An analysis of entry-level postgraduate students’ readiness for student-centred, Masters Level learning

© 2006 The AuthorJournal compilation © 2006 Blackwell Publishing Ltd.

Learning in Health and Social Care

,

5

, 3, 133–141

Original article

Blackwell Publishing Ltd

An analysis of entry-level postgraduate students’ readiness for student-centred, Masters Level learning

Clare

Kell

MSc MCSP PGCTLHE (OU) ILTM

*

Lecturer, Department of Physiotherapy, Cardiff University (formerly the University of Wales College of Medicine), Heath Park, Cardiff CF14 4XN, UK

Abstract

Allied health professionals have an obligation, through their rules of professional

conduct, to maintain currency of practice and to demonstrate active continuous

professional development (CPD). Many therapists choose postgraduate (M-Level)

studies as part of their ongoing CPD activity. Assuming that practitioner maturity and

autonomy can be transferred to educational contexts, many M-Level courses adopt a

student-centred approach to their learning and teaching activities. This article reports

the results of a learning profile exercise on a group of entry postgraduate students.

The results suggest that some students have learning profiles incompatible with direct

transition into a student-centred, M-Level learning environment. Learning profiles

appear to reflect routes to professional qualification, namely degree vs. graduate

diploma. The article will consider the possible learning support needs of postgraduate

learners.

Keywords

continuing professional

development, learning

autonomy, postgraduate

studies

*Corresponding author. Tel.: +44 2920 742267; fax: +44 2920 742267; e-mail: [email protected]

Introduction

In 1992, physiotherapy became a degree-access

profession in the UK. This was a move away from

the previous Graduate Diploma system where the

Chartered Society of Physiotherapy (CSP) was

responsible for curriculum design, examinations

and the award of qualifications. Graduate Diploma

programmes were generally didactically delivered

with minimal encouragement of critical thinking

or reflective practice. The shift into the Higher

Education (HE) system was intended to facilitate

development of the skills of enquiry and lifelong

learning essential for providing ongoing, evidence-

based patient-centred clinical care (Palastanga 1990;

Higgs

et al

. 1999; Chartered Society of Physiotherapy

2002). Indeed, the 1992 CSP Curriculum Framework

Document charged all HE providers to develop courses

that balanced the immediate postgraduate needs of

the student with the development of the skills and

attributes required for career progression and practice

as physiotherapists. These skills and attributes could

include: a sense of personal agency; a repertoire of

learning skills and the interpersonal skills of group

membership (Candy 2001); a commitment to continu-

ing professional development (CPD) and lifelong

134 C. Kell


learning (Chartered Society of Physiotherapy 1996);

the ability to perform as independently thinking

problem-solvers (Hunt

et al

. 1998); and, more bluntly

by Coffield, ‘the ability to detect “bullshit” and the

moral courage to expose it’ (Coffield 2002, p. 42)!

Lifelong learners are said to display a confidence in

their decision-making skills, a strong sense of belief

that they will succeed, and an ability to work through

and challenge academic hurdles (Bandura 1986;

Abouserie 1995). Students demonstrating maturity

in learning have also been shown to be able to

abstract factual knowledge across contexts/situations

(Biggs & Collis 1982) and to work effectively in both

interpersonal and individual self-structured learning

environments (Garrison 1997), key skills in the

modern, fast-changing healthcare environment.

The provision of Masters Level (M-Level) courses

for allied health professionals has increased nation-

ally over recent years. Partly in response to calls from

the clinical environment, HE institutions now

support practising therapists in their obligations

for CPD and currency of practice (Morris 2002;

Health Professions Council 2003). M-Level courses,

however, require students to engage in learning

activities of greater complexity than that expected

of undergraduates (BSc Level). Generic M-Level

descriptor statements include the following keywords:

autonomous, complex, independent, mastery, critical

reflection and responsibility for self.

