Combining Problem-Based Learning and Team-Based Learning in a Longitudinal Integrated Clerkship: How Do Students Spend Their Self-Study Time?

Self-study is essential for student learning, and active learning methods aim to facilitate constructive self-study time usage. How active learning strategies actually affect student self-study in medical education, however, remains partly unknown. The aim of this study was to examine medical students' use of self-study time in a longitudinal integrated clerkship employing active learning strategies. Week-long time logs were used to collect quantitative data on students' scholastic activities. Furthermore, semistructured individual interviews were conducted for in-depth exploration of different learning activities' influence on students' self-study behaviour. Preparation for and follow-up work after scheduled learning activities were specifically addressed. Students spent on average 42.1 h per week on educational activities, of which self-study comprised 23 h. Preparation for upcoming learning activities was highly prioritized by the students. Team-based learning (TBL) generated most self-study hours, closely followed by patient encounters, while problem-based learning (PBL) induced least amounts of self-study. 50% of self-study time was done without specific relation to scheduled learning activities. Active learning methods appear to promote preparatory work, in accordance with their pedagogic theory. Type of learning activity appears to be decisive in determining the amount of self-study students choose to undertake. Future research should address how quantity and content of different learning activities influence self-study behaviour.