Problem-Based Learning as an Effective Learning Tool in Community Medicine: Initiative in a Private Medical College of a Developing Country

Imparting child nutritional assessment skills among medical students using hybrid problem-based learning approach in a community setting

Background

Malnutrition affects up to a third of children in India, with severe and acute malnutrition prevalent among under five children. Nutritional assessment skills for detecting malnutrition in children in primary care settings are vital. Hybrid problem-based learning (HPBL) is an innovative, collaborative, and adaptable instructional learning strategy that can be used to teach medical students clinical skills in a community setting.

Methods

A two-month quasi-experimental study was undertaken in a rural setting with third-year medical students. Faculty members were sensitized and subject experts developed a training module addressing the knowledge, attitude, communication, and practice domains. The students underwent a 3-week training module where pre-testing, case presentation, and group formation in first week, an anchoring lecture, tutorial and self-directed learning and role-play by students in subsequent week, and in last week, case discussion, post-testing, and feedback rounds were done.

Results

In all domains, knowledge (3.8, 0.01), practice (4.3, 0.01), attitude and communication (3.7, 0.01), and proportional satisfactory responses, the HPBL approach resulted in a significant improvement in nutritional assessment competency. Teachers preferred the practical and engaging character of the approach, stating that doubts and questions were better addressed and that they would use it to teach similar topics.

Conclusion

HPBL is an excellent teaching method for clinical skills, like nutritional assessment in simulated/field settings. The novel teaching-learning approach was well received by students and faculty members. Learning outcomes and satisfaction rates enhanced in students and faculty were encouraged to apply the approach to other topics.

Effectiveness of selected small group teaching methods for undergraduate medical students on basic concepts of epidemiology: A quasi-experimental study

BACKGROUND

Teaching epidemiology to young medical students using traditional teaching techniques is fraught with myriad challenges. Incorporating innovative small group teaching (SGT) approaches that promote active learning, practical application, and critical thinking can help in overcoming these challenges.

AIM/OBJECTIVE

To identify the most effective SGT method from selected three approaches [tutorial technique (TT), problem-based learning (PBL), and fishbowl technique (FBT)] to teach the basic concepts of epidemiology to the third-year undergraduate medical students of a private medical college in Puducherry, Southern India.

MATERIALS AND METHODS

A quasi-experimental study was conducted among third-year undergraduate medical students for 6 months. The sample size was calculated to be 60 using the nMaster 2.0 sample size software. Three groups were formed with 20 students each. A pre-test, which included fifty multiple-choice questions covering topic one, was conducted for students in all three groups. An SGT session on topic one (dynamics of disease transmission) was held on the same day by different facilitators for three groups A, B, and C using the TT, PBL, and FBT, respectively. After 6 weeks of the SGT session for topic one, a post-test using the same questions was organized for all three groups to identify the effectiveness of each SGT method. The above sequence of events was followed for topic two (study designs) and topic three (investigation of disease outbreak) among all groups in the subsequent months. A written informed consent was sought from all students. The collected data was entered in MS Excel 2010 and analyzed using SPSS 21. The pre- and post-tests for all topics in all three groups were compared using a paired t-test, and an ANOVA test was used to find any difference between the groups.

RESULTS

The mean post-test score in each of the three groups for all topics had improved when compared with the mean pre-test score, which was significantly different between the three groups. Further, the mean score of group B (PBL group) was found to be higher than group C (FBT) but not significantly higher compared to group A (TT). The mean score of the feedback where the participants were asked to rate the overall session was found to be high in group B (PBL) followed by group A (TT).

CONCLUSION

PBL and TT were found to be an equally effective way of small group methods for teaching-learning epidemiology in medical school.

Barriers and Solutions to Successful Problem-Based Learning Delivery in Developing Countries - A Literature Review

Problem-based learning (PBL) was introduced in the 1960s as an alternative to traditional teacher-centered and discipline-based preclinical medical education. A literature review was conducted to explore the barriers and solutions to successful PBL uptake and delivery in developing countries. The review involved the search of articles and scientific studies on PubMed, The Lancet, and Scielo. The review focused on the medical education literature, using as a primary search criterion "problem-based learning" in combination with "developing countries" and "education". The search was limited to articles in Spanish and English published between 2011 and November 2021, except for three articles due to their relevance to the subject. Faculty development programs are the cornerstone when implementing a new methodology in developing countries. Early career development, PBL methodology, and the available assessment options should be the primary learning objectives of these programs. Stakeholders will need to plan using available resources following the experience of other countries and institutions encouraging collaborative development. Evaluation and assessment will be crucial to understand the impact of PBL, and considerations should be taken to implement an integrated curriculum. Medical Education Research should be encouraged, appraised, and disseminated to improve evidence-based decision-making, creating a constant development cycle. PBL is innovative and represents many unanswered questions that will develop in the following decade as more schools implement new methodologies and Research on PBL.

