Learning effectiveness and satisfaction of international medical students: Introducing a Hybrid-PBL curriculum in biochemistry

Evidence-Based Strategies for Reforming the Medical Curriculum at the National Autonomous University of Honduras: A Systematic Literature Review

Medical education worldwide has undergone numerous stages of reform. Cultural and financial restraints have decelerated progress in developing countries. Current reforms should focus on creating integrated, competency-based, and student-centered curricula that emphasize patient-centered care. The following review of literature published between 2014 and 2023 on global curricular reforms highlighted key components, challenges, and strategies for implementing or evaluating undergraduate medical programs that prioritize student-centered approaches and competency-based models. This review also compared the current curriculum at the National Autonomous University of Honduras (UNAH) with these international experiences to suggest strategies in order to encourage significant reform. The following review identified 47 articles that provided insights into ideal contexts for curricular reforms, while 15 publications detailed the current state of the UNAH medical curriculum and its potential weaknesses. Additionally, 25 articles discussed specific reforms in other countries, offering valuable results and conclusions for consideration. Drawing from these models and experiences, strategies were proposed for UNAH's curriculum reform, including identifying basic needs, defining project vision, training teaching staff and students, and integrating multidisciplinary teams of experts. Although training all teaching staff abroad may be financially unfeasible, selecting and training key individuals to train others could be a viable alternative. Successful reform requires a comprehensive, periodic, and systematic evaluation. Despite the challenges faced by developing countries, global experiences with alternative reform models offer promising solutions, providing an opportunity for the Faculty of Medical Sciences at UNAH to overcome local limitations and fulfill the primary task of training professionals who are clinically, ethically, and adaptively competent, with a focus on patient-centered and primary care approaches.

An acceptability study of the introduction of total online or partial online PBL in a large classroom setting in biochemistry

BACKGROUND

Traditional problem-based learning (PBL) relying on tutored learning in small groups is very resource-intensive. Little is known about the benefits of PBL in a large classroom setting. This paper introduced a PBL case into the traditional didactic biochemistry course and investigated the acceptability of total online or partial online PBL in a large classroom setting introduced during the coronavirus pandemic.

METHODS

The students were allocated into either total online Group 1, partial online Group 2, or partial online and with poorer academic performance Group 3. A questionnaire comprising of 8 closed-ended questions and 2 open-ended questions and final exam performances were used to evaluate the acceptability of total online or partial online PBL in a large classroom setting. The 8 closed-ended questions were analysed by the Kruskal-Wallis test or chi-square tests. The word cloud analysis of the 2 open-ended questions were conducted by Wenjuanxing. Students' performances in the final examination were analysed by One-way Anova.

RESULTS

Both total online and partial online PBL were rated highly by the students. Overall, there were no significant differences in the effectiveness evaluation of PBL between Group 2 and Group 3. There were no significant differences in final exam performances between Group 1 and Group 2. However, Group 1 rated the effectiveness of PBL much higher than Group 2 and 3. Word cloud analysis of the 2 open-ended questions showed students' positive perspectives of PBL. In biochemistry teaching, from the perspective of the students, the expected optimal number of useful PBL cases might be 2.

CONCLUSIONS

Both total online and partial online PBL in a large classroom setting were widely accepted as a beneficial supplement to traditional biochemistry classes.

Students' perception of problem-based learning at a Japanese medical school: an exploratory sequential mixed method

OBJECTIVES

This study aimed to assess the perception of PBL among Japanese medical students.

METHODS

Learning effects and challenges of PBL from the students' viewpoint were assessed with an exploratory sequential mixed method. Focus group discussions followed by thematic analysis were conducted with 27 students and residents. Then a questionnaire survey was carried out. A total of 119 out of 258 students (46.1%) responded. The results from 24 questions were analyzed with a residual analysis.

RESULTS

Thematic analysis extracted 14 themes from four discussion topics. The participants in focus group discussion regarded the PBL program as a better learning method than lectures. But some key phrases on the challenge of social interaction, including reluctance to actively discuss and collaborate with unfamiliar peers, were found. The questionnaire survey revealed a significantly lower adjusted standardized residual (ASR) for the positive response in five of six questions in the category of social interaction; improvement of communication skills (ASR = -3.303, n = 118, p < .001), enhancement of responsibility at group discussions (ASR = -2.078, n = 119, p = .038), building social networking (ASR = -3.006, n = 119, p = .003), becoming to sympathize with patients (ASR = -2.449, n = 119, p = .014) and understanding social aspects of clinical practice (ASR = -5.790, n = 119, p < .001). Conclusion: The Japanese medical students perceived PBL as an effective learning strategy. However, they had a problem with social interactions.

