Abstract:

Background:
Healthcare professionals have to cope with rapid changes in health care, fast outdating of information and evidence, and increasing complexity of practice. As a result, Problem-Based Learning (PBL) is becoming a popular method of teaching in the healthcare professions in an effort to ensure continued competence through self-directed learning. However, the development of self-directed learning skills is a process that is not limited to the tutorial group, but involves the students interacting with many different knowledge resources and undergoing a variety of learning experiences. Thus, any PBL-driven curriculum should be designed to facilitate integrative learning, or the ability to "make connections". To facilitate integrative learning for students of the BSc (Hons) in Speech and Language Therapy at University College Cork (UCC), Ireland, the PBL-driven curriculum includes supplementary lectures and skills workshops that are explicitly linked with the content of the core PBL modules, to foster integrative learning across modules, as well as within modules. However, it is not known whether students perceive this approach to be helpful in facilitating integrative learning, or what different sources they actually use to facilitate their own integrative learning.
Aims: To investigate student perceptions of the degree to which they have been able to facilitate learning by integrating knowledge and skills from different sources (e.g., tutorials, lectures, personal experiences, readings from the literature); and which particular sources students perceive facilitate integrative learning in Speech and Language Therapy.
Methodology: The reflective journals of 40 Speech and Language Therapy students at UCC (9 x 1st year, 16 x 2nd year, 15 x 3rd year) were qualitatively analyzed using thematic analyses. In their journals, which were carried out as part of continuous assessment, students were asked to reflect on the degree to which they had been able to facilitate learning by integrating knowledge and skills from different sources, for example, tutorials, readings, internal and external lectures, discussions with colleagues, their own experience.
Results: First year students emphasized personal experience and discussions with PBL colleagues as the most important sources of information that facilitated integrated learning, but felt they had not been able to facilitate learning to much degree by integrating knowledge from introductory lectures. In contrast, second and third year students emphasized lectures (e.g., Anatomy, Speech and Hearing Sciences, Research Methods) and practical workshops, along with PBL readings and their own internet searches, as important sources for integrating knowledge and skills. Several of these students felt the explicit links between content across modules greatly facilitated integration of knowledge and skills.

Conclusion: Integrative learning is perceived by students in this study to be facilitated more effectively via curriculum design following their first year, after they have moved on from the more generic, introductory curriculum content to the more specific topics covered in Years 2 and 3, and after they have begun to develop their self-directed learning skills through PBL. These findings have possible implications for the curriculum design of first year in the BSc (Hons) Speech and Language Therapy, if integrative learning is to be effectively facilitated from the start of the programme.

Keywords:

integrative learning, problem based learning, curriculum, student perceptions.