Medical School Teaching Styles: How To Choose A Medicine Course: PBL, CBL, Spiral, Integrated & Traditional Courses
When choosing the right university to study medicine, one of the first things to consider is the medical school course structure and style of teaching.
There are many different types of medical school curricula, each of which suits different learning styles. These include traditional approaches, integrated approaches, case-based learning (CBL), team-based learning (TBL) and more.
It’s important to figure out which learning style suits you best, and whether this is compatible with the type of course structure that you’re applying to.
Here we’ll discuss all of these different course types, and provide some pointers on how to decide which is best for you.
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What Are The Different Medical School Teaching Styles / Courses?
All medical schools produce graduates who meet the central standards for competency and knowledge, as set by the General Medical Council (GMC).
The main educational differences between medical schools are due to the type of teaching style and course structure employed. When applying to medical school in the UK, you should ensure that the course structure and teaching method suit you.
Overall, there are 5 different styles of medicine courses:
Traditional Course
Integrated Approach or Systems-Based Course
Problem-Based Learning (PBL)
Case-Based Learning (CBL)
Enquiry-Based Learning (EBL)
There is a further structure of teaching known as a spiral course. Any of the above teaching styles can be found within a spiral course. We will explain these in more detail below.
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What Is A Traditional Course Style?
A traditional medicine curriculum is split into pre-clinical and clinical phases.
The pre-clinical stage is typically 2 years long and includes classical lecture-style teaching of the basic medical sciences, including physiology, pharmacology, biochemistry, genetics, pathology and anatomy,
The clinical stage generally lasts from year 3 to year 5, and involves hospital and clinical placement, with additional lecture teaching. In this stage, the teaching is almost entirely focused on developing the student’s clinical knowledge of disease presentation, diagnosis, investigation and management.
This is in addition to developing clinical skills required to work as a junior doctor.
Traditional Course Style Advantages:
Comprehensive Foundation: Students receive thorough teaching of basic sciences through direct lectures from subject experts, ensuring a solid theoretical understanding.
Structured Learning Environment: The clear separation of pre-clinical and clinical phases provides a well-defined learning pathway.
Focus on Theory: The emphasis on foundational knowledge before clinical practice can enhance understanding of complex medical concepts.
Traditional Course Style Disadvantages:
Delayed Clinical Contact: Limited practical teaching and delayed hands-on experience can hinder the early development of practical skills and patient interaction.
Less Practical Experience: The focus on lectures and theoretical learning may reduce opportunities for practical application in the early years.
Rigid Structure: The fixed progression from pre-clinical to clinical phases may not suit all learning styles and can limit flexibility.
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What Is An Integrated Course Or Systems-Based Course Style?
This is the style of course most recommended by the GMC.
Unlike a traditional course, the integrated course pairs the pre-clinical knowledge with the associated clinical knowledge, so they are taught together.
Topics are taught within the systems to which they belong. For instance, as part of 1 block, you’ll cover respiratory anatomy, physiology, pharmacology and pathology while learning about respiratory disease diagnosis, investigations, and management.
This can make meeting the course's learning objectives easier and is a little bit like what life is like in medical practice.
Much of the teaching in a systems-based course combines lectures and problem-based learning, such as case discussions.
This type of course integrates the clinical exposure throughout all 5 years of medical school, allowing for early patient contact. This means you’ll have longer to develop your communication skills with patients compared to UK medical schools' traditional 3-year clinical stage.
Integrated Course Advantages:
Holistic Understanding: Combines pre-clinical and clinical knowledge, making complex topics easier to grasp and promoting practical application of studies.
Early Clinical Exposure: Promotes early patient contact, helping students develop communication and clinical skills from the beginning.
Contextual Learning: Teaching within specific systems (e.g., respiratory system) makes it easier to understand the relevance and application of knowledge.
Integrated Course Disadvantages:
Challenging Balance: Requires effective time management to juggle theoretical learning with clinical placements, which can be demanding for some students.
Integrated Complexity: The simultaneous teaching of multiple disciplines can be overwhelming for some students.
Variable Teaching Methods: The mix of lectures, case discussions, and clinical exposure may require adaptation to different learning styles.
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What Is A Problem-Based Learning (PBL) Course?
Problem based learning is much more a hands-off teaching style, whereby as a student, you will self-teach a lot of the content.
The medium of this teaching is often through clinical cases, where you are provided with a patient presentation, and are tasked with engaging in self-directed learning and group work with medical students to learn the associated information.
You will also have group sessions with a facilitator, where you will discuss the case and teach each other.
This course style also has early patient contact, as often the cases are in the form of real patients whom you will examine and take a history from. It also helps develop your communication skills and clinical reasoning early in the degree.
An Example PBL Teaching Session:
In a group of 5, you are provided with a patient presenting with a problem
In this group, you will create a list of differential diagnoses and learning outcomes, which detail what you will need to go away and learn to fully present answers to the case.