A Virtual Approach to Promote Inter-Professional Learning (IPL) Between Biomedical Science and Medicine in Higher Education for the Benefit of Patient Care

In the clinical setting, collaboration between multidisciplinary teams is core to providing effective patient care. The delivery of traditional interprofessional education is associated with a number of logistical challenges, which were heightened by the Covid-19 pandemic. This workshop was developed to bring together Biomedical Science and Medical students using an online platform. The workshop consisted of (1) defining interprofessional education, (2) introducing the role of the Pathology laboratory, (3) Professional registration with regulatory bodies and (4) an insight into Covid-19 laboratory diagnosis. The session was supported by mixed group breakout rooms and interactive polling. Thirty four percent of students completed a post-workshop online survey which included open and closed questions. Thematic analysis revealed a better understanding the role of the pathology laboratory in diagnosing disease, an increased awareness of the similarities and differences in the roles of a Biomedical Scientist and a Medic and the importance of a multi-disciplinary team in achieving effective patient care. Quantitative analysis of survey data revealed that the majority of students reported positive experiences of interprofessional education online. Approximately 90% of students agreed that the workshop enabled them to increase their understanding of their own roles within healthcare, in addition to increasing their understanding of the roles of other healthcare professionals. 74.3% of participants reported that working with students from a different programme provided an alternative perspective. Seventy nine percent of students agreed that the online format enabled interactivity and discussion of the tasks. Of the 204 students, 85% engaged with the four polls during the workshop. This online workshop enabled discussion between degree programmes, enabled interactivity and allowed the learning outcomes to be met. Universities should embrace online platforms to provide a novel, engaging and effective interprofessional educational experience.

How interprofessional education could benefit the future of healthcare - medical students' perspective

As British medical students, we believe the impact that interprofessional education can have upon the future of healthcare to be a positive one. This is if it is implemented in health professions' pre-registration curricula worldwide. Our motivations for producing this article stem from our own experiences with IPE or rather our limited experiences during our medical school journey. We have exemplified the UK's NHS to demonstrate how IPE would positively impact a nation's healthcare system. With patient safety, patient experience and the economical functioning of the NHS always pertaining mainstream topics of discussion within the healthcare field, the need for improved interprofessional cohesion is now more important than ever before; especially with an increasingly demanding population. Through this article, we deeply analyse and expand upon the significance IPE has in enhancing interprofessional interactions at a pre-registration stage, in preparation for work within the NHS.

Problem/case-based learning with competition introduced in severe infection education: an exploratory study

BACKGROUND

Problem/case-based learning (PCBL) is one of the most commonly used educational methods in medical schools.

AIM

To further improve PCBL in clinical course of severe infection by introducing competition mode.

METHODS

Two classes of medical students were divided into two groups by class-based simple randomization and were taught the course of severe infection by PCBL. A team-based competition was introduced in the study group (n = 35) while not in the control group (n = 36). After the course, four closely associated references were recommended. All the students were notified about a group consultation on a similar case. In the final examination, a case with severe infection complicated with infectious shock was presented for the students to analyze and resolve listed questions. Their performances were qualitatively evaluated to justify the effectiveness of the competition-based PCBL.

RESULTS

The students in the study group were more active and initiative in case discussion and interaction, in referring to case-related articles and attending clinical group-consultation. They had better performance in the case analysis in the final examination. The typical case analysis test easily figured out more excellent students in the study group.

CONCLUSIONS

The PCBL with competition mode introduced in is an effective approach to guide students to fully understand the clinical diagnoses and treatment of severe infection. It also prompts medical students' initiative in referring to case-related articles and attending group-consultation, both of which are essential to equip medical students with sufficient competency for clinical practice.