Conception of learning and clinical skill acquisition in undergraduate exercise science students: a pilot study.

LEARNING CLINICAL SKILLS presents a novel experience for undergraduate students, particularly when it comes to preparing for skill assessment. Compared with the thousands of hours of practice believed to be necessary for the development of motor skill expertise (1), these students have significantly limited exposure time. Furthermore, effective clinicians combine procedural skills expertise with the flexibility required to implement these in the real-world environment in which clients and situations can change. Therefore, unlike the learning of theory (such as solving a physics problem), rote learning and repetition may not maximize learning outcomes for the development of new clinical skills. There is a substantial body of research that shows that conception of learning influences the learning outcomes in university students, and much of this research has been conducted in undergraduate science cohorts (3, 5, 6, 9, 11). For instance, when first-year physics students approached learning with a focus on understanding (a deep conception and approach), their learning outcomes were superior to those who intended to merely complete the task requirements and associated learning with memorization and reproduction (a surface conception and approach) (4). Yet it is unclear whether conception of learning influences outcomes for clinical skill development. Conception of learning varies with the academic task (7), and it could be argued that, unlike theory-focused learning (e.g., physics), a deep conception and approach may not lead to superior learning of hands-on clinical skills. Arguably, a conception of learning that emphasizes memorization and procedural skill reproduction (characteristics of surface learning) may be ideal for undergraduate students preparing for clinical skill assessment, particularly given the limited preparation time available in the context of a 10to 13-wk unit of study. Students have a tendency to identify for themselves what counts for assessment (or at least what they perceive counts) and orientate their efforts in study in preparation for assessment accordingly (2). This pilot study reports the level of clinical skill mastery in undergraduate exercise science students who were learning and being assessed on clinical skills for the first time. In this unit, we provided the students with a variety of learning experiences (delivery modes: videos, face-to-face tutorials, printed handouts, and lectures) from which to prepare for a skills examination that assessed their accuracy of implementing clinical techniques with real human subjects. The purpose of this investigation was to examine whether student performance in the skills assessment was related to their conception of learning, which was inferred from responses to a voluntary survey. To gain some insight into student approaches to the learning of clinical skills and to inform future teaching and learning approaches, we also sought to examine student engagement with the learning material and the possible interaction between clinical skill mastery and conceptions of learning.