Development of knowledge in basic sciences: a comparison of two medical curricula

Basic medical sciences education differs among medicine courses, especially as traditional and integrated problem-based learning (PBL) curricula teach basic sciences in very different ways. The literature shows no clear differences in the performance of students of these different educational philosophies. The Charité Medical University of Berlin (Charité Universitätsmedizin Berlin) teaches both a traditional medical curriculum (TMC) and a PBL reformed medical curriculum (RMC). Both curricula conduct the Progress Test in Medicine (PTM), which examines competence in the basic and clinical sciences from the first to the last semester.

The aim of this study was to compare the development and retention of knowledge in the basic medical sciences between students on the traditional and reformed undergraduate medical curricula, respectively.

For each student and single PTM, relative frequencies of correct answers were computed for basic sciences items only and for the whole curriculum. Frequencies were averaged and grouped by semester and curriculum. Analyses of variance (anovas) were performed at all measurement points with a Bonferroni-corrected p-value at the level of p < 0.005. Eta-squared (η(2)) was used to classify effect size.

In the first three semesters, RMC students slightly outperform TMC students in the basic sciences, although TMC students receive more systematic teaching. After this, TMC students develop a peak of knowledge in basic sciences and overtake RMC students. The knowledge of TMC students then decreases over time, but despite this, they perform better in the final semester. Students on the RMC show constant progress throughout their undergraduate studies. Overall, the development of medical knowledge is consistent in both curricula. There is no significant difference in this outcome between the traditional and PBL courses.

Progress testing as a longitudinal method allows us to better understand the development of knowledge during formal undergraduate education. The main difference between traditional and problem-based medical education seems to be provoked by the high-stakes national examination undertaken in the traditional course (the Physikum).