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We read with interest the paper by Dr Lockey describing the different learning approaches that may be taken by students.1 We are aware that the field of educational psychology is woolly and littered with many definitions and it may be difficult to give a brief overview of learning approaches. The author has made a valid point in suggesting that as doctors we are expected to teach but are rarely trained in the teaching process. The author goes on to describe how there are essentially two learning approaches adopted by students: “surface” and “deep”. We are then told how deep learning is superior to surface and that as educators we should attempt to promote deep learning.
This is fine. However, Dr Lockey has made an important omission in his paper. The author has failed to describe a third and very important learning approach. That is the “strategic” approach as described by Miller and Partlett.2
The strategic learner is a success driven person who approaches the learning process as a game where a high mark is the end point. These people will focus only on what they perceive to be relevant to exam success and disregard additional information. They may attempt exam prediction or even attempt to obtain inside information from authority figures. This approach results in poor long term recall and patchy subject knowledge. McManus et al have shown that medical students with the most clinical experience do not perform best in final exams but deep and strategic approaches do correlate well will exam success.3 The worry here is that as medical students these people may flourish in exams but as clinicians lack the knowledge base or understanding to work safely or effectively.