Since 1994, the School of Healthcare Studies,

Cardiff University (formerly the UWCM), has offered

a range of postgraduate courses, including M-Level

studies in Occupational Therapy, Physiotherapy

and Radiography. Candidates are accepted onto the

programmes if they possess a first degree (or graduate

diploma) in the area of study. Participants will also,

normally, have completed 2 years of postregistration

experience (taking age at commencement to be

at least 23 years) and be able to provide some

evidence of CPD. The programmes aim to develop

the skills necessary for effective lifelong learning

(including critical thinking), provide a qualification

that will afford holders greater professional stand-

ing, and grant the opportunity to study both generic

and profession-specific modules, thus sharing ideas

with other health professionals. The programmes’

learning/teaching ethos encourages students to take

responsibility for their own learning ‘from the

beginning’ (Department of Postgraduate Education

1994 p. 18). Anecdotal evidence from general obser-

vation and discussion with student groups has led

to increasing staff concern that some students are

struggling with the transition into postgraduate study.

Lea, Stephenson & Troy (2003) interviewed

undergraduate and postgraduate students and found

that both student groups felt anxiety about courses

that presumed the ability to engage with student-

centred learning. This anxiety had the potential to

increase such that a class could be divided between

those students who were able to rise to the learning

challenge and those who were not (p. 331). This ‘dis-

advantaging’ of student groups (Pillay 2002, p. 95)

could be augmented in contexts where learners feel

‘estranged’ from the language, culture and practices

of their current environment (Mann 2001) (i.e.

where learning carries different forms and expecta-

tions from earlier experiences; Lowe & Cook 2003).

Ongoing research is exploring the influence of the

BSc (Hons) Physiotherapy curriculum on its students’

perceived learning profiles, including their learning

environment preference, readiness for self-directed

learning, motivation for learning and approaches to

learning (Kell & van Deursen 2000, 2002). Succes-

sive undergraduate cohorts have shown consistent

learning profile changes over time. On admission,

undergraduate students tend to prefer a fact-based,

teacher-centred learning environment and display

high motivation and belief in their abilities to

engage effectively with the programme of study. The

methodology for the BSc studies has demonstrated

both reproducibility and sensitivity to change.

This current study sought to explore the un-

explained transition ‘problems’ of an M-Level student

cohort using a learning profile approach. This

preliminary investigation was intended to help the

teaching team evaluate the observation that it was

the students who had been through the Graduate

Diploma route to practice who had the greatest

difficulty in making the transition to M-Level study

– a reflection of the staff ’s view that Graduate

Diploma courses tended to be content-loaded and

teacher-directed. It was expected that, as mature

learners and autonomous professionals working

within multi-disciplinary care settings, many of the

Readiness for M-level learning 135


M-Level entrants would be able to work in both

independent and group learning contexts as a reflec-

tion of their common working environment, would

demonstrate high motivation for learning, a confi-

dence in their own abilities as learners, and a desire

to learn in a more abstract and student-centred

environment than that experienced at undergraduate

level.

This article therefore reports the results of an

exploratory study investigating the learning profiles

of intake M-Level students and considers the possible

learning support needs of postgraduate learners.

Methods

The sample and measuring tools

The 2001 intake cohort on the M-Level Occupational

Therapy, Physiotherapy and Radiography pro-

grammes (

n

= 30) completed a battery of self-rating

inventories on admission. The inventories were

selected from data-collection tools used previously

with BSc (Hons) Physiotherapy students and reflected

the range of learning profile variables identified

within the literature as important for successful

engagement with lifelong and self-directed learning

activities.

Readiness to undertake self-directed learning

The 58-item Self-Directed Learning Readiness Scale-

A (SDLRS; Guglielmino 1977) asks students to rate

their perception of the extent to which they possess

the attitudes, abilities and personality characteristics

necessary for undertaking self-direction in learning.

Scores range from 58 to 290. Guglielmino (1977)

suggested that mean scores for samples similar to

this study (more than 10 years of formal education

completed) should range between 189 and 240, with

higher scores suggesting greater perceived readiness

for self-directed learning.

Belief in personal control over academic outcomes

The Health Student Academic Locus of Control

Scale (ALOCS; Eachus & Cassidy 1997) is a 20-item

inventory asking respondents to rank their belief in

their own ability to control their academic environ-

ment and the level of success or failure that they

achieve. Data processing produces two scores (range

10–60), one each for perceived internal (self; ALOC

Int) and external (other; ALOC Ext) control (Cassidy

& Eachus 2000). The greater the score, the higher

that belief dimension is held.

