CLINICAL EPIDEMIOLOGY - AN EXPERIMENT IN STUDENT-DIRECTED LEARNING INWESTERN-AUSTRALIA

This paper describes an experiment at the University of Western Austra lia (UWA) medical curriculum, in which the focus of the 1 week of face -to-face teaching in public health in the 3-year clinical rotation was changed from important health problems affecting whole communities to one emphasizing the use of epidemiological principles to enhance doct ors' decisionmaking. The students are now left to choose the clinical subject matter, and instead of being presented with predetermined read ings selected by the teaching staff, the students have assumed respons ibility for discovering the latest relevant information on the topics they choose and of presenting this to the class. The teacher now spend s much less time in front of the class, providing only mini-tutorials each day on presenting to small groups, and on the skills required to understand the published literature on the aspects of the diagnosis, i nvestigation, management and prognosis of individual patients. The top ics chosen by students for exploration differ little, either in terms of the nature of the health problems concerned or the epidemiological principles at issue, from those covered previously when the programme was set entirely by the staff. However, attendance at the course has i mproved sharply, the short time between mini-tutorials and application of the material they cover has increased the perceived relevance of t he teaching, and feedback collected systematically from successive cla sses of students has been very positive. Any anxiety on the part of th e staff at relinquishing control of the curriculum has proved unfounde d while the new programme has much to recommend it as a model of self- directed learning.