Medical Teacher

ISSN: 0142-159X (Print) 1466-187X (Online) Journal homepage: http://www.tandfonline.com/loi/imte20

AMEE Medical Education Guide No 16: Study

guides-their use and preparation

R.M. HARDEN, J.M. LAIDLAW, E.A. HESKETH

To cite this article: R.M. HARDEN, J.M. LAIDLAW, E.A. HESKETH (1999) AMEE Medical
Education Guide No 16: Study guides-their use and preparation, Medical Teacher, 21:3, 248-265,
DOI: 10.1080/01421599979491

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Published online: 03 Jul 2009.

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M edical Teacher, Vol. 21, No. 3, 1999
AMEE Medical Education Guide No 16:
Study guidesÐ their use and preparation
R.M. HARDEN, J.M. LAIDLAW & E.A. HESKETH
Centre for Medical Education, Tay Park House, 484 Perth Road, Dundee DD2 1LR, UK
SU M M AR Y Study guides can m ake a major contribution to
learning. They are likened to a tutor sitting on the student’s
shoulderÐ available 24 hours a day to advise the student what
he/she should be doing at any stage in their study. Study guides are
different from textbooks. They can be seen as a response to changes
taking place in the curriculum, to the challenge of information
overload and to different approaches to learning. Study guides have
three roles in facilitating learning: (1) assisting in the management
of student learning; (2) providing a focus for student activities
relating to the learning; (3) providing information on the subject or
topic of study. A study guide triangle model can be used to represent
these different roles. Guides can be placed at different points in the
triangle re¯ ecting the relative emphasis on these three functions. The
composition of a study guide will depend on its purpose. Study
guides may include an overview of the course, the expected learning
outcomes, the prerequisites, the timetable, the learning strategies and
opportunities, assessment information, staff contacts and personal
comments from staff.The guide can be designed to encourage students
to interact with the subject through questions, student activities and
self-assessment exercises. The guide may be developed as a portfolio
or record of students’ information. Extracts from previously published
content inform ation or new information on the topic produced by
the authors can be included in the guide. Steps in preparing a guide
can be considered under the following headings: (1) deciding on the
function and format of the guide; (2) relating the study guide to the
curriculum; (3) writing the guide.A well-written guide is a manage-
ment tool that encourages both the teacher and the student to
assume responsibility for learning.
Introduction
Travel guides are an expanding area in publishing. Their
popularity stems from travellers’ needs to seek guidance or
support when visiting a country or area, perhaps for the first
tim e.Travellers recognize that, to maximize the often limited
time at their disposal, they need to be pointed in the right
direction to visit the attractions or sights of most interest to
them. A good travel guide can m eet their needs. The guide
will help them to get the maximum bene® t from their visit
and help them to understand and appreciate what they are
seeing. Advice is usually contained in the guide relating to
accommodation and the different form s of transport avail-
able at the destination and the relative costs. Inform ation in
the guide may be read in advance of the visit to prepare the
traveller for the journey. Some travellers prefer to plan their
own itinerary. In these circumstances, information in a travel
guide is invaluable.
Just as a travel guide is a useful resource for the traveller,
a study guide serves the same functions relative to students’
studies. It highlights, for example, what students should aim
to achieve as they work through a curriculum. It emphasizes
248
the areas which are essential to study and the areas which
may be of speci® c interest to som e students. The study
guide provides the students with the understanding or
background necessary for them to appreciate the areas being
studied. It enables students to make the best use of available
learning opportunities and to tailor these opportunities to
meet their speci® c needs. Through study guides, students
are encouraged to develop effective study skills and to
become independent learners.
This AM EE publication outlines the concept of study
guides, and how they can be prepared and used most
effectively. The ideas in this booklet have been developed
from our personal experiences in preparing study guides for
different target groups and to ful® l different purposes. To
emphasize many of the important features of guides we
have used examples from practice.
We hope you ® nd this publication helpful. It has been
divided into 10 sections.You can choose to read through the
booklet systematically or skim through it reading the sections
that are of particular interest.
(1) The sum m ar y . You m ay already have read this. It
highlights some of the key issues in preparing and
using a study guide.
(2) Introduction . This section introduces the concept of a
study guide and the contents of this booklet.
(3) W hat is a study guide? This provides a short descrip-
tion of the key features of a study guide and how a
study guide is different from a textbook.
(4) The context in which study guides have become im portant .
Study guides can be seen as a response to current
developments in education.
(5) W hy use a study guide? The reasons why, if you have
responsibilities in the ® eld of education, you cannot
ignore study guides.
(6) W hat m akes up a study guide ? An account of the wide
range of components that can go in to m ake up a
study guide.
(7) W hat type of study guide should you produce? A novel
way of looking at study guides and deciding the
emphasis you wish to give to your own guide.
(8) H ow to prepare a stu dy guide . P ractical hints on
preparing your own study guide.
(9) C onclusions. Some ® nal words about developing and
using study guides.
(10) References. W here you can read more about the subject
if you are interested.
Although the illustrated examples are from the ® eld of
medical education, we believe that those working in other
disciplines will ® nd the booklet of value.
0142-159X/99/030248-18 ½ 1999 Taylor & Francis Ltd

