Medical teaching is an evolving and modernizing process that substantially requires that both students and teachers continuously reflect and upgrade upon themselves to improve learning and teaching (Koh et al., 2008). This is a huge challenge, as teachers must impart a large amount of medical knowledge within a limited time frame, so that students can not only remember and understand, but also be able to interpret and apply their knowledge for future internships or clinical practice. This has led to a crucial shift for most medical schools needing to reorganize their curriculum and adopt new methods of learning and teaching to varying degrees from traditional didactic teacher-oriented and basic subject learning-centered teaching to interactive, student-centered or problem-based teaching methods (Koh et al., 2008; Samarakoon et al., 2013). Researchers suggested that this approach to learning styles was beneficial for both teachers and students because teachers could adjust pedagogy according to students' learning styles and students would be empowered to use the best techniques suited to their learning styles, resulting in better educational satisfaction and better learning outcomes (Busan, 2014; Samarakoon et al., 2013).
Learning is the process whereby knowledge is created through the transformation of experience (D. A. Kolb et al., 1984). Each student has his own unique way of learning to acquire, process, memorize and recall information. Learning styles differ from one learner to another and each has specific attributes to learning and the methods by which they can cope with the learning environment. Students may adapt one or more preferred learning styles to acquire new knowledge. Learning styles also play a major role in students' preference for certain teaching approaches and learning environments (Witkin, 1973). Learners consistently have styles that they believe are reasonable enough to apply in their setting to help them attain the most positive learning outcomes (JilardiDamavandi et al., 2011). Although there are many different types of learning styles with different conceptual models, the Attitudes Toward Thinking and Learning Survey (ATTLS) model is one of the most common ones, designed to help learners better understand their own personal learning preferences (Galotti et al., 1999). Procedural knowing, which is the process of obtaining, reacting to, evaluating, and communicating knowledge, has been given the greatest attention in ATTLS. Belenky et al. identified two distinct types of procedural knowledge, which they called "separate" and "connected" knowing (Belenky et al., 1986). In a separate knowing, something is objectively, analytically, detachedly evaluated, often thought of as being the same as "thinking." In contrast, connected knowing involves aligning oneself with another's point of view, even if it differs from one's own. The concept of procedural knowledge (also known as practical knowledge, imperative knowledge, or performative knowledge) refers to knowledge that is used to perform a task.
Medical education teachers are entrusted with a mission to emphasize individual differences and to effectively achieve their learning needs. Understanding learning styles and attitudes will help teachers develop appropriate approaches to their students' education-orientated approach to the preferred method of learning. Students' learning processes are determined by their individual differences in learning, which is an important factor in improving their academic performance (Nuzhat et al., 2013; Samarakoon et al., 2013). Learning styles and attitudes vary according to students' tendency to understand, consolidate, process information, and acknowledge learning experiences. Therefore, each student has different learning strategies and attitudes based on their distinct individual differences. Different learning methods have been proposed to determine students' learning styles. Kolb's learning style, the creation of knowledge through experience, is one of the most prominent methods used by educators to create a more effective learning experience (A. Y. Kolb and Kolb, 2009). Both Kolb's (1984) learning stages and cycles could be used by teachers to critically evaluate the learning provision typically available to students, and to develop more appropriate learning opportunities and strategies to improve their learning outcomes (D. A. Kolb et al., 1984). Medical teachers should ensure that activities are designed and carried out in ways that offer each student the chance to engage in the manner that suits them best. Medical students can also be helped to learn more effectively by the identification of their lesser preferred learning styles and the strengthening of these through the application of the learning cycle.
Launched in 2013, the bachelor’s degree in medicine scholarship for students from diplomatic allies is funded by the Ministry of Foreign Affairs (MOFA) of Taiwan and overseen by Taipei City-based International Cooperation and Development Fund (ICDF), the country’s foremost foreign aid organization. Participants attend the School of Medicine for International Students (SMIS) of the I-Shou University, a division of the university’s College of Medicine established specifically for the initiative. The SMIS curriculum is divided into two stages. For their first two years, students take general education and medical science curricula at ISU in fields ranging from genetics and human morphology to microbiology and physician-patient communications. All of the lessons are conducted in English, with the exception of mandatory Mandarin language classes. In the final two years, students complete clinical clerkships through participating in rounds and outpatient care at one of two nearby health care facilities, E-Da Hospital and E-Da Cancer Hospital. Both institutions, along with ISU, are affiliated with the Kaohsiung-based conglomerate E United Group (Her, 2018).
This is a unique post-baccalaureate medical education program exclusively for foreign students in Taiwan. In the context of ongoing changes in the theory and methodology of teaching, student-centered practices are crucial in improving teaching and learning outcomes and are especially important for students from many countries. Thus, this study aimed to explore learning styles and attitudes towards curricula among post-baccalaureate medical students during the first two years of their participation in the teaching process. In addition, it attempts to determine the effects of students' grade, gender, and nationality on the connected and separate knowing of learning styles and attitudes associated with the medical science curricula.