**2. Theoretical background**

The dominant conceptual approach today [7] is that most learning should be active so as to enhance the student's abilities and adapt them to the period and its demands [8]. This approach challenges both teachers and students because of the total change in the setting of learning goals and the perception of the learning process. The change requires a shift from teacher-centered pedagogical approaches to approaches in which the students and the development of their learning abilities are at the center. This shift constitutes an important element in adapting academic teaching to 21st-century needs and ensuring that the student becomes a lifelong learner [9].

Student-centered teaching methodologies have existed for years to various extents in educational institutions, but most teachers view them with suspicion and prefer to cling to traditional methodologies [10]. Resistance to student-centered methodologies exists at three levels: teachers, students, and the teaching environment. Many faculty members fear losing their power as the sole authority in learning and knowledge [11]. They also find it difficult to adapt curricula and courses to more innovative methods [12]. Students are deterred by the intensive work deriving from the requirement that they invest resources and time and take personal responsibility for the course of their studies [13]. In addition to this resistance to change on the part of faculty and students, often the academic learning environment does not make it easy to implement the necessary changes. Among these obstacles are budget constraints, a large number of students in a course, fear of students' objections to the many course requirements, research pressure, and other academic demands. All these create strong competition for the teacher's time and abilities [14]. These sources of resistance constitute an obstacle to implementing broad changes in academe, where the extent to which changes are adopted varies from one discipline to another.

#### **3. The needs of the 21st century in medical education**

The requirements of medical systems worldwide have changed in recent years along with global changes in the needs and demands of the general labor market [2]. The localized organizational changes that health organizations are undergoing as part of becoming patient-centered affect the character of the medical staff, medical management, and paramedical professions and training [15]. These changes require health-related higher education to adapt accordingly. This adaptation includes

#### *Students Guided Learning for Medical Students - Novel Teaching for the 21st Century DOI: http://dx.doi.org/10.5772/intechopen.98823*

broadening students' set of abilities and skills and making them lifelong learners [16]. The set of abilities required in medical education includes coping with dilemmas, solving complex problems, teamwork capability, self-regulation, medical literacy, individual and managerial flexibility, and the ability to cope effectively daily with the challenges of a new and constantly changing world, under conditions of pressure and ever-expanding knowledge [17, 18].

The changes in the labor market's requirements and the consequent need to change teaching methods have moved the center of gravity in the class from the teacher to the student. This change is the basis for the change in approach in learning strategies. Student-guided learning (SGL) refers to a methodology that combines several teaching methodologies, such as problem- or project-based learning (PBL), cooperative learning, and creating a toolbox of skills. In using SGL, the student is guided by the teacher from the very beginning through the stages that include choosing a topic for the course and the learning materials, setting goals, students' acceptance of responsibility for the process of learning, and presentation of the product of learning. This methodology requires the teacher's constant supervision and oversight while leading the student on a long, active journey to the goals defined in the course [1].

Methodologically, SGL includes a combination of project-based learning [19] and models of learning collaboration. This combination enables the students to achieve a shared goal [20]. Achieving the goal requires positive interdependence among the students, in which each individual is responsible for his or her own learning and for the contribution to the group [21]. This learning emphasizes the process of learning and is characterized by active learning. The teacher is not the sole source of knowledge, and the learning is led by the students' choices, with direction from the teacher.

In SGL, the teacher sets the learning goals and broad topics that constitute the values and learning framework of the course. The study topics problem and cases to be written by students and will be presented within these boundaries. The teacher guides the student throughout the process [22].

This methodology has nine stages that constitute points for guidance and interface between teacher and student: describing an individual's experience, turning the experience into an event or dilemma, making the student an expert in the selected area/building a knowledge base, learning collaboratively, discussing and decisionmaking as a group, carrying out a summary project, presenting the project by the group, and evaluating the project by peers. This semester-long process is accompanied by maintenance of a reflective journal that describes the process of individual and group learning [1].