Exploratory application of an integrated topic-based curriculum in biochemistry experimental teaching

Biochemistry, a complicated basic course in health sciences, plays a fundamental role in describing pathogenic mechanism of illness in molecular terms, and is required to be learned for all medical students. Due to various obstacles to biochemistry learning and teaching, there is a pressing issue of curriculum reform to arouse the student's enthusiasm in biochemistry learning. In this study, an integrated topic-based biochemistry training program (TBBTP) combining the traditional lectures, question-based learning and experimental practices, was introduced in biochemistry teaching. Its effectiveness was evaluated through examination and questionnaire analyses. Consequently, we found that TBBTP promoted the dissemination of biochemical knowledge via traditional lecture, designated learning issues and experimental practices, and acquisition of various skills through practical operation, presentation, and independent learning. It motivated students to study biochemistry with intense interest and enthusiasm. This study explored the feasibility of the topic-based biochemistry teaching as a supplement to biochemistry curriculum in medical education and as a mainstream pedagogy in biochemistry lab.

Evaluation and perception of online teaching of molecular biology using DingTalk for international medical students during the COVID-19 pandemic

The COVID-19 pandemic has greatly impacted the education of international students. The authors taught a molecular biology course using the DingTalk platform for international medical students (IMS) in the autumn semester of 2020. We assessed the effect of this online teaching based on an online questionnaire and by analysis of the final examination scores. Our findings demonstrate that the DingTalk platform is a free, effective and convenient online teaching tool for international students. The students' feedback showed that most of them were satisfied with this live teaching with DingTalk. They considered who viewed that the questions used in the live classroom setting were helpful for their learning. There is nonetheless still scope to improve this online teaching mode for international students, such as providing more pre-recorded teaching videos for offline application and use of a virtual simulation experimental molecular biology course. We hope that our findings regarding the experience of IMS with this teaching mode will be of value to other academic faculty.

Problem based learning approach increases the academic satisfaction of health science students in Ethiopian universities: a comparative cross sectional study

BACKGROUND

Problem based learning is being highly implemented in many medical schools worldwide due to its perceived advantages including improvement of problem-solving abilities, development of communication skills, creation and development of critical thinking skill, and making of individuals to be lifelong learners & responsible for their own learning process.

OBJECTIVE

The study aimed to compare academic satisfaction of Problem and Lecture based learning of regular undergraduate health science students in Ethiopian Universities, 2021.

METHOD

Institution based comparative cross sectional study was conducted from February 1-30, 2021. Data were collected using a pretested structured and self-administered questionnaire among 850 eligible students from two Universities. Data were entered into EPI info version 6.04 and analyzed using SPSS version 23. Binary Logistic regression model was fitted to identify factors associated with academic satisfaction considering the association to be significant p- value < 0.05.

RESULT

The study result revealed that the magnitude of academic satisfaction among problem based and lecture based learning students were 50.9 and 49.9% respectively. Similarly, problem based learning students were more likely to be academically satisfied than lecture based learning students in their type of curriculum with (AOR = 1.50, 95% CI = 1.02, 2.21). Experience of classroom distress (AOR = 1.93, 95% CI = 1.22, 3.06), quality of teaching (AOR = 0.54, 95% CI = 0.34, 0.86), relationship with classmates (AOR = 0.33, 95% CI = 0.13, 0.80), course content (AOR = 0.56, 95% CI = 0.33, 0.93) and accessibility of technology in the campus (AOR = 0.62, 95% CI = 0.40, 0.96) were the significant factors of academic satisfaction of problem based learning students. Year of study (AOR = 0.29, 95% CI = 0.17, 0.48), quality of teaching (AOR = 0.51, 95% CI = 0.31, 0.85), course content (AOR = 0.59, 95% CI = 0.35, 0.97) and energy & effort (AOR = 0.55, 95% CI = 0.35, 0.88) were significantly associated with academic satisfaction among lecture based learning students.

CONCLUSION

The study revealed that the academic satisfaction among problem based learning students was higher than lecture based learning students. Incorporating and implementing problem based learning as a formal instructional method in across the universities curriculum is recommended.