W hat is a study guide?
In an earlier article (Laidlaw & Harden, 1990) we de® ned a
study guide as ª an aid, usually in the form of printed notes,
designed to assist students with their learning. It indicates
what should be learned, how it can be learned, and how
students can recognize if they have learned itº .We suggested
that ª A study guide can be seen as a management tool
which allows the teacher to exercise his responsibilities while
at the same time giving the student an important part to
play in m anag ing his own learningº . R ow ntree (1986)
captured the idea well when he likened a study guide to
tutors sitting on the students’ shoulder, available 24 hours a
day to advise the students what they should be doing at any
stage in their study. Study guides are presented usually in
text format, but they may be presented electronically. These
different formats will be discussed later.
A study guide is a tool designed to facilitate students’
interaction with the various components of the curriculum,
as shown in Figure 1. They can help students to:
· plan their learning in line with the expected learning
outcomes;
· m ake the best use of the learning opportunities provided;
· adopt appropriate learning strategies;
· prepare for the assessment procedures which are part of
the educational programm e;
· respond appropriately to the educational environment of
the institution (Genn & Harden, 1986).
Figure 1. Study guides help students to interact with the
various com ponents of the curriculum .
Study guides highlight the choices available to students in
term s of:
· what they have to study;
· the methods of study;
· the sequence of learning.
Study guides are som etim es confused with textbooks.
However, there is a marked difference. A textbook is a
depository of inform ation with the emphasis on content.
Students can study systematically the information contained
in a textbook, can read sections of it, or can refer to the
book using the contents page or index to answer speci® c
queries. In contrast, a study guide has as its main function
the facilitation of students’ learning. Students might be
referred to appropriate sections of standard texts or provided
AM EE G uide No. 16
with a summ ary or key inform ation on a topic. The emphasis
in a study guide is on the process of learning, and not on
content. The guide advises students about what they should
be learning and how they should be learning, rather than
simply being a source of inform ation. Some differences
betw een th e featu res of a textboo k and a guide are
sum marized in Table 1.
Table 1. Differences between textbooks and study guides as
sum marized in a dental training guide produced for the
Scottish C ouncil for Postgraduate M edical and Dental
Education.
Textbook
x Presents content related to the subject, e.g.
com prehensive chapters on caries or m inor oral
surgery
x Provides knowledge about the content
x Reading is the only activity required
x C oncerned mainly with the area of knowledge
Training Guide
x Tells how you can acquire competence in the
com ponents of the task, e.g. how to develop an
understanding of the hygienist’s role in periodontal
treatment
x Provides a starting point to learning upon which you
can build up your experience
x Provides a wide range of activities likely to lead to
solid and lasting learning
x Spells out a range of learning objectives particularly
related to skills and attitudes
Source: Abdel Fattah et al . (1991), Scottish Dental
Vocational Training Com mittee (1993).
T he con text in w h ich st u dy gu ides h ave b eco m e
im por tant
Study guides are a key tool, arguably an essential tool, in the
education process. Six trends in education have contributed
to this importance.
(1) Potential information overload
There are increased expectations of training programmes
but the time available for their delivery is ® xed. Students are
expected to learn m ore but within the sam e period of time.
Information overload is well documented as a major problem
facing education, with knowledge expanding at more than
14% per year, a ® gure predicted to rise to 40% per year.
The public’s expectations of the competences required of a
doctor on quali® cation have never been higher. Not only
have doctors to keep abreast with current developments in
medicine, they also require to develop appropriate attitudes
and skills, and to have an understanding of disease preven-
tion, health prom otion, information technology and other
new aspects of m edical practice. The result is that they have
to be selective in what they study and they need help to do
this.
(2) Curriculum change
The medical curriculum has become increasingly complex
with vertical and horizontal integration, the introduction of
249
R.M . Harden et al.
new educational strategies such as problem-based learning,
and teaching and learning in a variety of sites and contexts
(Harden et al., 1984). Rich and varied learning opportuni-
ties, many of which have not been previously available, are
now on offer to students. Previously students learned from
lectures, a small number of standard textbooks, and through
an attachment to a hospital ward. Now students have access
to information from m any sources including a wide selec-
tion of printed texts in different styles and formats, and
from a range of m edia such as videota pes, com puter
programm es and the Internet. Clinical experience can be
gained not only in hospital, but in ambulatory care teaching
centres, in clinical skills laboratories and in the comm unity.
Study guides help students to learn within an integrated
curriculum and assist them to m ake the best use of the
resources and learning opportunities available.
(3) A spiral curriculum
There is a growing m ovement to break down the barriers
between the different phases of education with iterative
revisiting of topics or subjects at different levels of complexity
th ro ugho ut th e ed u catio nal prog ram m e. In a sp iral
curriculum, students develop a deepening understanding of
the subject, building on it with each successive encounter
(Harden & Stamper, 1999). Study guides can play an
important role in leading the students through this process.
(4) Independent learning
The undergraduate curriculum cannot equip students with
the knowledge and skills required for a lifetim e practice of
medicine. The curriculum should ensure, however, that
students develop the ability to continue their education
after quali® cation. There has been a move from a teacher-
centred didactic approach to education to a student-
centred approach where the students take more responsibility
for their own learning. Students need guidance and assist-
ance with this approach and study guides have an important
role to play.
(5) Work-based learning
An increasing emphasis is being placed on work-based
learning (Kolb, 1984; Boud et al., 1993), on situated learning
(Brown et al., 1989) and on task-bas ed learning (Harden et
al ., 1996a, 1996b). Potential con¯ ict exists in the clinical
setting between education and service comm itment. There
is a need for doctors in training to gain the maxim um
bene® t from learning on the job, and study guides can be
particularly helpful in this context (Mitchell et al., 1998).
(6) D istance learning
Dista nce lear nin g is now an e stab lish e d edu cat ion al
approach. A key characteristic of distance learning is that
the teacher manages the students’ learning and interacts
with them at a distance (Harden, 1988). Study guides
provide a vehicle for this interaction.
W hy use a study guide?
We have looked at the reasons underlying the increasing
popularity of study guides as an aid to teaching and learning.
250
Here we look, in more detail, at the potential roles for study
guides in facilitating learning. These can be categorized into
three groups:
(1) the m anagement of students’ learning;
(2) the provision of a focus for students’ activities related
to the learning;
(3) the provision of information on the subject or topic.
(1) The m anagement of students’ learning
The study guide can:
· Interest the student : The guide helps to enthuse the students
in the subject. W hy is the topic or course important? Are
there any particularly exciting or interesting features?
· Introduce a course : The guide sets the course in the context
of th e c u rr ic ulu m . T he pape r, `T h e ne w D un d ee
curriculum Ð the whole is greater than the sum of the
parts’ (Harden et al., 1997), recognized the importance
of students and staff having a broad perspective on the
curriculum . Study guides were identi® ed as playing an
important role with respect to this.
· H ighlight the expected learning outcom es: The study guide
can describe the aim s and objectives of the course and
can explain to students what is expected of them in terms
of learning outcomes (Harden et al., 1999a). A not
infrequent criticism by students is that they are uncertain
of what is expected of them in a course in term s of the
learning outcom es. The rather trite question ª How will I
know how to get there if I don’ t know where I am going?º
is nonetheless a valid concern.
The study guide can identify the core curriculum and
highlight what students need to learn, what it is nice for
them to learn and what they do not need to learn.
· Ensure uniform ity : In som e training situations, such as the
later years of a medical course, students have a range of
different experiences. It is important, however, that core
experiences are shared by all students. Study guides can
help to ensure a m easure of uniformity of the curriculum
while at the same time encouraging students to exploit
the diversity of experiences available to them.
· Provide a fram ework : Study guides provide a framework or
structure for students’ learning.Without such a framework,
learning can be likened to knitting without a pattern.
Students can build on the framework as they work through
the course. A guide to the endocrine system, for example,
encouraged students to build a framework based on a list
of the endocrine glands to be studied and the problems
associated in each gland with over-production of hormone,
under-production of hormone and normal production of
hormone. Another approach is the use of the tasks facing
a doctor, or the problems they m ay encounter in practice
to provide a structure for learning.
· Assist in planning and delivering an integ rated prog ram m e :
The guide can bring together material from different
perspectives which relates to the course and encourages
the student to look at the topic from different viewpoints.
Thus, in a study guide on pain, the perspectives of the
surgeon, the oncologist, the anaesthetist, the physiologist,
the pharm acologist and the general practitioner can be
introduced.
Study guides can facilitate both horizontal and vertical
integration. Vertical integration is often difficult to achieve

