Effects on student results and course evaluations of reduction in teaching hours in an undergraduate medical course

Background: The Bachelor of Medicine Bachelor of Surgery (MBBS) course at the University of Tasmania (UTAS) is a 5-year undergraduate degree, with approximately 100 domestic and 20 international students enrolled per year. Years 1-3 feature subject-based basic and clinical sciences teaching organised by organ systems, clinical practice skills, public health, and professionalism, with integration achieved through case-based learning tutorials. To alleviate a perceived overcrowded curriculum, to achieve operating efficiencies, and to provide greater time for students’ self-directed learning, staff were directed to reduce teaching hours by 20%.

Methods: In this case study, we evaluated the effects of reduced teaching hours on students’ learning outcomes and course evaluations in Years 1-3, comparing the two academic years prior to reductions in teaching hours (2013 and 2014) to two years after (2015 and 2016). Learning outcomes were measured by overall academic results (summative examinations and assignments). Students’ opinions were obtained through biannual anonymous Likert-scale (1 = strongly disagree, 2 = disagree, 3 = agree, and 4 = strongly agree) course-experience questionnaires (eVALUate) administered by the central UTAS Survey Team. This study was approved by the UTAS Social Sciences Human Research Ethics Committee (H0016408).

Results: Teaching hours were reduced by 15%, 13%, and 17% in Years 1, 2, and 3, respectively. There were no statistically significant changes (t-tests, Bonferroni-adjusted significance level of P<0.017) in overall summative assessment scores after the cuts in Year 1 (0.4% increase), Year 2 (1.5% decrease, P=0.029), or Year 3 (1.7% increase, P=0.027). The proportion of students successfully completing the academic year did not significantly change (Chi-square tests) in Year 1 (93.2% before cuts vs. 93.4% after), Year 2 (93.7% vs. 90.2%, P=0.173), or Year 3 (96.3% vs. 96.2%). Average survey response rates were 40%. There was significantly increased agreement (P ≤ 0.001, Mann-Whitney U tests) on the item, ‘The workload in this unit is appropriate to the achievement of the learning outcomes’: average Likert scores increased from 2.75 before to 3.07 after the cuts (66% to 87% agreement), 2.70 to 3.04 (68% to 90% agreement), and 2.72 to 3.05 (73% to 91% agreement) in Year 1 Semester 2 (Y1S2), Y2S1, and Y2S2, respectively. There were no significant changes in the other ten survey items, including ‘The learning experiences in this unit help me to achieve the learning outcomes’, 3.12 to 3.14 (92% to 93% general agreement).

Conclusions: Reduction in teaching hours of 13% to 17% had no statistically significant effect on student learning outcomes, successful completion rates, and student satisfaction with the course, except for improved perception of reasonableness of the workload in three of six units. The transferability of these findings to other contexts and course designs remains to be explored.