Using e-learning tools in biochemistry teaching for undergraduate medical students in multicultural environment in Ukraine during COVID-19 crisis

Through the special situation like the COVID-2019 lockdown, interactive techniques play a prime role in the study process. The strategy of lockdown ways of higher education was provided in Ukraine as well as in other countries since March 2020. Our investigation was performed at the Department of Biochemistry and Medical Chemistry of Dnipro State Medical University during the first lockdown of COVID-19 from March to June 2020. The main aim of the research was the evaluation of the students' attitudes to studying Biochemistry using Google classrooms and Moodle. Four hundred and sixty-three students studying in English, French, and Ukrainian took part in the survey. Our results reveal that majority of the students found Google classrooms and Moodle as useful e-learning tools. However, questions dealing with the technical issues of using the Google classrooms on laptops and mobile phones and submitting the replies to the Google classrooms cause difficulties among the students.

Application of blended teaching model based on SPOC and TBL in dermatology and venereology

BACKGROUND

In this study, we applied the small private online course (SPOC) and team-based learning (TBL) blended teaching model to dermatology and venereology to ensure a higher quality learning experience for clinical medical students.

METHODS

A total of 52 fifth-grade clinical undergraduates from Xiangya School of Medicine of Central South University were randomly divided into an experimental (n = 26) and a control group (n = 26). In March 2018, we used the SPOC and TBL blended teaching model in the experimental group and explored the effects of innovative teaching in the dermatology and venereology course, compared with the control group receiving the conventional teaching method. We analyzed the two groups' theoretical assessment scores and questionnaire results to evaluate the efficiency of the new pedagogy.

RESULTS

Students in the experimental group had a better understanding than the control group of the dermatology and venereology content and higher scores on the case analysis questions in the final theoretical examination. The results revealed that the majority of the experimental group students agreed that the novel teaching model blended with SPOC&TBL helped them significantly stimulate motivation and develop their ability in self-directed learning, independent thinking, literature retrieval, presentation board, teamwork, communication, and systematic clinical thinking. The teaching satisfaction survey of the two groups showed that the students' satisfaction in the experimental group was significantly higher than in the control group (p < 0.05).

CONCLUSIONS

The SPOC&TBL teaching model is better than the traditional one in enriching students' professional knowledge and cultivating their comprehensive ability. It can effectively promote educational quality, improve students' learning effects, and enhance their satisfaction. This method has broad application prospects.

Delivering an online course in emergency nursing education during the pandemic: What are the effects on students' learning?

Background

Online learning emerged as an auxiliary approach in 2013 when MOOCs were imported and popularized in Chinese universities, particularly in the duration of pandemic outbreaks worldwide. World health organization (WHO) had recommended online education to keep social distance which still needs further evaluation. This study aimed to examine whether an open online course is superior to conventional education in emergency nursing during the COVID-19 pandemic.

Methods

Two groups of conventional education students (CG) and two groups of students participating in an online course that utilized an application (called SuperStar) as the SuperStar Group (SSG) were studied to compare their abilities in the process of new knowledge acquisition. The SSG was divided into a blended group (S1) and an online group (S2). The emergency nursing course was scheduled in 16 independent classes, which contained stochastic tests at least eight times.

Results

The CG group showed better performance on the final exam than the SSG group, but there was no statistically significant difference. The CG group obtained better scores on the memory capacity tests while the SSG had better scores on the application capacity tests. The SSG group scored higher on the later tests during the process of education compared to the CG group.

Conclusions

Comprehension of an emergency nursing course was stronger in the SSG group than in the CG group. Horizontal comparison of subentry tests discriminated between the groups, with a better trend for the SSG group in application ability. There are potential effects on chronological learning through the use of the online course for emergency nursing education, not only during COVID-19 but also in the post-pandemic era.

Engaging Pharmacy Students in Interactive Life-Based Situations as the Basis for Teaching a Biochemistry Course

Objectives

Undergraduate pharmacy students have neither sufficient training on analyzing the role of biochemistry in actual-life situations nor on its effect on both health and disease. Therefore, we conducted this study to link the biochemistry course with actual-life situations and to encourage students to search for biochemistry answers for the health problems they face.

Methods

Students were randomized into different groups of three to five students. Every week, a group was asked to search the Internet for the most prevalent disease in their area associated with the biochemistry title studied. The group was asked to have an open discussion was their colleagues about a hot topic in life that is related to this subject. Finally, the group was asked to dig into social media for a current event that grabbed their attention in relation to this subject and write a short paragraph beyond the details. This scenario was repeated weekly using different student groups. The students’ opinion was collected before the conduction of the course and the end of the semester.