in a curriculum. The guides can emphasize, in the early
years, the clinical relevance of basic science principles. In
the later years, guides can show how the com petences
and understanding gained in the early years contribute to
the work in the clinical context. Study guides support a
c on structivist ap proach to learning by encourag ing
students to build new ideas on their current knowledge.
In cur ricu la with a sign i® cant com m u nity -b ased
com ponent, there is often a failure or partial failure to
inte grate th e stud ents’ learn ing e xp erien ces in th e
com munity with those in the hospital. Study guides can
be used effectively to link the experiences in these different
settings so ensuring that the students do not consider
them as separate curricula.
· Inculcate in students appropr iate study skills : The develop-
m ent of appropriate study skills is particularly important
when unfamiliar educational strategies are introduced.
An example is problem-based learning (Davis & Harden,
1999). Hodgkinson (1994) suggested that ª Students who
are asked to carry out a lot of work on their own will need
a lot of psychological supportº . Study guides can inform
students about their approach to studying and may identify
appropriate and inappropriate behaviour. Study guides
can also assist them to make the best use of the tim e they
have available.
Study guides can identify how students can get further
support when required. The guides can introduce the
m embers of staff responsible for the programme and how
they might assist the students.
· O utline the timetable and learning opportunities available :
The study guide can include the timetable and can identify
the learning opportunities available to the students. These
m ay include form al lectures, other timetabled activities
and opportunities for individual work and self-learning.
The guide can show how such opportunities contribute
to the expected learning outcomes.
The guides can also help to ensure that the students
m ake the best use of their study tim e. This is particularly
impor tant when they have been provided with large
reading lists and a range of multimedia material. Students
m ay be unwilling to invest time studying a programme on
the off-chance that it might be of help to them. They may
be willing to invest the time, however, if the study guide
demonstrates how the programme can contribute to their
understanding of the subject. Study guides can help to
ensure that the maximum use is made of the learning
resources available and that the resource material is related
to parts of the curriculum where it is likely to be m ost
appropriate.
The production of learning resource material from
scratch, particularly m ultim edia prog ram mes, is time
consuming. It is more sensible for teachers to identify the
resources available and to spend their time on the produc-
tion of a study guide that illustrates how these resources
can be used effectively.
· D escribe the librar y and other student facilities : The study
guide can introduce students to library facilities, study
areas and other facilities that improve the learning environ-
m ent.
· M atch the curriculum to the needs of individual students :
Study guides help to dem onstrate how the needs of
individual students can be m et in a curriculum. Guides
AM EE G uide No. 16
can outline the knowledge and skills that a student should
have on entering a course. If a student does not have the
desired com petences, the guide can identify how this
de® cit can be rem edied. Guides can assist students to
study a topic at an appropriate depth and level of
com plexity and can cater for different learning styles. Not
all students, for exam ple, may learn best using a problem -
based approach. Students may also have different prefer-
ences with regard to choice of learning m aterials (Harden
et al., 1975).
· Prepare the student for exam inations : Study guides can
prepare the students for examinations by explaining the
format and arrangements for the assessm ent. Examples
of questions can be provided. Opportunities for the
stu d e n ts to asse ss th e ir ow n c om p e te n c e c an be
incorporated into the guide.
· M ake the details of the course public:The study guide can be
seen as a public statement about the course, the expected
learning outcomes, the course content, the approaches to
teaching and learning, and the assessment. Comm unica-
tion about the curriculum is less of a problem where a
teacher, along with a few colleagues from the sam e depart-
m ent, is responsible for a stand-alone course. W ith
integrated programmes, in contrast, teachers from a variety
of backgrounds make a contribution, and students gain
experience not only in a teaching centre but in smaller
hospitals or in the community. Study guides allow teachers
to have a better appreciation of the scope, content and
approaches to teaching and learning adopted. This allows
them to contribute more effectively to the curriculum.
Study guides help to docum ent the developm ent of
courses over a number of years and record how the course
materials and learning opportunities have been added to
and enriched.
A study guide provides a valuable preview of a course.
This is particularly helpful for a student who is considering
enrolling in a programm e. We have found it useful, for
exam ple, in special study module programmes where the
guides m ay provide a better insight into the course than
the information contained in a course brochure.
(2) The provision of a focus for students’ activities related to the
lear ning
· To encourage students to interact w ith the course : Activities in
the study guide provide an interactive elem ent to the
students’ learning, and enhance the learning experience.
Students may be asked to think, re¯ ect and apply to the
practice of medicine, the knowledge and skills acquired.
This encourages deep rather than super® cial learning.
· As a record of the students’ work : There may be a need in a
course to keep a record of the work undertaken and the
experiences gained by a student. This may be in the form
of a diary, a logbook, a portfolio or a record of achieve-
ment. Such records can be integrated into the study guide.
An advantage of this is that the activities required of the
student are related directly to the students’ learning. Such
records can be used for form ative or sum mative assess-
ment.
· As the basis for a lear ning contract : A relatively new concept
is the use of learning contracts (Parsell & Bligh, 1996).
The study guide can be constituted to serve as th e
appropriate documentation for a learning contract.
251
R.M . Harden et al.

(3) The provision of information on the subject or topic program me for surgical trainees, produced by the Royal
College of Surgeons of Edinburgh and the Centre for
Occasionally, teachers feel a need to provide students with
M edical Education in Dundee. This de® nes the concept
information which supplements what is presented in lectures
and highlights the topic’s importance for the surgeon.
or in other resource m aterial. Traditionally, such inform a-
This introduction is followed by a series of six short
tion was presented as `handouts’ that accompanied a lecture
clinical examples. These help to de® ne the topic, interest
or practical class. The need for additional inform ation m ay
the reader and emphasize the importance of the subject in
arise when:
clinical practice.
· there is a lack of books and resource material;
· there is a need to emphasize and highlight key or core
information;
· the sources of information available are out of date or do
not relate to the local context;
· it is too difficult or too tim e consuming to access the
information required from the resources available;
· there is a need to present a range of perspectives or views
which m ay not be apparent from the resources available;
· teachers want to feel some ownership of the information
provided to the student.

It is unlikely that one study guide will serve all three func-
tions. A study guide should be tailored to the needs of a Below is the introductory section in a study guide to the
particular course and the teacher responsible for producing cardiovascular system prepared for second-year m edical
the guide. The functions expected of a study guide will students.
affect its content and design. This will be discussed in
subsequent sections.

W hat m akes up a study guide?

The features of a study guide and the emph asis in the

guide on each com ponent will depend on th e purposes for
which th e guide is intended. The com ponents can be
grou ped round th e th ree fu nctions descr ibed in the
previous section.

(1) The managem ent of the students’ learning

An over view of the topic or course : The guide can include a

general orientation to the course and might incorporate:

· features in the course of particular interest;

· details of how the study of the topic contributes to the
overall curriculum Ð the relationship of the topic to the
earlier and later parts of the course;
· cross-references to other guides used in the curriculum to
emphasize the interrelationship;
· an advance organizer or framework for studying the topic.
Shown below is the introduction to the study guide for the
`Altered consciousness/confusion’ module of the SELECT
The course outcom es and content : The outcomes de® ne what is
to be covered in the course and can be presented as one or
more of the following:
· A list of the expected learning outcomes. These can be
classi® ed using the three-circle model described by Harden
et al. (1999a), with the inner circle covering `what the
student should be able to do’ , in the middle circle `the
approach to doing it’ , e.g. with ethical considerations,
and in the outer circle `the development of the individual
as a professional’ .
· A detailed list of aims and objectives. Holsgrove et al.
(1998) reported that the identi® cation of a core curriculum
in the medical school had been ª long, difficult and fraught
with institutional political battles. Learning objectives
incorporated into th e study guides in one of three
categories `essential, important or nice-to-know’ had been
an immediate success.º

252
 AM EE G uide No. 16

· A summary of the learning issues. An example is given in

Table 2.
· A concept map of the areas to be studied.
· A list of contents.
· A set of books or other resource material covering the
areas.
· A set of problem s or tasks, as in task-based learning.
· Details of the assessment which will be used to ascertain
whether the students have achieved mastery of the topic.

Table 2. The learning issues sum marized in the `labour’

section of a study guide on obstetrics.

(1) What symptoms/signs may herald the onset of

labour?
(2) How is the diagnosis of labour con® rmed? · Lectures: What topics are covered? Should the students
(3) De® ne the three stages of labour. do preparatory work before attending the lecture? Should
(4) How is the progress of labour assessed? they make notes during the lecture?
(5) What aspects of m aternal care need to be addressed This is a reference to lectures in the cardiovascular
in labour? system study guide for second-year medical students at
(6) How is fetal well being assessed in labour? Dundee.
(7) What forms of pain relief can be used in labour?
(8) What are the indications for an episiotomy?
(9) What steps are taken to m anage the normal third
stage of labour?
(10) How is the condition of the baby assessed at birth?
(11) What special tests are performed in a Rhesus
negative mother and baby at delivery?

