U.S. medical schools' valuing of curriculum time: self-directed learning versus lectures

As medical schools implement curriculum changes to address the relevancy of medical education to today's health care needs, examining schools' grading systems and their valuing of curriculum hours has become a priority.

In 1991-92 all 126 U.S. medical schools were surveyed regarding various issues related to the schools' grading systems and valuing of curriculum time, including the ways in which the schools achieved a balance between lectures and self-directed learning activities.

A total of 122 schools responded. Forty-eight schools calculated grade-point averages and used them to compute and publish class ranks; 72 published grade-point averages. Fifty schools reported curriculum revisions that decreased lecture hours, incorporated small-group discussion, or used problem-based learning and/or assessments using standardized patients. These 50 schools fell into four categories: had a system to balance lecture time and self-directed learning (11 schools); were moving toward such a system (27 schools); had tried but failed to balance lecture time and self-directed learning (one school); and had no policy to achieve a balance (11 schools).

The survey results indicate that most schools have not established systems for the valuing of curriculum time that include balancing values for lecture time and values for self-directed learning. If needed curriculum reforms are to be implemented effectively, they must be valued meaningfully.