Knowledge and skills acquisition in medical students: exploring aspects of the curriculum

Medical curricula are aimed at supporting students in developing knowledge and skills until they are able to perform as a medical doctor. The general aim of this thesis was to gain more insight into several aspects of the curriculum by studying students’ knowledge development in different medical curricula, students’ performance on progress tests and the effect of spacing training sessions and different types of feedback on skill acquisition. Because of the complexity of studying aspects of curricula, different methodologies were used, such as retrospective, quasi-experimental, systematic review and experimental research. The findings of this thesis demonstrate that only two aspects of the curriculum seem to benefit students’ knowledge development and, interestingly, both are related to repeating the learning material over time, before students forget what they learned. Regarding skill acquisition, two important findings emerge from this thesis. First, the complexity and nature of the skill plays an important role. For example, complex skills that require a lot of medical knowledge benefit from spacing the training sessions, whereas simple skills can be trained in one session. Second, how often a skill will be performed in the future determines the focus of the training. When a skill is practiced frequently, the focus can be on skill acquisition using one single training session and when a skill is practiced rarely, the focus can be on skill retention using multiple, spaced training sessions. Future research is needed to explore the implications of the findings of this thesis.