Source: M ires et al . (1998).

Note: In the study guide, space is left between each issue
for the student’s response.

· Sm all-group sessions: W hat is their purpose and what is

expected of the student?
· Practical courses: How will these contribute to the achieve-
The prerequisites : These are the knowledge and skills required ment of the learning outcomes?
of the individuals before they com mence a study of the · Clinical experiences, e.g. wards, ambulatory care, com -
topic. They include the terms and concepts students have munity, clinical skills centre. The study guide m ay advise
mastered previously. A pre-test may be included to let the the student or trainee how best to gain the required clinical
students assess their prior understanding. experience as in this extract from the SELECT pro-
T he tim etable : This section of the g uide presents the gram me.
tim etable for the students and outlines any choices of th e
sequence in which the topic can be studied. W here there
is no formal tim etable, the guide may indicate the estimated
tim e for studying a topic. In a vocational training guide
for dentists, it was suggested that the trainees should
allow four weeks for completion of each topic (Abdel-
Fattah et al., 1991).

The learning strategies : Strategies to be adopted in the study

of the topic should be outlined, e.g. an emphasis on problem-
based learning, independent learning, or integration. In the dental vocational trainee guide an icon is used to
The PASS guide for dental trainees produced by the indicate when the trainee should watch the trainer in action.
Royal Colleges of Surgeons of Edinburgh, Glasgow and
Ireland in collaboration with the Centre for M edical Educa-
tion, Dundee, gives general advice to the students on study
skills as shown in the next column.

L ear n in g O ppor tu nities : A d escr iption of th e lear ning

opportunities and an indication of how students m ight
interact with them can cover:

253
R.M . Harden et al.

Hill et al. (1995) describe the use of a study guide to Below are two extracts from the dental vocational training
support structured teaching round a clinical problem. guide. The ® rst describes a useful reference for revision.
The second refers to speci® c papers on a new topic.
· Individual learning , e.g. books, jour nals, videota pe,
computer-assisted learning material. In the example below
dental trainees are referred to a videotape. The text
explains how the videotape can be of help and what the
trainee should look for when viewing it.

An important function of study guides is the direction of

students to appropriate texts. Horton et al. (1990) have
In a guide produced for trainees in paediatrics, the trainees
suggested that study guides ª usually consist of written ques-
were referred to texts and to ward protocols as indicated by
tions or statem ents which distract or isolate important pieces
the icons.
of information from larger contents, thereby structuring or
guiding the comprehension of textbook materialsº . Some
basic information should be provided with the references to
texts. This should include:

(1) the speci® c pages or paragraphs within a page or the

appropriate diagram or table;
(2) what the student will gain from reading the text:

· a simple explanation of a difficult concept;

· a good and succinct overview;
· a useful diagram, ® gure or photogr aph;
· further case studies or examples;
· a m ore in-depth study of the topic;
· a review of the topic from a different context, e.g. a
nurse’s perspective;
· different views on a controversial issue;
(3) an indication of topics or areas where the book is out
of date; Some lecturers are concerned that providing detailed
(4) an indication of when the advice in the book does not directions to texts is spoonfeeding the students. Certainly,
® t with the local situation; students should be expected to be able to ® nd information
(5) inform ation as to how the book ® ts into the broader for themselves in a book, journal or on the Internet. Students,
context of their studies of the subject in the cur- however, do not have the time to com plete such searches for
riculum: their studies. Their work needs to be directed if they have to
complete the reading expected of them within the time
· a review of what they should know; available. This is especially true of students who are reading
· an introduction or starting point for their studies; texts in a language other than their native one.
· an extension of the topics covered in the curriculum .
Assessment : Details of the assessm ent procedures in the
Users of a study guide may be referred to a standard text as curriculum should include:
in this exam ple from an endocrinology system guide for
medical students. · information about the assessm ent tools used and how to
tackle these;
· how best to prepare for examinations.

M CQs relating to the topics covered in the m odules were

included in the PASS guide for dental trainees, and the
answers were provided.These followed the style of the college
exam ination. They allowed the trainees to assess their
knowledge of the topic and to get practice in answering this
type of question. Speci® c advice about preparation for an
exam ination m ay be included, as in the examples from the

254

SELEC T prog ram m e, or about behaviour during the
examination.
S taff contacts: It m ay be helpful to include in the study
guide the name of the mem ber of staff responsible for the
teaching sessions, and staff who are available for consulta-
tion. G ive details of when they are available and how they
can be contacted, e.g. by telephone, email, or in their
office.
In the dental training guide, trainees are advised when
th ey should seek help from th eir trainer.
Personal com ments : Personal comm ents from teachers or
subject experts in the ® eld can add a human or personal
touch to the guide, and can help to m ake the subject real.
The com ments in the guide m ay:
· express an opinion on the content, e.g. ª a comm on
m isconception is . . .º ª th ere are differ ing opinions
about . . .º ª probably the most important new develop-
m ent in this ® eld is . . .º ;
· recognize that the student may have difficulty mastering a
topic and provide reassurance, e.g. ª Many students ® nd
difficulty with this. Once you have ® nished the section
and looked at the references recommended, you will have
a much clearer understanding of the subjectº .
Comments from the authors m ay be used to provide
additional insights into studying the subject. Here are two
examples from the SE LECT programm e.
AM EE G uide No. 16
A study guide for a distance learning programme for
nurses includes com ments from the authors as in this
exam ple from the `Q uality of Life’ module.
(2) Student activities related to the learning
The study guide may be used as a workbook, with precise
instructions on what activities students are expected to
undertake as they work through the guide. The student
activities may include the following:
Interactions with texts or other learning resource material: Horton
et al. (1990) suggested a dynam ic study guide format
ª wherein students are provided the opportunity to interact
with a reading passage at their highest level of independent
activityº .
The student may be directed to read a passage in a text
and then asked a question which requires the student to
relate the text to his/her study of the topic. The student may
be asked to inspect a diagram or table of ® gures. The activi-
ties m ay require the student to:
· summarize;
· interpret;
· apply the principles or aspects covered to another context.
Questions were an integral part of the core text in the
SELECT programm e. They were identi® ed by a `?’ icon
and allowed the trainees to assess their understanding of the
topic as they worked through the module. Answers were
provided immediately beneath the question as shown in this
example.
255
R.M . Harden et al.

The trainees were invited to document their activities as

part of a personal portfolio which recorded their learning,
or as part of a logbook which was required for the college
examination.Trainees were invited to bring both the portfolio
and the logbook to the examination.
In the following example, from a section of the dental
vocational training guide on comm unication skills, the
trainees are recomm ended to m ake a videotape of their
interaction with a patient with caries.

Users of the guide may be asked to stop and re¯ ect on an

issue as in these two exam ples from the SELECT pro-
gram me.

The following example from the paediatric training guide

asked the trainee to think about teamwork.

In the example below, nurses were asked to apply some of

the principles they had studied relating to `Q uality of Life’
to their clinical practice.
Application of theor y to practice: Activities which relate the
students’ studies to their clinical work are a powerful
com ponent of study guides. The `learning-by-doing’ which
results m ay be a key feature of the guide.
In the SE LECT programm e activities were identi® ed
which were designed to encourage trainees to apply what
they learned to their surgical practice. Here are examples.

