PBL curriculum improves medical students' participation in small-group tutorials

Performance and preference of problem-based learning (PBL) and lecture-based classes among medical students of Nepal

Background: PBL (problem based learning) is new active learning educational strategy that has been extensively tested and used in recent years. Patan Academy of Health Sciences (PAHS) is one of medical schools from Nepal, a Low Income Country (LIC) implementing PBL for undergraduate medical education. This study aims to compare PAHS students' understanding and knowledge retention when taught through PBL and lecture-based classes and compare students' perceptions of PBL and lectures in medical education. Methods: This is a cross-sectional study of medical students of a PBL based medical school in Nepal, a non-Western low-income country. Ethical approval was given by the institutional research committee of the Patan Academy of Health Sciences. Understanding and knowledge retention was assessed with 50 vignette-based multiple-choice questions, half of which were taught through PBL sessions, and the remaining half were taught in didactic lectures during basic science years of medical school. A separate pre-validated perception questionnaire was used to assess students' preferences regarding PBL and lectures. Results: Out of 107 students, 99 participated in the understanding and knowledge retention questionnaires and 107 completed perception questionnaires. Understanding and knowledge retention of students was found to be the same for topics taught by PBL and lectures, with median scores of 17 and s16, respectively. PBL were mostly preferred for the physiology (59.81%), pathology (51.40%) and pharmacology (53.27%) concepts, and lectures were mostly preferred for the anatomy (78.50%), biochemistry (45.79%), and microbiology (42.99%) topics. Students wanted the same concepts to be taught through both PBL and lectures, especially for anatomy. Conclusions: Understanding and knowledge retention is the same for topics taught by either PBL or lectures during the basic science years of undergraduate medical education. Students prefer PBL for physiology, pathology, and pharmacology-related concepts, conventional didactic lecture for physiology and microbiology, and a combination of lecture and PBL sessions for anatomy.

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.

Alternative approaches for clinical clerkship during the COVID-19 pandemic: online simulated clinical practice for inpatients and outpatients-A mixed method

BACKGROUND

The COVID-19 pandemic has created a need for educational materials and methods that can replace clinical clerkships (CCs) for online simulated clinical practice (online-sCP). This study evaluates the impact of using simulated electronic health records (sEHR) for inpatients, and electronic problem-based learning (e-PBL) and online virtual medical interviews (online-VMI) for outpatients, for an online-sCP using a learning management system (LMS) and online meeting system facilitated by a supervising physician.

METHODS

The sEHR was reviewed by medical students and subsequently discussed with a supervising physician using an online meeting system. In the e-PBL, medical students reviewed the simulated patients and discussed on the LMS. For the online-VMI, a faculty member acted as an outpatient and a student acted as the doctor. Small groups of students discussed the clinical reasoning process using the online meeting system. A mixed-method design was implemented. Medical students self-assessed their clinical competence before and after the online-sCP. They answered questionnaires and participated in semi-structured focus group interviews (FGIs) regarding the advantages and disadvantages of the practice.

RESULTS

Forty-three students completed the online-sCP during May and June 2020. All students indicated significant improvement in all aspects of self-evaluation of clinical performance after the online-sCP. Students using sEHR reported significant improvement in writing daily medical records and medical summaries. Students using e-PBL and online-VMI reported significant improvement in medical interviews and counseling. Students also indicated CCs as more useful for learning associated with medical interviews, physical examinations, and humanistic qualities like professionalism than the online-sCP. Eight FGIs were conducted (n = 42). The advantages of online-sCP were segregated into five categories (learning environment, efficiency, accessibility, self-paced learning, and interactivity); meanwhile, the disadvantages of online-sCP were classified into seven categories (clinical practice experience, learning environment, interactivity, motivation, memory retention, accessibility, and extraneous cognitive load).

CONCLUSIONS

Online-sCP with sEHR, e-PBL, and online-VMI could be useful in learning some of the clinical skills acquired through CC. These methods can be implemented with limited preparation and resources.

A nationwide cross-sectional survey of student experiential practice at community pharmacies in South Korea

BACKGROUND

In South Korea, community pharmacy experiential practice (CPEP) is very important because most pharmacists (71.8%) work in community pharmacies, which also employ the majority of students after graduation. The present study investigated student responses to the current CPEP status, suggestions for improvement, and advancement in their competency after practice based on evaluation of Community Pharmacy Experiential Practice Model (CPEPM) outcomes.