Motivation for learning and study approach

commonly adopted

The Approaches and Study Skills Inventory for

Students (ASSIST, Tait & Entwistle 1996) is a 52-

item inventory evaluating perceived approaches to

learning across the following variables: deep, strategic

and surface learning. Summed scores (range 12–60)

give an indication of the students’ motivation for

their learning and the strategy they might employ to

attain their learning goal. Table 1 summarizes the

Table 1 The Approaches and Study Skills Inventory for Students (ASSIST) learning approaches and related subscales of

motivation and strategy (Tait & Entwistle 1996)

Approach to studying

Deep Strategic Surface

Motivation Intention to understand Intention to excel Intention to reproduce

Relating ideas Fear of failure

Strategy Use of evidence Alertness to assessment demands Unrelated memorising

Study organization

Each ‘Approach’ score is calculated by summing the three related subscales (range 4–20). The total ‘Approach’ scores range from

12 to 60.

136 C. Kell


approaches and the related subscales of interest in

this study.

Preferred learning environment

The M-Level cohort also completed the Rezler

and French Learning Preference Inventory (LPI).

Rezler & French (1975) developed the LPI specifically

for use with undergraduates and postgraduates

from the allied health professions. Students rank

their perceived preference for learning in one

academic environment over another with six learning

environments paired as the dipole dimensions:

abstract vs. concrete learning (LPAbstract-concrete);

teacher-structured vs. student-structured learning

(LPteacher-student); and interpersonal vs. individual

learning (LPgroup-lone). The scores for each of the

six dimensions can range from 15 to 90. High scores

reflect preference for learning in that environment if

a choice were available. Rezler & French suggested

that mature learners were those who could demon-

strate ‘flexibility’ across learning environments and

adapt their learning strategies to suit the context.

Such learners would display scores of about 50

across all dimensions, reflecting an ability to draw as

much learning opportunity as possible from each

environment.

Data-collection process

The study inventories were randomly sorted to form

the data-collection battery. Data collection com-

menced during programme induction. Participants

who were unable to complete during this time were

invited to forward the completed battery to the

researcher. Four completed data sets were returned

in this way. Simple demographic data, relating to

profession, age, professional qualification and CPD

activities, were also collected.

Data analysis

All inventories were processed, and mean scores and

their standard deviations were calculated for each

variable across the cohort. The demographic data

was used to look for differences within the group

which might support the observation that some

students were experiencing difficulty engaging

effectively with M-Level academic study. Differences

were sought using parametric analyses. A significance

level of

P

< 0.05 was used; if the results were not

significant, a

P

level of < 0.1 was used to indicate a

trend towards significance.

Results

Demographic data

Completed data sets were returned for 20 of the 30

students from the M-Level intake cohort of 2001.

Table 2 summarizes the results of the demographic

questionnaire and illustrates response frequencies

by variable. From Table 2, the profile of the respondents

can be described as follows: young (aged 32 or

under, 55%); the majority were physiotherapists;

and equal numbers had qualified through the

Graduate Diploma and Degree routes to practice.

All the graduates were physiotherapists. Eleven

respondents (55%) felt that they had not engaged in

any previous CPD activities since graduation. This

finding was surprising given that six (67%) of the

respondents who said that they had not engaged in

any CPD had been qualified and working clinically

Table 2 Summary of responses to demographic questions

Variable Frequency

Age (years)

23–32 11

33–42 6

42+ 3

Professional qualification

Degree 10

Graduate diploma 10

Professional group

Occupational Therapy 2

Physiotherapy 12

Radiography 6

Evidence of CPD

Yes 9

No 11

CPD, continuous professional development.



for more than 10 years. It seems unlikely that such a

result is accurate, and calls into question the clarity

of the questionnaire item concerned with respect to

its definition and scope of the term CPD. Of the nine

entrants who had formal CPD experience, five

(56%) said that they had deliberately chosen courses

that were teacher-led.