Opportunities for self-assessm ent : The students m ay be encour-

aged to assess th eir understanding of the subject by

256
 AM EE G uide No. 16

answering questions included in the study guide and to New inform ation provided by the teacher, which m ay
compare their answers with those provided. Questions are include:
often of a multiple-choice form at, but may be open-ended.
· short comments or quotations on the topic. These add a
The students m ay be able to obtain a score indicating their
personal touch to the quote and create hum an interest;
level of understanding.
· short notes on the topic. Key messages in a programm e
Student records: A record of the work undertaken, and a on clinical audit `M oving to audit’ were emphasized with
documentation of their experience and their interpretation a `remember’ icon;
may be a feature of a guide. Such a record provides a base
for the students’ portfolio or record of achievement, and
may be used for assessment purposes.
Increasing attention is being paid to the use of portfolios
in education (Snadden & Thomas, 1998). The value of a log
in which students systematically register essential learning
activities has been documented (Dolmans et al., 1999).
This record can be incorporated into a study guide where it
is integrated into the overall program me of teaching and
learning (Mires et al., 1998).

Personal infor mation bank : The guide may be used as the
basis for the development of a personal information bank.
In this way, the study guide is seen as a dynamic and not a
static aid to learning. Students will add to it as they pass
through their studies and create their own living learning
resource.
Evaluation of the guide : Students may be asked to comm ent
on the guide. Hodgkinson (1994) suggested that ª interact-
ing m ay be used to good effect by inviting individuals or
groups to annotate current course guides. Knowing that
their responses are to be built into next year’s course can
boost student commitm ent.º
The different types of activities described above may be:
· an integral part of the study guide with the completion
of the activities a necessary part of the student’s studies.
This is the case where the student’s work is the basis of
a portfolio that is used to assess progress;
· additional or optional when the activities are used to:
(1) reinforce the student’s understanding of the topic;
(2) extend the student’s studies to another area;
(3) apply the theoretical studies to a practical context.
(3) Inform ation on the subject or topic
Teachers may use the study guide to com municate informa-
tion to the student. This may be in a number of form s:
· key or core information relating to the topic;
· a more extended account of the topic;
· a glossary, set of de® nitions or list of new term s encount-
ered in the topic.
The components of a study guide described in this section
are summ arized in Figure 2 on the next page.
W hat sor t of study guide do you want?
(1) The three fu nctions of a guide
As will have become apparent from the previous sections,
the concept of a study guide embraces a num ber of func-
tions. Som e teachers see the principal function of a guide as
the presentation of content inform ation, with the key facts
emphasized, difficult concepts explained and illustrated, and
new up-to-date facts provided. O thers see a guide as a tool
to manage students’ learning, providing students with advice
about the expected learning outcomes and how they can
achieve these, and guiding students in their approach to
their studies and in th eir use of the various learning
opportunities provided. A third perspective of a guide is
where the emphasis lies with the student activities. These
are an integral part of the guide. The guide provides a
vehicle for students to record, and/or assess their achieve-
ments. Study guides in this category include guides that
have been published as supplements to standard texts and

Information previously published, which may include:

· references to sections of textbooks or articles and journals;

· short quotations from books or journals;
· longer extracts of texts;
· com plete text or an article from a journal to accompany
the guide.

Texts were provided with the study guide in our palliative

care and nursing distance learning courses in Dundee, as
we wished to ensure that the course participants had
immediate access to the recommended texts.
Q uestions of copyright arise when use is m ade of m ate-
rial previously published and careful attention needs to be
paid to this. Figure 3. The study guide triangle.

257
R.M . Harden et al.
Figure 2.
which consist of sets of questions to allow students to test
their understanding of the text. Feedback is provided with
references to the text.
In practice, m ost guides provide a mixture of th ese
functions in var ying proportions. The orientation of a
study guide can be represented as an equilateral triangle
as shown in Figure 3. The three points of th e triangle
represent th e three types of function. A represents a study
guide wh ere the only function is to provide students with
inform ation. Such a guide would be indistinguishable from
a set of notes on the topic. B represents a guide where the
function is to m anage th e students’ learning. The assum p-
tion is that students have ready access to appropriate
sources of inform ation. C is a guide where the function is
based on prescribed student activities. This type of guide
may constitute a student’ s portfolio or record of achieve-
ment.
(2) A com bination of functions
Guides almost always ful® l a num ber of functions, and in
practice it is unusual to ® nd unidimensional guides. It is
258
also unusual to ® nd guides, as identi® ed at D , where all
th ree fun ction s are e m phasize d equ ally. Teac her s or
curriculum comm ittees usually have a vision as to which of
the guide functions they consider to be m ost important, and
emphasize this in the guides. The emphasis may relate to
personal perceptions of the nature of teaching and learning.
Traditional teachers or institutions more familiar with a
didactic approach have a bias towards the provision of
content information. The emphasis in a guide may re¯ ect
the resources available. Teachers may favour a more content-
inform ation approach if learning resources are not readily
available to the student. In this situation students will not
have access to content information unless it is provided with
the study guide.
Th e approach adopted m ay be in¯ uenced by the stage
of developm ent of the student. For exam ple, study guides
for students in the early phases of the curriculum at
Dundee em phasize both the provision of inform ation and
the m anagem ent of learning as indicated by H in Fig 3.
Relatively less attention is paid to student activities. A
typical study guide includes infor mation about the course
structure and the aim s of the course, the week’ s tim etable,
 AM EE G uide No. 16

th e clinical problem for the week and the learning issues

to be addressed, the learning opportunities, a glossary of
term s and self-assessm ent questions. Also included is a
sum m ar y of key facts relating to the topic. In the study
guides for years 4 and 5, less attention is paid to the
provision of inform ation and m ore to student activities
and to the m anagem ent of students’ learning (M ires et
al., 1998), as shown at F .

(3) Activities-orientated study guide

The guide in obstetrics and gynaecology was structured

round 12 com mon clinical problem s. It outlined the objec-
tives and the learning opportunities available relating to
each problem . The learning issues were in the form of ques-
tions. The issues for one of the topics, `normal labour’ , are
given in Table 2. Suggested responses to the learning issues
are provided at the end of the guide. A key component of
each guide was the structured case report provided for each
topic. This required the student to collect inform ation about
a patient and interpret it (Table 3). This section of the guide
was the basis for an important part of the student’ s end-of-
course assessm ent.

Table 3. Example of a structured case report to be completed

by students from the `labour’ section of the obstetrics study
guide.

(1) What was the presentation of labour?

Note sym ptoms/signs which made the patient come
to hospital.
(2) What initial assessm ents were made?
Note how these assessments helped in the
management of the patient.
(3) What m ethod(s) of analgesia was/were used?
Note any com plications/difficulties/effectiveness.
(4) What m onitoring was performed during labour?
Note both maternal and fetal methods.
(5) Plot the progress of labour on the partogram.
(6) What was the duration of the three stages of labour?
F igure 4. An exam ple of a page from the training guide for
(7) Was an episiotomy required?
dental vocational training produced by the Scottish Council
Note the reason for performing it.
for Postg raduate M edical & Dental Education and the
(8) How was the third stage managed?
Centre for Medical Education, Dundee. Source: Abdel Fattah
Note drugs administered/how placental separation
et al . (1991), Scottish Dental Vocational Training Committee
was con® rm ed/blood loss.
(1993).
(9) What was the outcome of labour?
Note sex of baby/birthweight/Apgar scores.
(10) What care/adm inistration was perform ed after the
delivery?
In the case of breast-feeding m others, note the time The emphasis in study guides for som e special study
of the ® rst feed. modules is on student activities during the module as identi-
(11) What preparation did the mother receive prior to her ® ed at G , although some contain core content inform ation
labour? as an introduction to the module.
Indicate what opportunities for choice were given to
her.
(12) What concerns did the mother have about labour? (4) M anagement-orientated study guide
M ake a note about the response of the mother and
A training guide produced for dental vocational trainees
her partner to the birth.
emphasized the management function of a study guide.
(13) Note three key lessons learned from this topic.
This is illustrated in Figure 4. The guide emphasizes how
Source: M ires et al . (1998). the trainees can make best use of the learning opportunities
Note: In the guide, space is allocated after each question available to them. The guide adopts a task-bas ed approach
for students’ responses. (Harden et al., 1996a, 1996b) and is divided into six sections,