You will then engage in self-directed learning for your allocated learning outcomes.
Finally, you will have a final group session where you teach each other the information you’ve learnt from your learning outcome
This final session is observed by a facilitator who will intervene if the information is not correct or complete.
PBL Advantages:
Self-Directed Learning: Encourages independence and critical thinking by having students engage deeply with clinical cases.
Collaborative Environment: Promotes teamwork and communication skills through group-based learning.
Early Patient Contact: Offers early exposure to patient interactions, helping to develop practical clinical skills.
PBL Disadvantages:
Variable Structure: This relies heavily on group dynamics and self-motivation, which can lead to inconsistent learning experiences depending on group members.
Lack of Guidance: Some students may find the hands-off approach challenging without structured support.
Inconsistent Quality: The quality of learning can vary significantly based on the effectiveness of group work and facilitators.
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Case Based Learning (CBL) in Medical School Teaching In The UK
Case Based Learning (CBL) is a structured teaching method that combines elements of problem-based learning (PBL) with more direct guidance from facilitators and tutors.
This approach is widely used in UK medical schools to enhance clinical reasoning and the application of theoretical knowledge through real-life patient cases.
How CBL Works
CBL involves the use of detailed patient cases that are integrated into various teaching formats such as seminars, lectures, and small group discussions. These cases form the foundation of the curriculum, linking theoretical knowledge to clinical practice.
Seminars and Lectures:
Provide in-depth knowledge on medical theories and clinical guidelines.
Link directly to patient cases, making learning more relevant and practical.
Small Group Teachings:
Encourage collaborative learning and discussion.
Allow for hands-on practice and closer interaction with facilitators.
Benefits of CBL
Enhanced Clinical Skills: Students develop critical thinking and diagnostic skills by working through real patient cases.
Structured Learning: Facilitators guide the learning process, ensuring all key concepts are covered.
Early Patient Contact: Similar to PBL, CBL offers early exposure to patient interactions, improving communication skills and empathy.
Drawbacks of CBL
Dependency on Case Quality: The learning experience can be impacted by the availability and quality of patient cases, with limited flexibility compared to PBL.
Less Flexibility: The structured nature of CBL may limit opportunities for independent exploration and self-directed learning.
Resource Intensive: Requires significant resources and coordination to provide high-quality, realistic patient cases.
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What Is An Enquiry-Based Learning Teaching Style?
Enquiry-based learning (EBL) is similar to both problem-based learning (PBL) and case-based learning (CBL) but involves engaging with multiple questions, scenarios, diagrams, and mini-cases instead of a single patient case.
These diverse problems are designed around specific learning outcomes, promoting critical thinking, analytical skills, and independent research.
By investigating and solving these activities, students enhance their clinical reasoning, diagnostic skills, and comprehensive understanding of medical concepts.
This method encourages active learning, collaboration, and the application of theoretical knowledge to practical situations.
An Example Enquiry Based Teaching Session:
In a typical Inquiry-based teaching session, you may be provided with a worksheet to complete before the session, before attending a facilitator-led question and answer seminar, where you can seek support on learning outcomes that you found difficult.
Provided learning outcome examples:
Explain the structural and functional characteristics of connective tissue that distinguish it from other basic tissue types.
Describe the three fundamental components of all connective tissues.
Predict the functional consequence of structural defects in connective tissue.
Enquiry Based Teaching worksheet example:
Benefits To The EBL Teaching Style:
Active Learning: Promotes critical thinking and independent research through diverse scenarios and problems, fostering comprehensive understanding.
Collaborative Engagement: Encourages teamwork and communication by involving students in group discussions and problem-solving activities.
Real-World Application: Helps students apply theoretical knowledge to practical situations, enhancing clinical reasoning and diagnostic skills.
Downsides To EBL Teaching:
High Self-Discipline Needed: Requires significant motivation and organisation, which can be challenging for students who prefer structured learning environments.
Diverse Learning Challenges: The variety of scenarios and questions may be overwhelming for some students, requiring strong analytical skills.
Inconsistent Facilitation: The quality of learning can vary based on the effectiveness of facilitators and the design of learning activities.
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What Is A Medical Degree Spiral Curriculum?
Any of the above medical teaching styles can sit within a spiral curriculum framework.
A spiral curriculum is where content is revisited repeatedly, each time increasing in the level of complexity and reinforcing previous learning. By building on previous course material, it helps to improve student recall and understanding of content.
This is especially useful in a medical degree, where the sheer volume of content over 5 years is very difficult to retain and therefore repeated revisiting of information is hugely beneficial.
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Which Medicine Course Style Is Best?
There is no easy answer to the question of which medicine teaching and course style is best, as this depends heavily on what type of teaching you respond to the most effectively.
The GMC highly recommends the integrated or systems-based teaching approach, however, there are advantages and disadvantages to each course type.