Results

The post-course questionnaire showed good improvement in the students’ ability to communicate effectively, conduct independent work, participate in active discussion, and solve problems. Overall, the students’ satisfaction was significantly elevated.

Conclusions

We have promoted a method to engage undergraduate students in linking biochemistry theories with real-life situations instead of just memorizing them. The new method improves the students' perception of biochemistry courses. Finally, it provides a promise of a new active learning strategy for undergraduate pharmacy students, which can be used widely to motivate students.

The case for plural PBL: an analysis of dominant and marginalized perspectives in the globalization of problem-based learning

The globalization of problem-based learning (PBL) in health professions education has been both celebrated and criticized. Using a critical narrative review approach, underpinned by our archive of global PBL literature and a targeted literature search, we analyze these dominant global discourses of PBL in health professions education. More precisely, we explore what is missed when the globalization of PBL is theorized either as a positive consequence of standardization, or a problematic spread of Western educational ideals and values around the world. We make visible how two dominant global discourses, a universalist and culturalist discourse, have emerged in the global proliferation of PBL. We also discuss the limitations of the two discourses by demonstrating how they either ignore contextual and cultural diversity or see it as problematic. We then turn to a perspective that has been marginalized in the PBL literature that emphasizes the global origins of PBL, transcending the dichotomy between West and non-West. We make a case for relating to PBL as a plural construct in order to learn from the cultural and situational nuances of educational activities labeled PBL around the world. We argue that PBL as a singular and universal concept has no global future, yet versions of PBL may continue to thrive locally. Finally, we propose avenues for future research that may help elucidate the global and local values that underpin our curricula, as well as the socio-political factors that perpetuate neo-colonialist views and practices in the uptake and implementation of PBL approaches across the globe.

Current status of international medical education in China: A cross-sectional study

Objective: This study aims to understand the current learning state, curriculum evaluation, and career planning of international Bachelor of Medicine, Bachelor of Surgery (MBBS) students in China in order to support educators and policy makers in developing interventions to support international MBBS students.

Methods: A cross-sectional survey was conducted at Fudan University from March 2017 to May 2018. A self-administered questionnaire regarding medical teaching and evaluation methods and recommendations was used to collect the data from international MBBS students ([Formula: see text]) and native Chinese medical students ([Formula: see text]) currently at the school as well as teachers directly involved in teaching activities with these students ([Formula: see text]). Data were analyzed using GraphPad Prism 6, and all results are presented as frequencies (percentages).

Results: Most of the international MBBS students had never studied at a university before (76%). The first and second most common reasons for choosing the MBBS program were an interest in medical science (79%) and relieving patients’ sufferings and realizing self-value (61%). The learning motivation of international MBBS students came mainly from the interests in medicine (90%). A total of 74% of international MBBS students considered the course setting to be appropriate or neutral. The top biggest problem in clinical practice reported by international MBBS students was communication barriers caused by the lack of language proficiency. The first choice of future work after graduation for international MBBS students was studying or working abroad. The top two recommendations among teachers for improving academic achievement were providing textbooks in students’ native languages (64%) and reading more medical books (47%).

Conclusions: International MBBS students generally thought that the course setting was rational, and were mostly satisfied with the international MBBS program. The use of textbooks in the international MBBS students’ native languages was reported to be helpful for improving these students’ academic achievements.

Is hybrid-PBL advancing teaching in biomedicine? A systematic review

BACKGROUND

The impact of instructional guidance on learning outcomes in higher biomedical education is subject of intense debate. There is the teacher-centered or traditional way of teaching (TT) and, on the other side, the notion that students learn best under minimal guidance such as problem-based learning (PBL). Although the benefits of PBL are well-known, there are aspects susceptible to improvement. Hence, a format merging TT and PBL (hybrid-PBL, h-PBL) may advance education in biomedical sciences.

METHODS

Studies that employed h-PBL in higher biomedical education compared to TT and/or pure PBL were systematically reviewed. Specifically, this review addressed the following question: does h-PBL in biomedical sciences result in superior marks and a better student's perception of the teaching and learning process?

RESULTS

We found that the use of h-PBL in higher biomedical sciences was superior compared to TT and pure-PBL. This was evidenced by the higher performance of the students in h-PBL as well as the level of student's satisfaction as compared to TT or pure PBL.