259
R.M . Harden et al.

Figure 5. Example of a page from SELECT programme produced by the Royal College of Surgeons of Edinburgh and the
Centre for Medical Education, Dundee.

each covering a task that the trainees encounter in their
clinical practice. Each section has ® ve parts:
(1) an advance organizer for the trainees’ studies relating to
the task;
(2) a note of the com petences expected of the trainee by
the end of the learning program me, related to the tasks;
(3) guidelines and a suggested sequence for learning;
(4) a self-assessm ent table which enables the trainees to
m onitor their achievements;
(5) a sum mary of the learning resources referred to in
different parts of the text.

260
 AM EE G uide No. 16

Figure 6. Two pages from the section on neonates in the `Learning paediatrics: A Training Guide for Senior House Officers’
study guide. Note: Produced by the Centre for M edical Education, University of Dundee, with funding from the Scottish
Council for Postgraduate M edical and Dental Education. The ® rst page provides useful information for the trainees when
dealing with neonates and the second page from later in the section helps to guide the trainees’ learning as they deal with
neonates.

(5) Inform ation-orientated study guide (6) U se of the study guide triangle

E represents the study guide for the SELECT programm e
for surgery trainees. A greater emphasis is placed in this
guide on the provision of core information.This is illustrated
in Figure 5. It also contains advice on studying and training,
and recommended activities.
A pocket-sized training guide with an emphasis on the
provision of information as well as the management of the
trainees’ learning was developed to support on-the-job
learning for senior house officers in paediatrics (Mitchell et
al., 1998). The guide adopted a task-based approach using
common clinical problem s as the focus for the learning.
The ® rst section in the guide relating to each task included
key information on managing the clinical problem . This was
designed to support the day-to-day work of the junior doctor.
A second section provided advice on how to relate the
learning opportunities to a study of the task. These learning
opportunities were grouped under themes such as clinical
assessment, practical procedures and teamwork. An example
of the two sections is shown in Figure 6.
Study guides can be located along the boundaries or within
the triangle as illustrated by the exam ples provided.You will
® nd the triangle helpful when thinking about your own
study guides. Given the traditional values of most teachers
and the perceived importance of subject content, there is a
tendency for guides to gravitate to the information corner
of the triangle. This has to be guarded against. In som e
cases an emphasis on information m ay be appropriate but,
for the most part, more emphasis should be given to the
management of learning and to the engagement of the
student or trainee with activities.
Preparation of a study guide
This section outlines the steps in the preparation of a study
guide. It describes what requires to be done in three areas:
(1) decisions about functions and form of the guide;
(2) relation of the study guide to the curriculum;
(3) writing the study guide

261
R.M . Harden et al.
Tim e sp en t in th e pre paratio n of a stu dy g uid e is
well rewarded. Students are likely to m ake very good
use of well-produced guides but m ay not read those wh ich
are unattractive or poorly compiled (Holsg rove et al.,
1998).
(1) D ecisions about fu nctions and for m of the guide
Identify the unit of lear ning : The unit of learning is the
topic or th eme for each study guide. The length of a
gui d e w il l va r y w i th the c irc u m stan c e s an d l on g e r
study guides can be broken into par ts or sections. In
the Dundee undergraduate program m e (Harden et al.,
1997), for example, a study guide was prepared for each
of the 12 system-based courses in the early years of the
curriculum .
In th e later years, where a task-based approach (H arden
et al., 1996a, 1996b, 1999b) was adopted, one hundred
tasks, e.g. management of a patient with abdominal pain,
were identi® ed as a focus for the students’ lear ning and a
guide was produced for each task with the guides arranged
in groups of sim ilar tasks.
D ecide the pur pose of the guide : Is the function of the guide to
provide students with content inform ation, to help them to
manage their learning or to provide activities which might
be used as a portfolio or record of their achievements? You
may ® nd it helpful to try to locate the function of your study
guide in the study guide triangle (Figure 3). This encour-
ages you to consider the needs of the students, the resources
available and the value of the guide as a record of student
achievement.
D ecide the com ponents for your study guide : The checklist in
Figure 2 summarizes the possible components. What you
include in your guide should re¯ ect its purpose.
If you include references to books, think of these as m ore
than a book or reading list. Give speci® c references to pages
and paragraphs and indicate what the students should gain
from their reading. It is best to use a small number of core
texts to which students will have easy access. If students
have a choice of more than one book, the references should
be provided for each of them.
D ecide the form at for the guide: The guide may be in paper or
electronic format.While some schools still use paper versions
of their guides, others have adopted an electronic format
(Ross & Davies, 1999).
Electronic guides offer a number of advantages (Harden
& Smyth, 1994):
· It m ay b e less c ostly th an the pape r p rod uc tio n,
although the com puter overheads need to be taken into
account.
· The guide m ay be m ore readily available to students in an
electronic form.
· Links within the guide can help the student to navigate
between different sections of the guide in response to
their personal needs.
· Students can use the guide as the basis for the develop-
ment of a personal information bank stored electroni-
cally.
262
· There are fewer content restrictions and greater freedom
with regard to the amount of information included and
the use of colour and video sequences.
· It encourages computer literacy.
· The com puter version can be updated more easily.
· Computer-based study guides can be used to provide
different levels of instructional cues that match students
to their highest level of independent interaction with the
guide.
Com puter facilities, however, m ay not yet be widely
available in all settings to support an electronic study
guide.
Consider the packaging and portability of the study guide : Should
the guide be loose-leaf so that the student may add additional
pages? Is it intended that the students carry the guide in
their pocket?
A training guide for junior doctors in paediatrics was in
loose-leaf format and measured 8.5 x 11.5 cms (Mitchell et
al., 1998). In contrast, the SELECT guide for surgery
trainees was bound and presented in A4 format.
An added advantage of th e loose-leaf form at adopted
for the paed iatr ic g u ide w as th at sec tion s c ou ld be
individualized to the needs of the different hospitals in
which the trainees were working. Inform ation speci® c to a
locality such as the library arrangem ents, or staff acting as
educational super visors, was located in this section of the
guide.
D evelop the educational design and layout for the guide :
· Should the guide be divided into sections, and if so on
what basis?
· W hat e du c at ion al strat e gy shou ld b e ado pte d for
th e guide? A study guide on the thyroid gland for third-
year students, for exam ple, was problem-based (H arden
et al., 1999c). Each of the four sectionsÐ hyper-
thyroidism , hypothyroidism , non-toxic goitre and pain
in th e thyroid glandÐ was introduced by a clinical
proble m . The guid e led th e stu de nts th rou gh th e
investigation and m anagem ent of the problem . As they
worked through the problem s, students were directed
to th e le a r n i n g o pp o r tu n i tie s avai la bl e . S tu d e n ts
acquired, in the process of working through the problem s
in the study guide, the necessar y com petences related
to thyroid disease.
· W ill a two- or one-colum n layout be adopted? If a
two-colum n layout is used, what will be the function of
each column? A typical page from the SELECT pro-
gramme study guide is shown in Figure 5. There are two
colum ns with the core information on the left column.
The right column is designed to enhance the left column
material and expand the trainees’ understanding of the
topic. It includes short succinct `inform ation bites’ which
could be further reading, quotes, comments and activi-
ties.
· W ill icons be used to provide visual cues? In Figure 5,
graphic sym bols (icons) are used to enable the trainee
to identify easily the functions of different par ts of
th e prog ram me. Note the emphasis on this page on the
provision of inform ation. The trainee is encouraged
to interact with the m aterial through the `T hink’ icons
 AM EE G uide No. 16

Table 4. Extract from grid from dental vocational training guide.

