs) and reports students' perceptions of this type of interprofessional and professional training., Context: A 2-week interprofessional clinical course was designed for medical students in their surgical eighth term, and nursing, occupational therapy and physiotherapy students, all in their sixth term. Clinical tutors were responsible for the patients and also supervised the students. The goals for the students included: to provide the patients with good medical care, nursing and rehabilitation; to develop their own professional roles; to enhance their level of understanding of the other professions; to stress the importance of good communication for teamwork and for patient care; to enhance understanding of the role of the patient, and to become more aware of ethical aspects of health care., Material and Methods: A questionnaire developed by teachers from the 4 educational departments was used. A total of 962 students responded (78%)., Results: The CEWs provided the students with good clinical practice in terms of training in their own professions as well in learning more about the other professions. The importance of good communication for teamwork and for patient care was recognised. The quality of supervision and students' perception of their own professional roles were important factors regarding satisfaction with the CEW course., Conclusions: The CEW course seemed to provide the students with an opportunity to develop their own professional roles and their functions as team members.

Context: We developed a structured portfolio for medical students to use during their obstetrics and gynaecology undergraduate training. The main objective was to support the learning process of the students. We also wanted feedback information to enhance teaching., Methods: The study population consisted of 91 medical students who completed the portfolio during their training course. The portfolio consisted of a 28-page A5-size booklet. The students entered all the clinical procedures they had performed and all the deliveries they had attended. After each group session, they answered questions about what they had learned and evaluated the performance of the teacher. They also indicated their general evaluation of the course and the portfolio itself. The teachers listed the 13 most important skills to be learned during the course. The students were asked to evaluate their own development on a scale of 0-5 before and after the course. A content analysis was performed on all the texts the students produced, and all quantitative variables were coded., Results: The amount of text written in the portfolio correlated (P < 0.001, F-value 4.2) with success in the final exam. In addition to acting as a logbook, use of the portfolio enhanced the learning process during the course. Students' attitudes towards the portfolio were mainly positive. Students appreciated the departmental interest in their learning process., Conclusion: Portfolios support the personal and professional development of medical students. A portfolio clarifies the learning goals and helps students to monitor how these goals are achieved. A portfolio encourages constant self-reflection.

An extensive staff development program was started in 1998 in the Faculty of Medicine at the University of Helsinki. A problem-based learning method was introduced as a new style of teaching in the curriculum reform. This paper describes a teaching method 'Problem-based learning - tutorial laboratory' for training medical teachers to act as tutors and to understand their roles as facilitators of learning and the dynamics of a small group. The method was based on learning cycles: teachers had a possibility to experience tutoring, to get feedback about it from an educational expert and from a peer teacher and also they were able to reflect on their views in the group. The teachers were content with the training. Sessions improved teacher cooperation across the departments and brought new teaching ideas for shared use. It also helped to cope with the resistance related to the curriculum change process.

This study examines how quantitative and qualitative differences in spontaneously taken notes are related to text comprehension in combination with reviewing or not reviewing previously made notes. High school graduates (N = 226) were allowed to take notes in any way they desired while reading a philosophical text. Approximately half the participants were told that they could review their notes during writing tasks designed to measure the ability to define, compare, and evaluate text content. The other half of the participants answered the subsequent questions without their notes. The process of taking notes was rated on the basis of note quality and quantity. The results revealed significant review and process effects in spontaneous note-taking. Reviewing the notes during essay-writing generally resulted in good performance in an exam calling for deep-level text comprehension. However, this review effect was mainly limited to detailed learning instead of making one's own inferences. Results pertaining to note quality indicated that the participants who summarized the content of the text resulted in better performance in all tasks in comparison with those who produced notes following the text order or verbatim notes. The amount of note-taking was also positively related to text comprehension. The discussion focuses upon the situational appropriateness of note-taking effects that pose challenges to educators. Copyright 1999 Academic Press.