Curriculum Inventory in Context
November 2015 Volume 2, Issue 11
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Monitoring Instructional Hours
Why should we monitor instructional hours? At the most basic level, the information helps us consider
time allocations and compare educational programs. Such baseline information is used to consider what
is normative and evaluate the use, underuse or overuse of curricular time. This matters because
meaningful learning, retention and application of knowledge requires more than exposure—it requires
time to reflect, actively engage with material, and recognize its relevance, all of which takes time.
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Monitoring how curricular time is used is a standard part of managing a curriculum. Programs report the
number of required weeks and contact hours and the average number of scheduled hours per week that
students spend in required activities during the first and second years of the curriculum. The need for
students to have sufficient time to learn and retain content more meaningfully is captured in Element 6.3
of the Liaison Committee on Medical Education (LCME)’s accreditation standards. This standard requires
schools to report “required activities outside of regularly-scheduled class time, such as assigned reading
or online modules that include information to prepare them for in-class activities,” although this does not
include time that students spend in assigned work outside of class.1 A recent LCME policy on distance
learning (including temporally distant learning such as asynchronous instruction) reinforces the need to
assure that students have sufficient protected time for independent and self-directed learning.2
Until recently, instructional time and required activities were relatively easy to determine. These
generally reflected the amount of time students were in the presence of a faculty member providing
instruction-- essentially “seat time.” Instructional technology now provides opportunities for instruction
to be accomplished asynchronously. Asynchronous instruction offers many benefits, but accurate
estimations of the demands placed on student time is challenging. While it occurs outside of formal class
meetings, it may not be equivalent to other kinds of independent learning.
Concerns associated with asynchronous learning recently were identified in a study of the large-scale
adoption of the “flipped method” by a pharmacy school.3 The flipped classroom method requires
students to engage in pre-class preparation, frequently recorded lectures but also activities such as
discussion boards or readings. These pre-class requirements are often graded. When 10 courses adopted
the flipped classroom method concurrently, several concerns were identified, some of which relate to
instructional hours. One problem related to instructional time involved the increased workload shifted to
out-of-class hours by these pre-class requirements. Students described the amount of pre-class
preparation for multiple courses as frustrating, excessive and overwhelming. Faculty often
underestimated the amount of time required to complete the assignments. In addition, students reported
frustration with the “double lecture,” which occurred when pre-class lectures were followed by in-class
lectures over the same material or over new material rather than using the time for active learning or
problem solving to deepen comprehension of pre-class content.
This highlights the problem of how to categorize pre-class required activities and what should be reported
as instructional hours or required activities. The LCME policy states that instructional hours do not include
time that students spend in assigned work outside of class. This is understandable when it pertains to
students’ self-governed attempts to master material over an extended time frame, but when the outside
of class requirements involve shifting activities that were previously covered in-class (e.g., a recorded
lecture or pre-class discussion) and especially if it involves a brief time frame, these methods may
effectively annul a student’s ability to manage their study time.
MedBiquitous defines Independent Learning as “Instructor-/ or mentor-guided learning activities to be
performed by the learner outside of formal educational settings (classroom, lab, clinic).”4 This definition
fits with pre-class preparation for flipped classroom sessions. However, if medical education programs
categorize required pre-class preparation as independent learning, is this an accurate representation of
the type of work that is occurring? The independent learning required for asynchronous instruction is less
under the student’s control. Required pre-class activities need to be distinguished from other activities
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such as studying for exams or preparing presentations, which are also “required,” but do not have the
same acute impact on student time and are not reported in term of instructional hours. It is difficult to
gauge the amount of readily available unstructured time if both self-governed study and pre-class
requirements are considered independent learning. Developing policies on pre-clerkship workloads to
protect independent and self-directed study time is challenging when a category like independent
learning might be used to describe activities that functionally affect student time differently.
The questions raised about how to conceptualize instructional time indicates the need for serious
consideration of how to accurately reflect instructional methods and capture the time they require. The
MedBiquitous Curriculum Inventory Standardized Vocabulary list has recently moved the term “selfstudy” as a synonym for Independent Learning to a synonym for Self-Directed Learning. This should help
emphasize that activities that are preparation for specific learning activities should be categorized as
Independent Learning. This should help distinguish these requirements from student self-study, which
students govern themselves, and enable tracking required activities that occur outside of formal settings
but which consume self- study time. Monitoring the impact on time will be important as asynchronous
instruction evolves. It may require faculty development to assure that asynchronous instruction does not
create time burdens that functionally undermine the goals of engagement and contextual learning that
Independent Learning has the potential to foster.
About the Author
K. Ramsey McGowen, PhD, is Associate Dean for Curriculum and Associate Chair in the
department of Psychiatry and Behavioral Sciences at Quillen College of Medicine, East
Tennessee State University.
References
1. Liaison Committee on Medical Education. 2016-2017 Data collection instrument for full
accreditation surveys. http://www.lcme.org/survey-connect-dci-download.htm#16-17 Accessed
Nov 16, 2015.
2. Liaison Committee on Medical Education. Accreditation Issues Related to Spatial and Temporal
Distance Learning. http://www.lcme.org/publications.htm Accessed Nov 16, 2015.
3. Khanova J, Roth MT, Rodgers JE, McLaughlin JE. Student experiences across multiple flipped
courses in a single curriculum. Med Educ 2015: 49: 1038–1048.
4. MedBiquitous Curriculum Inventory Working Group Standardized Vocabulary Subcommittee.
(2012). Curriculum Inventory standardized instructional and assessment methods and resource
types (September 2012 version). Washington, DC: Association of American Medical
http://medbiq.org/curriculum/vocabularies.pdf Accessed Nov 16, 2015.
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