Tasks perform ed by the trainee in a dental practice

Aims of the training year Caries and A Acute dental An Partial or M inor
restorations periodontal pain endodontic complete surgical
patient problem denture procedure

(d) Competence in
implementation of
treatm ent plans
Surgical techniques + + + + ± +
Preparing kits ± ± ± + ± +
Taking impressions ± ± ± ± + ±
Fitting inlays, crowns and ± ± ± ± + ±
appliances
Adjustments and + ± ± ± + ±
m odi® cations of ® llings and
appliances

Key to symbols + Applies; ± M ay apply in certain conditions; ± Does not apply.

Source : Abdel-Fattah et al . (1991).

in the left colum n and th e `to do’ icons in th e right Plan the preparation of study guides using a series of g rids :
colum n. Look also at the use of icons in Figures 4 Study guides facilitate learning by relating the expected
and 6. learning outcomes to the learning opportunities and courses
· W hat is the role of illustrations and photogr aphs? These available, as shown in Figure 7. O n one grid plot the overall
play an important part in a study guide if the provision of course learning outcomes against the range of study guides,
inform ation is a function. or the individual sections of a longer guide. The extract
· W hat typeface will be used? In his book Kem ber (1991) from the dental training guide in Table 4 is an exam ple of a
describes in more detail the presentation of study guides section of such a grid showing how the training aims are
and the use of typography and visuals. achieved through a study of the six `tasks’ which are the
· W hat about house style? If a num ber of study guides focus for the guide.
are being produced, it is useful to prepare a tem plate
for their production. Holsg rove et al. (1998) repor ted
that stud e nts ® nd it m o re diffic u lt to use g u ide s
where each has a different layout. They suggested that
a n ag re e d `h ou se style ’ for stud y g u id es c onvey s
important messages about the quality and cohesion of the
curriculum.

W ho w ill contribute to the production of the guide? A team

approach is advisable. M embers might include:

· content experts perhaps from different specialities and

backgrounds;
· educationists with experience in the curriculum planning
and the production of guides;
· graphic designers/DT P operators.

Experience has shown us that a coordinator is pivotal in the

production of study guides.
(2) Relation of the study guide to the curriculum
Identify the expected lear ning outcom es: These should be clearly
stated in the guide.
Identify the learning opportunities : Show how the learning
opportunities available as part of the educational pro-
gramme can contribute to the students’ understanding of
the subject.
F igure 7. Study guides facilitate learning by relating the
expected learning outcomes to the learning opportunities
and courses available.
A grid was used in the development of the paediatric
study guide. It related the tasks that were the focus for the
different sections of the guide to the areas of competence.
An extract is given in Table 5 for four tasks and two
outcomes.

263
R.M . Harden et al.
Table 5. Extract from grid showing relationship between tasks and outcomes in paediatric training guide.
Outcome Convulsions Dehydration
Practical procedures Admin. of rectal IV access
diazepam
Com munication skills Discuss prognosis of Explain how to give
febrile ® ts oral rehydration
Source: M itchell et al . (1998).
The front page of the task-based study guides used in
the Dundee curriculum (H arden et al., 1999c), highlights
how a study of th e task contributes to the achievement of
the learning outcom es. The guide describes how this is
achieved through the learning opportunities and clinical
attachm ents. A second grid can look at this relationship
between th e outcom es and th e lear ning oppor tunities.
Each lear ning opportunity will contribute to only some of
the outcom es, but together all the outcom es should be
covered.
(3) W riting the study guide
· Decide what fu rther infor m ation, if any, needs to be
prepared for inclusion in the guide.
· Plan activities to be incorporated into the guide. Consider
how the guide, if it is being used as a record of achieve-
ment, can be used as part of the assessment process.
· Pay attention to the style of w r iting. In general, this
should be user friendly and inform al and written in the
® rst person, e.g. ª you will ® nd that . . .º , ª last year
students . . .º .
Here is an example from the beginning of the training
guide for dental vocational trainees.
· Arrange critical readers to review the guide and develop-
m entally test it with a sample of students for whom the
guide is designed. This testing can lead to signi® cant
improvements in the content and design of the guide.
· Evaluate and update the guide after it is in use. Encourage
students to annotate their copies of the guide with
suggestions for improvem ent. It is important to keep
guides up to date with changes in th e curriculum and
the resources available. They should be reviewed each
year with this in m ind and any changes incorporated
into the guide.
264
Task
Pyrexia Breathlessness
Lum bar puncture Use of peak ¯ ow meter
Counsel parents M inimize anxiety while
giving a maximum of
realistic information
C onclu sion
There are good reasons why the concept of study guides is
attracting increasing attention as an aid to teaching and
learning. A study guide can be seen as a managem ent tool
that allows teachers to exercise their responsibilities while at
the same time giving students an important part to play in
managing their own learning. This is true in both under-
graduate and postgra duate education.
The study guide can lead to more effective and efficient
learning. This is achieved in a number of ways as we have
described. It can help the students to look at the course
content in the broader context of the overall curriculum. It
can clarify the expected learning outcomes and can ensure
that students make the best possible use of the available
learning resources and learning opportunities. It can suggest
appropriate learning strategies for the students. It can prepare
the student for examinations.
The study guide may be used as a workbook, giving
students more precise instructions as to what activities are
expected of them. Students may be asked to undertake a
task or series of tasks, to review a particular area and to
document and analyse their ® ndings with regard to the task
undertaken or the review. Records can be kept as part of the
study guide, which can provide a basis for either formative
or summative assessm ent of the students.
The study guide can give the student ready access to
inform ation through speci® c references to available books
or journals, through the inclusion of extracts from published
material in the study guide and in the form of material
produced by the author. Hodgkinson (1994) emphasized
that study guides should take account of the individual
learner’s motivation and need to be:
ª m ore and less
attractive serious
supportive instructive
user-friendly dense
interactive didactic
varied uniformº
He goes on to suggest that study guides should give a clear
sense of direction and that they should offer frequent rewards
and should encourage thinking, re¯ ection and involvement
by the learner.
Key features of study guides can be summarized as 10
`I’ s. Study guides are:
(1) important, in term s of contributions they can make to
the education process;