METHODS

A nationwide cross-sectional, self-administered online survey was conducted in 2017 for the sixth-year pharmacy students who completed CPEP, using 50 item questionnaire. The answers were evaluated using the 4-point Likert scale, used a scoring system from 1 (strongly disagree) to 4 (strongly agree). Responses of 1 and 2 were considered negative, and 3 and 4 were considered positive. To identify factors affecting CPEPM outcomes, multivariate linear regression analysis was performed.

RESULTS

Initially, 1138 students participated in the survey. Of these, responses from 492 students were excluded due to missing data and eventually, data from 646 students were included in the analysis. In total, 95% of students responded in the affirmative that practical training influenced their future career decision. In addition, 78.5% of students were satisfied with the training. Further, they responded that their ability improved based on CPEPM outcomes. The most positive capability change was in the subdomain "personal and professional development", followed by "inter professional collaboration".

CONCLUSIONS

Students responded with the higher rating for satisfaction factor, who regarded CPEP as helpful in future career decision making, and those who wanted to practice elective Advanced Pharmacy Practice Education at a community pharmacy had a positive CPEPM outcome, while age was found to be a negative factor in terms of the regression analysis. These are valuable findings as they represent the current student perception of CPEP nationwide. They provide a basis to improve the quality of CPEP-based education not only in Korea, but in other countries as well.

Peer-assisted learning (PAL): skills lab tutors' experiences and motivation

BACKGROUND

Peer-assisted learning (PAL) is a common teaching and learning method in medical education worldwide. In the setting of skills laboratories (skills labs), student tutors are often employed as an equivalent alternative to faculty teachers. However, to the best of our knowledge, there is a lack of qualitative studies which explore the reasons for the personal commitment of student tutors. The aim of our study was to examine how undergraduate students experienced and evaluated their roles as skills lab student tutors, what their motivation was, and whether social and cognitive congruence played a role in their teaching experiences.

METHODS

We conducted in-depth, semi-structured interviews with student tutors who were currently teaching in a skills lab. After the interviews had been transcribed verbatim, two independent investigators performed a qualitative content analysis according to Mayring.

RESULTS

In total, we conducted nine interviews with student tutors. Our results revealed that all student tutors showed great enthusiasm and motivation for their jobs as peer teachers. One of the main motivating factors for student tutors to teach in a skills lab was the possibility to simultaneously share and improve their knowledge and expertise. In general, the participants of our study had high aspirations for their teaching. They found it particularly important to be empathetic with the student learners. At the same time, they thought they would personally benefit from their teaching activities and develop a certain expertise as student tutors.

CONCLUSIONS

With the present study we are able to gain some insight into what motivates student tutors to teach in a skills lab and what kind of experiences they have. Our results provide an important input for the future training of highly qualified student tutors.

A comparison of debate and role play in enhancing critical thinking and communication skills of medical students during problem based learning

Debate and role play for learning critical thinking and communication skills are being increasingly used in various undergraduate medical schools worldwide. We aim to compare students' views about effectiveness of two teaching strategies; debate and role play to exercise critical thinking and communication skills during problem-based learning (PBL). This is a comparative, cross-sectional, and questionnaire-based study. Our subjects were second year undergraduate female medical students enrolled in Imam Abdulrahman Bin Faisal University (IAU), College of Medicine from September 2014-2016, divided into 10 small PBL groups (10-13 students/group/year). Students rated role play and debate as equally effective in improving communication skills. Debate was rated superior to role play in "opening new avenues of thinking" (p-value is 0.01), whereas in "integration of knowledge of basic medical sciences with clinical skills" and "reflection of real life experience" students rated role play being superior to debate (p-value 0.01 and 0.00, respectively). Both role play and debate are well accepted by the students in PBL curriculum as an effective teaching methodology. Both are perceived equally good in improving students' communication skills. Few aspects of critical thinking are improved more by role plays compared to debate and vice versa. © 2018 by The International Union of Biochemistry and Molecular Biology, 46:336-342, 2018.

