This study revealed that the teaching method in the college is largely teacher-centred (content-oriented) rather than student-centred (learning-oriented) with very limited role for students in the teaching process. Iraqi medical colleges in general follow traditional teacher-centred curriculum since the establishment of the first medical college in Iraq in 1927 [11
]. Undergraduate medical curriculum in Hawler Medical College is not much different from that of the rest of Iraq. Few changes have been adopted by the college like introducing small group teaching in 5th
year since 2007 to meet increasing complexity of medical education and to prepare more qualified doctors in the future. Although implementing small group teaching in the 5th
year was a good step but it was not well planned and adequate infrastructure was not available for successful implementation of this method of teaching.
Use of different teaching aids by teachers in the classroom, having a small group teaching, participation of students in discussion in the classroom were recognized as the main positive aspects of the current teaching system. Use of audio-visual teaching aids in the classroom is widely used in the college and it is well perceived by the students. Small group teaching is an important component of undergraduate medical education; many medical schools around the world have adopted this strategy of teaching to make the classes more interactive and to give opportunities for students to take part in discussion [13
Many negative aspects or problems were reported about the current teaching methods including large number of students in the lecture hall, teacher-centred curriculum, lack of facilities and infrastructures suitable for proper teaching. Admission to medical colleges in Iraq is solely based on high school marks, in which students with the highest marks were admitted. In Kurdistan Region there are only three medical colleges and there is rapid increasing population in the region due to many factors including that the region is secure in comparison to the other parts on Iraq [15
Different themes were reported as priorities to improve the quality of teaching methods particulary application of small group teaching in all years of study in the college, improving the infrastructure and teaching facilities, continuous training of the teaching staff about updated methods of teaching, changing current teaching methods into more interactive giving more active role for students in the learning process. Due to lack of suitable infrastructure and facilities, small group teaching is only implemented in 5th year and on small scale in other years of study like practical sessions in preclinical years and clinical sessions in clinical years.
While many positive aspects and problems facing teaching methods as well as recommendations mentioned by the participants of this study are similar to the finding of other studies done in other countries, there are some new problems and recommendations emerged from the results of this study. Problems like depending on lectures and other didactic methods where the activity is teacher–centred were also reported by studies conducted in other countries like Saudi Arabia [16
] and Iran [17
] and the problem of inadequate number and poorly trained teaching staff was reported by studies from Libya [1
] and Saudi Arabia [18
]. Lack of suitable infrastructure and facilities for teaching was reported also in Saudi Arabia [16
] and Iran [17
] and the problem of large number of students reported in Iran study [17
]. New problems emerged from this study included poor teacher-student relationship, inadequate practical and clinical sessions, poor interest and participation of the students in the classroom.
The priorities to changing the curriculum toward more student-centred were also reported by other studies from Libya [1
], Saudi Arabia [16
] and Iran [17
]. Priorities for increasing number and training of teaching staff were also reported by studies from Libya [1
], Iran [17
] and Saudi Arabia [18
]. Improving the infrastructure and facilities to be suitable for proper teaching was reported by a study from Saudi Arabia [16
]. Other priority needs emerged from this study included more focus on practical and clinical sessions, building better relationship between teacher and students, using more teaching aids and skill laboratories in the learning process, regular feedback from students, getting use of the experience of other medical colleges of neighbouring countries, revising the examination system and improve cooperation between different departments in the college.
More than half of the respondents (51.8
%) have heared about student-centred learning approach and those were unsure as to what the term meant. This finding is a positive point since the research was conducted at a university which did not adopt the student-centred learning approach as learning and teaching strategy on large scale yet.
Seven different definitions of student-centred learning emerged from the data. Most teaching staff (44.1
%) held the following definition:
"Interactive sessions in which students are active and participate in discussion in the classroom".
We anticipated this difficulty in examining teaching staff belief about student-centred learning because it is a broad term and have been described differently by different authors [6
Some of the teaching staff described their own clinical teaching (38.0
%) and practical sessions (33.3
%) as student -centred learning. Indeed, they viewed any activity in which students are active and working in group with their classmate as student-centred.
The use of qualitative approach with open-ended questions in this research involves several limitations that require consideration. Because qualitative research involves complex analysis and interpretation of the issue under investigation, this makes it difficult to be conducted in areas with little experience about this type of research like Iraq [21
]. In open-ended questions, respondents usually face problems in completing the questions being of different level of education, background, and teaching experience [22
Since this study has only involved Hawler College of Medicine, its findings might not be generalizable to other universities in Iraq. However, based on our knowledge we think that the general situation of the teaching methods in the other universities in Iraq might be similar to a large extent.