Student trends and perspectives on medical education in a European medical school.

backgroundThe Pedagogic Surveys (IPUP) were validated and introduced in 2004 at the University of Porto to monitor and improve teaching quality. Despite the advancements and implementation of several revisions, the use of these tools for longitudinal analysis, and particularly in medical education, remains underexplored. This study seeks to address this gap by conducting a longitudinal analysis of medical students' feedback over consecutive academic years.

methodsThis study analysed student responses to the IPUP questionnaire collected between the academic years of 2020 and 2023, aiming to characterise trends and patterns in the evaluation of the undergraduate curriculum of the Integrated Master's in Medicine at the School of Medicine and Biomedical Sciences of the University of Porto (ICBAS). The IPUP is designed to assess nine subdomains of teaching and learning: appreciation and clarity, difficulty, support for autonomy, consistency and help, structure, relationship, effects of the unit course (UC), engagement, and assessment. A total of 221 observations from 74 curricular units across three academic years were included. The overall IPUP response rate ranged from 49.77% to 42.55% in the first semester and from 36.15% to 35.18% in the second semester across the analysed years. To assess temporal trends in the evaluation of each subdomain, linear mixed-effects models were employed. To facilitate interpretation and longitudinal analysis, three summary domains (Teacher, Unit Course and Difficulty) were created through principal component analysis (PCA), aggregating the original nine subdomains into broader dimensions.

resultsStudent evaluation scores were overall positive across all subdomains (mean scores > 5 on a 7-point scale). Differences were found between curriculum years, with the 3rd year consistently presenting the lowest scores and the 4th year showing the highest (e.g., the assessment subdomain ranged from a mean of 4.98 ± 0.89 in the 3rd year to 5.76 ± 0.69 in the 4th year; p < 0.001). When analysed by scientific domain, Pathology was the one with the highest scores, while Semiology and Pharmacology received the lowest scores (e.g., the assessment subdomain ranged from a mean of 6.57 ± 0.17 in Pathology to 4.15 ± 0.35 in Pharmacology; p < 0.001). A positive correlation was observed between average final grade and subdomain evaluations (ranging from r = 0.108 to r = 0.260 across subdomains), except for difficulty, which showed a negative correlation (r = -0.57, p < 0.001). A higher number of credits of the European Credit Transfer System (ECTS) was also positively associated with student perceptions. During the evaluation period, a significant decline was observed in the Teacher domain (β = -0.147, CI95%: -0.260, -0.034), whereas the UC and Difficulty domains remained stable. Intraclass Correlation Coefficient (ICC) values ranged from 0.45 (Teacher) to 0.86 (Difficulty), indicating a high level of consistency in student perceptions.

conclusionsThis study provides important insights into the potential use of the IPUP as a tool for longitudinal assessment of the student perspectives on undergraduate medical education quality. The study showed that student evaluation of the course were overall very positive and highlights the stability of the scores' trends over the three academic years analysed, with only a slight decline observed in the Teacher Domain. The overall consistency of results over the years suggests, on one hand, strong reliability and, on the other, that the opportunities for improvement were not taken into account nor led to the implementation of significant changes, denoting the missed opportunity provided by these tools for the refinement of teaching and learning processes.