Approaches to learning in pre-medicine: a multi-university mixed-methods study

Across three international cohorts, Deep and Strategic approaches predominated, with modest between-site differences, and approach-achievement links were limited after accounting for background factors. Qualitative data highlighted context-responsive switching and the role of practical strategic behaviours in managing assessment demands. Rather than aiming to shift students to a single "ideal" approach through curriculum change, programmes may achieve more by teaching self-regulated study skills, refining assessment/feedback to discourage unhelpful surface tactics, and targeting transition supports for students with differing educational and language backgrounds.