Learning profiles

Owing to the small sample size and the possible

ambiguity in the wording of the demographic

questions related to previous CPD activities, this

exploratory study will report only the results for

learning variables: Graduate Diploma (Diploma

entrants) and Degree entrants. The study groups were

drawn from a multidisciplinary cohort and comprised:

Diploma entrants (six Radiographers, two Occupa-

tional Therapists and two Physiotherapists); and

Degree entrants (10 Physiotherapists). The mean

age of the students in the Degree entrants group was

27.1 years and all had been qualified for 7 years or

fewer. By comparison, the Diploma entrants group

had a mean age of 39.5 years and gained their

professional qualifications between 10 and 28 years

previously. Table 3 presents the learning variable

mean scores and standard deviations for both cohort

subgroups. The statistical significance of group

score differences was tested using the unrelated

t

-

test for unmatched data (Hicks 1988).

Readiness to undertake self-directed learning

Published data for mean SDLRS scores (Guglielmino

1977) suggest that the normative score for this study

population would be 214, within an ‘average band’

of 189–240. Table 3 demonstrates that the mean

scores of both M-Level groups fell within the average

band. The difference between the groups was not

statistically significant.

Belief in personal control over academic outcomes

(ALOC)

While both groups perceived a greater internal (self)

motivation for their learning, the Degree entrants’

mean internal control score was greater than that of

those in the Diploma entrants group. This difference

demonstrated a trend towards statistical significance

(

P =

0.07).

Table 3 Learning variable mean scores and standard deviations for the Diploma entrants and Degree entrants study groups.

Differences between groups were tested using an unrelated t-test

Variable Diploma entrants (n = 10) Degree entrants (n = 10) P-value

SDLRS 206.6 ± 20.4 220.7 ± 26.6 0.200

ALOC Int 48.7 ± 4.8 53.2 ± 5.7 0.070a

ALOC Ext 25.8 ± 5.5 21.9 ± 8.7 0.248

Deep approach 45.2 ± 5.4 48 ± 8.3 0.406

Strategic approach 42.8 ± 4.4 46.9 ± 6.4 0.123

Surface approach 33.7 ± 5.1 27.5 ± 6.5 0.036b

Fear of failure 13.9 ± 3.4 11.0 ± 2.7 0.055a

LP Abstract 44.2 ± 7.8 51.6 ± 10.4 0.089a

LP Concrete 66.5 ± 9.4 53.5 ± 11.8 0.014b

LP Teacher 65.4 ± 11.8 55.5 ± 13.5 0.099a

LP Student 38.8 ± 12.5 49.7 ± 10.7 0.051a

LP Group 55.5 ± 13.6 54.6 ± 12.7 0.880

LP Lone 44.2 ± 8.1 50.3 ± 12.6 0.214

aP < 0.1; bP < 0.05.

ALOC Ext, Academic Locus of Control External; ALOC Int, Academic Locus of Control Internal; LP, Learning Preference;

SDLRS, Self-Directed Learning Readiness Scale-A.

138 C. Kell


Motivation for learning and study approach

commonly adopted

As Table 3 illustrates, the mean scores for both

student groups suggest that they all perceived

themselves to favour deep and strategic approaches

to learning. Of interest, however, is the higher use

of a surface-learning approach (

P =

0.036) and the

associated motivation for learning: fear-of-failure

score (

P =

0.055) in the Diploma entrants group.

The fear-of-failure subscale score was selected from

the other approach to learning variables because it

has been shown to have some predictive value for

poor academic outcome among our BSc (Hons)

Physiotherapy students (C. Kell, unpublished data).

Preferred learning environment

Finally, from Table 3, it can be seen that the Degree

entrants were demonstrating learning environment

flexibility across all dimensions. By contrast, the

Diploma entrant group display two dipoles in their

mean scores: a concrete learning environment being

preferred over one requiring abstraction; and a

teacher-structured environment favoured above

one that is student-structured. The difference between

group responses was significant for the concrete

learning variable (

P =

0.014: high for Diploma

entrants), and tended towards a trend for significance

for the variables: abstract learning (

P =

0.089, low

for Diploma entrants), teacher-structured learning

(

P =

0.099; high for Diploma entrants) and student-

structured learning (

P =

0.051: low for Diploma

entrants).

Summary

The results of this exploratory investigation suggest

that the M-Level intake cohort of 2001 fell into

two groups: those who entered their professional

practice with a Graduate Diploma, and those who

entered with a BSc (Hons) qualification. Reviewing

the learning profiles of the two M-Level subgroups

indicates a difference, with the Degree entrants

demonstrating greater perceived readiness to engage

with self-directed learning activities and a greater

intrinsic control for their learning success than their

Diploma entrant peers. The Diploma entrants

perceived a greater use of surface-learning approaches

and preferred to learn in environments that were

concrete/fact based and teacher-led.

