This paper reports the use of quantitative and qualitative measures of university student learning during teaching in psychiatry. Concept mapping, pre-and post test scores and performance in written assignments were used to measure the quality of change in personal understanding and to show the ways that the knowledge-targets of the course were achieved. The data show that: (1) Concept mapping can be used to explore personal understanding because it facilitates discrete statements of meaning. (2) These personal statements can be compared through time to assess change. (3) Specific criteria can be used to measure the quality of the change from one statement to another so that the different qualities of change that occur can be made-visible in the course of teaching. The approach is discussed in the broader context of learning theory and teaching practice. We show in particular, that prior-knowledge is an important determinant of learning because it affects the sense that can be made of taught material.