CONCLUSIONS

These findings encourage more research on investigating the pedagogical benefits of h-PBL. In addition, these data support an eclectic system in which the pedagogical tools from TT and PBL are used cooperatively in the best interest of the education and satisfaction of the students.

WeChat as a Platform for Problem-Based Learning in a Dental Practical Clerkship: Feasibility Study

Background

Problem-Based-Learning (PBL) has been widely accepted in student-centered medical education. Since WeChat is the most popular communication app in China, we have chosen to use WeChat as new platform for online PBL in order to reduce the limitations of traditional PBL in dental practical clerkships.

Objective

This study aims to demonstrate the feasibility and acceptability of online PBL using WeChat (WeChat-PBL) in a dental practical clerkship.

Methods

A total of 72 students in a dental practical clerkship and 10 tutors participated in this study from June to August 2017. We created 10 WeChat groups to provide a communication platform for the PBL teaching, in which the students selected the PBL cases themselves from their practical clerkship. After each individual PBL case, group members were required to complete an evaluation on the PBL process itself. A final questionnaire survey was completed by the participants to summarize the long-term evaluation of the whole WeChat-PBL experience after the 3-month clerkship. Data from the PBL cases, WeChat messages, periodic evaluations, and long-term evaluations were collected for analysis.

Results

There were 45 cases presented in the WeChat-PBL within the 3-month clerkship. All students had positive reactions to the communication within the PBL groups. The results of the periodic evaluation showed that the students and tutors were quite satisfied with the process of WeChat-PBL and appreciated the group members’ contributions and performance. The final questionnaire results indicated that the WeChat-PBL had achieved positive effects.

Conclusions

The results of this study indicate the feasibility and acceptability of the app, WeChat, for problem-based learning in a dental practical clerkship.

Using integrated problem- and lecture-based learning teaching modes for imaging diagnosis education

BACKGROUND

There are two parts included in traditional imaging diagnosis teaching: theoretical lessons and experimental lessons. Most of the time, the experimental lesson is a review of the theoretical lesson. The teacher is the centre of the course and students are passive learners. Thus, in this study we included the patient problem of the imaging centre in our imaging diagnosis education. The traditional theoretical lessen was used to discuss prior knowledge, the discussion and analysis of patient problems was arranged under class, and the experimental lesson was used to synthesize and test the newly acquired information. The aim of this study is to determine whether or not integration of problem- and lecture-based learning teaching modes in imaging diagnosis education was associated with a good teaching effect. Forty-six of sixty students (76.7%) like integrated problem- and lecture-based learning teaching mode and 53 of 60 students (88.3%) think that integrated problem- and lecture-based learning teaching mode can make their ability of self-study be improved.

METHODS

Sixty students participated in a prospective study with a two-phase cross-over design. All of the students were divided into 2 groups of 30 each. In the first term, the first group participated in an integration of the problem- and lecture-based learning teaching mode, whereas students in the second group underwent the lecture-based learning teaching mode alone. During the second term, the teaching modes were exchanged between the two groups. A close-exam and survey were used to evaluate the teaching effect, and the data were analysed means of analysis of variance with a two-phase cross-over design and a χ² test with a 2-tailed α of 0.05.

RESULTS

There was a statistically significant difference in the test scores between the integration of the problem- and lecture-based learning teaching mode and the lecture-based learning teaching mode alone (P < 0.05). The integration of problem- and lecture-based learning teaching mode was well-appraised.

CONCLUSION

Integration of the problem- and lecture-based learning teaching modes in teaching imaging diagnosis education resulted in a good teaching effect.

Update on research and application of problem-based learning in medical science education

Problem-based learning (PBL) is a unique form of pedagogy dedicated to developing students' self-learning and clinical practice skills. After several decades of development, although applications vary, PBL has been recognized all over the world and implemented by many medical schools. This review summarizes and updates the application and study of PBL in medical education through the literature published between 1993 and early 2017. It focuses on understanding real medical PBL courses and ways to improve PBL to achieve better learning outcomes. PBL aims to develop lifelong skills to solve practical problems rather than limiting learning to theoretical knowledge. To achieve this goal, strict and reasonable procedures need to be designed and implemented. Rigorous monitoring and timely feedback and evaluation are indispensable to constant improvements and perfecting of the process. © 2017 by The International Union of Biochemistry and Molecular Biology, 46(2):186-194, 2018.