Discussion

Sample limitations

Participation in this study was requested during a

period of induction to the M-Level programme.

Limited time for inventory completion may have

been an important contributing factor to the 66%

response rate. Non-responders were spread across

the professions and included the international

students. Future data-collection processes will be

timetabled more carefully to facilitate participation

by all entrants.

It should also be noted that the Degree entrants

group comprised physiotherapists only. Discussion

with the programme manager suggested that this

sample was representative of the intake. The follow-

ing discussion explores the results in terms of learn-

ing experience differences. Future research, with

larger samples, will aim to clarify any disciplinary

influence on the study findings.

Interpretation of learning profile data

Given the limitations, this exploratory study has

observed differences in the learning profiles of

entrants to M-Level programmes. The differences

have been noted between a group of students who

gained their professional qualification through a

Graduate Diploma route and a group who followed

a Degree programme. The results suggest that the

degree holders display maturity in their learning

profiles consistent with the need to engage actively

and effectively with CPD and lifelong learning

activities. By contrast, the Graduate Diploma holders’

learning profile includes elements of teacher and

fact dependence and a perceived tendency to use a

surface approach to learning. While interesting

from a research perspective, this latter observation

provides little guidance to teaching staff about the

level of learning at which the Diploma entrants

group are working.



Similar study data have been collected from

cohorts of undergraduate physiotherapy students

since 1994. While acknowledging the professional

mix of the Diploma entrants group, Table 4 com-

pares the mean scores for the entrants on the BSc

(Hons) Physiotherapy cohort of 2001 with those for

the Diploma entrants group for the purpose of

simple learning level comparison.

Not withstanding the limitations of direct score

comparison, the similarity between many of the

mean scores for the undergraduate and M-Level

Diploma entrants in Table 4 is striking. These obser-

vations suggest that the Diploma entrants perceive

themselves to be learning at a stage comparable with

the learning descriptors for ‘Level 1’ academic study

(Department of Physiotherapy Education 2003).

However, care should be taken in ‘labelling’ the

Diploma entrants in a negative way because the data

collection was carried out during the first few days

of the respondents’ contact with an HE institution.

These older learners, being more distant from their

professional training, may have been experiencing

feelings of insecurity and anxiety that could have

been reflected in their scores.

Table 4 also illustrates a potential contradiction in

variable scores. Both the BSc and Diploma entrants

groups have a positive internal perception of control

over their learning outcome success, but this is cou-

pled with a preference for learning in a teacher-

structured environment. In a study investigating

first year undergraduates’ conceptions of learning,

Devlin (2002) found that immature learners were

willing to take responsibility for their learning, but,

because they viewed learning as fact and procedure

accumulation, this responsibility only extended to

learning/memorizing the facts once the teacher

had transmitted them. Pillay (2002) supported this

observation, stating that school-leavers’ learning

conceptions were primarily focused upon acquiring

units of information and jumping the hoops to get

through the degree programme (p. 95). By contrast,

she found that mature students with workplace

experience had conceptions that emphasized under-

standing, self-development and lifelong learning

(p. 97), and who worked at an abstract level.

The results of the current study therefore suggest

that the Diploma entrants are not at a stage in their

learning development where they feel able to take

responsibility for what they learn. This observation

should worry professional bodies who are promot-

ing and demanding CPD and lifelong learning evi-

dence as part of their professional codes of practice.

The Diploma entrants’ profile (across variables

mirroring the BSc mean scores) suggests that

past-educational experience, rather than workplace

experience, may be the dominant influence in

academic learning development.

