Most surface learning in the third year: Dental student learning approaches and implications for curriculum and assessment

Context Dental schools seek to educate students to become inclined toward self-directed, lifelong learning, an important mindset for healthcare professionals that may be linked to deep versus surface learning approaches. Students using a deep learning approach are more intrinsically motivated and actively engage in higher-order thinking, while those using a surface learning approach are more extrinsically motivated and aim for passive learning. Objectives Because student learning approaches can be influenced by a wide variety of learning experiences, we sought to understand how student approaches to learning differ by year in dental school and are related to academic achievement. Methods A total of 244 students in a 4-year dental school program in South Korea voluntarily participated in this study. We collected data on school year and academic achievement, and approaches to learning of participants using the validated Study Processes Questionnaire to assess learning approach, which included the constructs of deep motive, deep strategy, surface motive, and surface strategy. Results We conducted 3 sets of statistical analyses and found that most students adopted a deep approach to learning (DAL) in their first and second years (Y1 and Y2), with third-year students (Y3) showing heavy dependence on a surface approach to learning (SAL) and sharp drops in intrinsic motives. Student approaches to learning were not significantly related to academic achievement. In the first 2 years of dental school, students tended to adopt a DAL, and viewed their learning as personal growth and their profession as necessitating deep intellectual inquiry. Conclusions In the third year, the change from a DAL to a SAL coincided with entry to clinical training. The lack of integration of biomedical science (Y1 and Y2) and clinical science (Y3 and Y4), and increased stress in the initial clinical context may account for this difference. The poor correlation between a DAL and high achievement may indicate a need for change in assessment methods. This study hopes to stimulate reflection regarding student learning approaches and educational efforts that prepare future dentists for lifelong learning.