(2) interesting for the learner, if appropriately designed;
(3) imm ediately available as support for learning;
(4) inspiring or motivating for the student;
(5) informative in communicating to students and teachers
what the learner needs to know;
(6) illustrative , by illustratin g th eor y with practical
exam ples;
(7) integrating, by bringing together different disciplines
and different contexts for learning such as the hospital
and community;
(8) interactive, with active involvement of the learner;
(9) iterative, encouraging students to revisit areas previ-
ously studied and to build on their knowledge or an
understanding of the topic;
(10) impacting, with potentially a profound effect on the
learner.
A cknowledgem ents
We are grateful to all who contributed to the Study Guides
referred to in this booklet. Copies of the paediatric study
guide are available from the Centre for M edical Education,
Tay Park House, 484 Perth Road, Dundee, DD2, 1LR, the
PA SS guide from th e Royal C olleg e of Surge ons of
Edinburgh, Nicolson Street, Edinburgh EH8 9DW, The
Royal C ollege of Physicians and Surgeons of Glasgow,
232± 242 St Vincent Street, Glasgow G2 5RJ and the Royal
College of Surgeons in Ireland, 123 St Stephen’s Green,
Dublin 2, Republic of Ireland, and individual modules of
the SELECT guide from the Royal College of Surgeons of
Edinburgh.
No tes on contributors
R. M . H ARDEN is Professor and Director of the Centre for Medical
Education and Teaching Dean, Faculty of M edicine, Dentistry and
Nursing at the U niversity of Dundee. He is also Director of the
Education Developm ent U nit (Scottish Council for Postgraduate
M edical & Dental Education), Dundee, U K.
JENNIFER M . L AIDLAW is Assistant Director of the Education Develop-
m ent Unit, Dundee, U K.
E. A NNE H ESKETH is Senior Education Developm ent Officer at the
Education Development U nit, Dundee, U K.
R eferences
A BDEL -F ATTAH , A.M .A., H ARDEN , R.M . & L AIDLAW , J.M . (1991 ) A
new approach to vocational training, Medica l Education, 25, p. 116.
B OU D , D., C O HEN , R. & WALKER , D. (E ds) (1993 ) Using Experience
for Learning (M ilton Keynes, Society for Research into Higher
Education and Open U niversity Press).
B ROW N , J.S., C O LLINS , A. & D U G U ID , P. (1989 ) Situated cognition
and the culture of learning, Education al Researche r, 18, 1, pp. 32± 42.
D AVIS , M .H. & H ARDEN , R.M. (1999 ) Problem -based learning: a
practical guide, Medica l Teacher 21(2) , pp. 130 ± 140.
D OLM ANS , D., S C HM IDT , A., VAN D ER B EEK , J., B EINTEM A , M . &
G ER VER , W.J. (1999 ) Does a student log provide a m eans to better
structure clinical education? M edica l Education, 33, pp. 89± 94.
G ENN , J. & H ARDEN , R.M . (1986 ) W hat is m edical education here
really like? Suggestions for action research studies of climates of
m edical education environm ents. Medical Teacher 8(2), pp. 111± 124.
H ARDEN , R.M . (1988 ) W hat is . . . distance learning?, Medical Teacher,
10(2) , pp. 139 ± 145 .
AM EE G uide No. 16
H ARD EN , R.M ., C RO SBY, J.R. & D AVIS , M.H. (1999a) An introduc-
tion to outcom e-based education, M edical Teache r, 21(1) , pp. 7± 14.
H ARD EN , R.M ., C ROSBY , J.R., D AVIS , M.H ., H OW IE , P.W., & S TR U -
TH ER S , A.D. (1999b ) Task-based learning: the answer to integra-
tion and problem -based learning in the clinical years, Medical
Education (in press).
H ARDEN , R.M ., D AVIS , M .H . & C ROSBY, J.R . (1997 ) The new Dundee
m edical curriculum : a whole that is greater than the sum of the
parts, M edica l Education, 31, pp. 264± 271.
H ARD EN , R.M ., L AIDLAW, J.M ., K ER , J.S. & M ITC HELL , H . (1996a)
Task-based learning: an educational strategy for undergraduate,
postg raduate and continuing m edical education. Part 1. AM EE
M edical Education Guide No 7, Medica l Teache r, 18, pp. 7± 13.
H ARD EN , R.M ., L AIDLAW , J.M ., K ER , J.S. & M ITCH ELL , H. (1996b)
Task-based learning: an educational strategy for undergraduate,
postg raduate and continuing m edical education. Part 2. AM EE
M edical Education Guide No 7, Medica l Teache r, 18, pp. 91± 98.
H ARD EN , R.M ., L EESE , G . & L AIDLAW , J. (1999c ) Problem -based
study guides, M edical Teache r (in press).
H ARD EN , R.M . & S MYTH , J.J. (1994 ) Computer-based study guides
II: educational com ponents and advantages, M edical Teache r, 16(4),
pp. 315 ± 321.
H ARD EN , R.M ., S OW DEN , S. & D U NN , W.R. (1984 ) Some educational
strategies in curriculum developm ent: the SPICES m odel. ASME
M edical Education Booklet No.18, M edical Education, 18, pp.
284± 297.
H ARD EN , R.M . & S TAM PER , N. (1999 ) W hat is a spiral curriculum ?
M edical Teache r, 21(2) , pp. 141 ± 143.
H ARD EN , R.M ., S TEVENSO N , M ., L EVER , R., D U NN , W.R., H OLROYD ,
C. & W ILSON , G.M . (1975 ) Tape/slide program mes for independent
study, B ritish Jour nal of M edical Education, 9(3), pp. 170 ± 175.
H ILL , D.A., M C C AR THY, W.H . & G U INEA , A.I. (1995 ) Learning to
m anage patients w ith acute abdom inal pain: a study guide for
m edical students, M edica l Teache r, 17(1) , pp. 25± 30.
H ODG KINSON , K. (1994 ) Course guides for ¯ exible learning, in: W.
WADE , K. H ODG KINSON , A. S M ITH & J. A RFIELD (E ds) Flexible
Learning in Higher Education, pp. 57± 67 (L ondon, Kogan Page).
H OLSG ROVE , G.J., L ANPHEA R , J.H . & L EDINGH AM , I.M C A. (1998)
Study guides: an essential student learning tool in an integrated
curriculum , M edica l Teache r, 20(2) , pp. 99± 103.
H OR TON , S.V., B O ONE , R.A. & L OVITT , T.C. (1990 ) Teaching social
studies to learning disabled high school students: effects of a hyper-
text study guide, B ritish Journal of Educational Technology, 21(2), pp.
118± 131.
K EM BER , D. (1991) Writing Study G uides (Bristol, Technical and
Educational Services).
K OLB , D.A. (1984 ) Experiential Learning: Experience as the Source
of Lear ning and Development (E nglewood Cliffs, NJ, Prentice-Hall).
L AIDLAW , J. & H ARDEN , R.M . (1990 ) W hat is . . . a study guide?,
M edical Teache r, 12, pp. 7± 12.
M IRES , G.J., H OW IE , P.W. & H ARD EN , R.M . (1998 ) A `topical’
approach to planned teaching and learning using a topic-based
study guide, Medical Teacher, 20(3) , pp. 438± 441.
M ITC HELL , H.E., H ARDEN , R.M . & L AIDLAW , J.M. (1998 ) Towards
effective on-the-job learning: the developm ent of a paediatric
training guide, Medical Teacher 20(2) , pp. 91± 98.
P AR SELL , G. & B LIG H , J. (1996 ) Contract learning, clinical learning
and clinicians, Postgraduate M edical Jour nal, 72, pp. 284± 289 .
R OSS , N. & D AVIES , D. (1999 ) Outcom e-based learning and the
electronic curriculum at Birm ingham M edical School, Medical
Teacher, 21(1), pp. 26± 31.
R OW NTREE , D. (1986) Teachin g Through Self-Instruction (L ondon,
Kogan Page).
S CO TTISH D ENTAL VOC ATIONA L TRAININ G C O M M ITTEE (1993) A
Training Guide (D undee, Centre for M edical Education).
S NADDEN , D. & T HOM AS , M . (1998 ) T he use of portfolio learning in
m edical education, M edical Teache r, 20(3) , pp. 192 ± 199.
265