Implications for M-Level student support

Developing postgraduate courses which focus on

student-centred learning presumes that all entrants

are able to engage effectively with the process and

take their learning forward to achieve the outcomes

desired. Mann (2001) warns that failing to consider

the different ‘levels’ of student learning development

on entry to a student-centred programme can increase

students’ sense of alienation and estrangement from

the group with which they are trying to bond. Such

alienation can force students to quash their desires

for learning autonomy in order that they conform

Table 4 Comparison of the learning profile variable mean

scores for the BSc (Hons) Physiotherapy and Diploma

entrants 2001

Variable

BSc group

(n = 74)

Diploma entrants

(n = 10)

SDLRS 209.45 ± 19.2 206.6 ± 20.4

ALOC Int 49.65 ± 6.0 48.7 ± 4.8

ALOC Ext 26.7 ± 7.2 25.8 ± 5.5

Deep approach 44.1 ± 6.4 45.2 ± 5.4

Strategic approach 45.3 ± 6.9 42.8 ± 4.4

Surface approach 31.9 ± 5.5 33.7 ± 5.1

Fear of failure 14.0 ± 3.2 13.9 ± 3.4

LP Abstract 47.1 ± 7.9 44.2 ± 7.8

LP Concrete 61.0 ± 9.6 66.5 ± 9.4

LP Teacher 62.0 ± 13.2 65.4 ± 11.8

LP Student 41.1 ± 11.7 38.8 ± 12.5

LP Group 58.8 ± 12.8 55.5 ± 13.6

LP Lone 45.0 ± 10.9 44.2 ± 8.1

ALOC Ext, Academic Locus of Control External; ALOC Int,

Academic Locus of Control Internal; LP, Learning Preference;

SDLRS, Self-Directed Learning Readiness Scale-A.

140 C. Kell


and acquiesce to the demands of the course (p. 13).

Marton & Saljo (cited in Case & Gunstone 2002),

however, suggested that students might have the

skills to adopt mature approaches to learning, but

elect to use those that they perceive will meet the

needs of the specific course for which they are

enrolled. If the Diploma entrants were all taught in

a fact-focused, teacher-led environment, could they

be expecting that to be repeated in their M-Level

studies and therefore have answered their self-rating

inventories accordingly?

Lowe & Cook (2003) support this theory with the

observation from their own studies that the factor

most consistently leading to poor educational

engagement and adjustment to courses of study is

the learner’s inaccurate prior perception of what the

course entailed. Lowe & Cook (2003) advocate the

use of a formal Induction Module [or Learning to

Learn (Candy 2001)] that is designed systematically

to induct learners into the culture and ethos of the

institution, staff and programme. They suggest that

the process should be intrusive, overt and proactive,

helping students to experience different options

for learning and study before they experience the

negative motivators of fear, failure and confusion

(p. 75).

Directions for the future

If we agree with Devlin (2002), that the two main

objectives of HE are to instil the capabilities of

thinking reflectively and becoming a lifelong learner

into our students (p. 126), then one way to facilitate

this student development is through developing

courses that are student-centred, with students

willing and able to take personal responsibility for

their learning and for knowing about and regulating

their cognition (p. 126).

The results of this study suggest that not all

entrants to our M-Level programmes are using

learning strategies that would easily facilitate transi-

tion into a student-centred academic culture. The

teaching team have therefore agreed to develop an

induction module for subsequent M-Level Cohorts.

To complement this process, it is intended that this

exploratory study will be continued and extended to

follow the students’ learning development over time.

But can we be sure that it is past educational ex-

perience and not current workplace experience that

is the dominant factor in learning profile develop-

ment? Future study should explore workplace

learning cultures and their relationship to learning

profile development.

Conclusion

Despite its small sample size, this study has raised

some important issues for the continuing education

of healthcare professionals. The results of the study

suggest that attention should be paid to the learning

profiles of entrants to M-Level programmes of study.

Programmes should acknowledge the need for, and

be able to provide, learning-to-learn support to

those potential postgraduate students who require

it. In addition, further studies could investigate the

CPD activities of practising healthcare professionals,

the routes practitioners select for their CPD, and the

learning and teaching ethos of their workplace

context and the CPD activities with which they

engage. HE institutions have a duty to support the

CPD development activities of the practising popu-

lation; helping clinicians develop their learning-

to-learn skills (Candy 2001) can benefit both the

individuals and professions as they jointly seek to

deliver evidence-based clinical care.

Acknowledgements

I should like to thank all the students for being so

willing to complete the inventory batteries. I must

also thank the editor and reviewers for their most

helpful comments on earlier versions of this paper.

The study was supported, in part, by a UWCM

Learning and Teaching Research grant.

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Documents

An analysis of entry-level postgraduate students’ readiness for student-centred, Masters Level learning