We’ve summarised these in this handy table below:
How To Tell Which Medical School Teaching Style Suits You Best?
Teaching Style | Advantages | Disadvantages |
---|---|---|
Traditional | Comprehensive and thorough Less stress on self-directed learning Teaching directly from subject experts in lectures | Less practical teaching Delayed clinical contact |
Integrated / Systems Based | Contextualises pre-clinical information and helps to chunk difficult topics like pharmacology across the year Early clinical exposure | Time management may be difficult with both theoretical teaching and clinical placement |
Problem-Based Learning / Case-Based Learning / Enquiry-Based Learning | Best for organised individuals who enjoy self-directed learning Best for students who enjoy group work Introduces problem-solving early in the course through scenario-based learning. | Experience of teaching will vary based on your allocated group members Some students find there to be a lack of structure to learning Very self-reliant |
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My Experience Of Medicine Teaching:
I applied for medical school in 2019, and predominantly chose traditional and integrated style courses.
I knew that from my experience of A-Levels, I found peer-to-peer teaching, as employed in PBL courses, rather anxiety-producing. I preferred to be able to cover the whole content myself and use group work as a supplementary method, rather than a primary approach to learning.
This meant that I ruled out PBL and CBL courses.
I enjoyed the idea of traditional lectures, as they are thorough and I am an auditory learner. I also appreciated the structure of the systems-based approach.
Eventually, I chose the University of Birmingham, as I felt that they used a wide variety of different teaching methods, but with the first 2 years predominantly taught through lectures and seminars. There was only a very small PBL component of the course. I appreciated that the first 2 pre-clinical years allowed me to build my confidence before the majority of clinical exposure in years 3 - 5.
When considering which university to apply to, you not only need to consider the course style but also whether you meet the entry requirements for the medical school, and further practical aspects, such as location and accommodation.
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Medical School Teaching Styles Frequently Asked Questions
What Are The Different Types Of Medical School Course Structures In The UK?
The main types of medical school course structures in the UK include Traditional Courses, Integrated or Systems-Based Courses, Problem-Based Learning (PBL), Case-Based Learning (CBL), and Enquiry-Based Learning (EBL).
How Does A Traditional Medical School Course Structure Work?
Traditional courses are split into clinical and preclinical teaching, with the first two years focused on lecturer teaching of basic sciences and the subsequent years centred around clinical placements and hands-on training. This traditional teaching style in the first 2 years most closely reflects the style of other non-healthcare degrees at university.
What Is An Integrated Or Systems-Based Medical Course?
Integrated or Systems-Based courses teach pre-clinical and clinical knowledge together within specific systems (e.g., respiratory system), promoting early patient contact and a holistic understanding of medical science. Instead of teaching anatomy separately to other modules, in integrated teaching, it may be covered in conjunction with other aspects of that medical system, such as physiology. The majority of medical schools use a systems based approach.
What Are The Advantages Of Problem-Based Learning (PBL) In Medical School?
PBL encourages self-directed learning, critical thinking, and problem-solving skills through clinical cases. It also promotes early patient contact and enhances communication skills which are vital for a medical career.
How Is Case-Based Learning (CBL) Different From Problem-Based Learning (PBL)?
CBL is similar to PBL but involves more structured guidance from facilitators and tutors. It includes a mix of seminars, lectures, and small group teachings related to clinical cases. There are several different methods of teaching employed in a CBL course, and you will receive mentorship from a variety of teaching staff from a clinical background.
What Is Enquiry-Based Learning (EBL) In Medical Education?
EBL involves students researching and solving multiple questions, scenarios, and medical cases to achieve pre-determined learning outcomes, fostering comprehensive clinical and pre-clinical knowledge.
What Is A Spiral Curriculum In Medical School?
A spiral curriculum revisits core content repeatedly, each time at a higher level of complexity. This method reinforces learning and helps students retain vast amounts of information more effectively.
Which Medical School Course Structure Is Best For Me?
The best course structure depends on your learning style. Traditional courses suit auditory learners, integrated courses offer early clinical exposure, and PBL suits self-directed, organised individuals. Choosing a medical school which suits your learning style best will increase your chances of success at medical school.
How Does The General Medical Council (GMC) Influence Medical School Course Structures?
The GMC sets competency and knowledge standards for all UK medical graduates. They recommend integrated or systems-based courses for their balanced approach to theoretical and clinical learning. Teaching is delivered by staff at the university, however, the teaching is informed and enhanced by GMC feedback to ensure that every student has a sufficient understanding and knowledge of medical pathology upon entering clinical duties.
What Are The Disadvantages Of Problem-Based Learning (PBL)?
Some students find PBL lacks structure and relies heavily on group dynamics and self-motivation. The experience can vary significantly based on the group members and their collaborative skills. The variety of teaching methods may prove to be too unstructured for some students.
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