Problem-based learning in undergraduate medical education in Saudi Arabia: time has come to reflect on the experience

BACKGROUND

Problem-based learning (PBL) is being increasingly used in many undergraduate medical schools worldwide due to its recognized advantages.

OBJECTIVES

To explore views of medical students in the Kingdom of Saudi Arabia (KSA) about the appropriateness of the PBL concepts and process. Differences in students' views were examined as well.

METHODS

This is a cross-sectional, questionnaire-based study conducted in two medical colleges in Riyadh, Saudi Arabia, during the period from April to June 2012.

RESULTS

One hundred seventy four undergraduate medical students participated in the study. Majority of the participants supported the concept of PBL and thought it is a beneficial learning strategy. However, only about half of them consider the problems used in tutorials are relevant for the local setting. Significant differences have been identified between the gender, schools, and study level of participants and their views on the process of PBL tutorials. About 35% of participants either undecided or will not recommend medical schools that adopt PBL curriculums for their friends.

CONCLUSIONS

The majority of participants were satisfied with PBL approach and valued its importance in their learning process. Specific concerns have been expressed about relevance of some aspects of PBL. Underlying factors should be further explored in order to improve the outcomes of PBL curriculum in the local Saudi setting.

Learning outcomes and tutoring in problem based-learning: how do undergraduate medical students perceive them?

OBJECTIVES

To explore opinions of undergraduate medical students regarding learning outcomes of the instructional strategy of Problem Based Learning (PBL). In addition their views were sought about the role of tutors and qualities of effective tutors.

METHOD

This was a cross-sectional, questionnaire based study which was conducted in two colleges of Medicine, Central region, Saudi Arabia during the period of 1st of April to 30(th) June 2012.

RESULTS

One hundred seventy four undergraduate medical students participated in this study. Seventy percent of participants have indicated that PBL strategy contributed to the development of their knowledge, presentation skills, team work abilities, and accepting criticism from other colleagues. Regarding the tutors' role in PBL tutorials, majority of the participants (75%) indicated that this role is essential, nevertheless, only 58% of students indicated that this role is clear and well identified. Sixty three percent of participants preferred a member role in the PBL tutorials and 80 percent of participants preferred both content and process expert tutors in the PBL tutorials. Significant statistical difference was noted between the views of students and their schools, gender, and study phase.

CONCLUSION

Majority of the participants believed that PBL had a positive impact on the development of their cognitive, personal and teamwork skills. The view of the students in this study and the available evidence suggest that tutor should have both qualities; content and process expertise, in order to have the best outcomes from the PBL tutorials.

Medical students preference of problem-based learning or traditional lectures in King Abdulaziz University, Jeddah, Saudi Arabia

BACKGROUND AND OBJECTIVES

Problem-based learning (PBL) is the most important educational innovations in the past 4 decades. The objective of the study was to compare between the preference of medical students for PBL and the preference for traditional lectures regarding learning outcomes (e.g., knowledge, attitude, and skills) gained from both methods.

DESIGN AND SETTINGS

A cross-sectional study was conducted among medical students who studied the hybrid curriculum (PBL and traditional lectures) in King Abdulaziz University, Jeddah, in 2011.

METHODS

Data was collected through a pre-constructed, validated, confidentially anonymous, and self-administered questionnaire. Students' perceptions toward PBL and traditional lectures were assessed through their response to 20 statements inquired about both methods of learning using a five-point Likert scale. Descriptive and analytic statistics were performed using SPSS, version 21 (SPSS Inc, Chicago, Ill., USA).

RESULTS

Learners preferred PBL more to traditional lectures for better linking the knowledge of basic and clinical sciences (t test=10.15, P < .001). However, no statistical significant difference (P > .05) was observed regarding the amount of basic knowledge recalled from both methods. Students preferred PBL more to lectures for better learning attitudes, skills, future outcomes, and learning satisfaction (P < .05). PBL motivates students to learn better than lecturing (P < .05). From students' opinion, the mean total skill gained from PBL (47.2 [10.6]) was much higher than that of lectures (33.0 [9.9]), and a highly statistical significant difference was observed (t test=20.9, P < .001).

CONCLUSION

Students preferred PBL more to traditional lectures for improving most of learning outcome domains, especially, learning attitudes and skills. Introducing hybrid-PBL curriculum in all Saudi universities is highly recommended.