Case-based Learning: Our Experience in Clinical Pharmacology Teaching

Understanding Pharmacy Students' Preparedness towards Counseling over Cannabis Use Disorder

The rise in cannabis use prompts significant concerns regarding pharmacy students' abilities to counsel patients over cannabis use disorder. This study aims to understand pharmacy students' preparedness to counsel patients with cannabis use disorder (CUD) and evaluate the relationship between knowledge, attitudes towards medical cannabis (MC) and recreational cannabis (RC), and behavior intention (BI) to counsel over CUD. A cross-sectional survey was administered to pharmacy students. Descriptive analyses of sample characteristics were assessed with the t-test and one-way ANOVA test. Pearson correlation and linear regression were conducted, measuring the strength and direction of relationships. The average scores for knowledge, attitudes towards MC use and RC, and behavioral intention were 81% (SD 16%), 4.13 (SD 0.75), 3.28 (0.80), and 2.74 (1.00). Significant correlations were observed between knowledge-attitudes toward MC, knowledge-attitudes towards RC, and attitudes towards RC-behavioral intentions. Linear regression indicated attitudes towards MC use and RC, academic year, awareness of MC use legality, obtained knowledge, and past patient interaction were significantly associated with behavioral intention on confidence in counseling over CUD. There is a gap in students' behavioral intention to counsel. These findings emphasize the importance of ample preparation that enables student pharmacists to address patient needs related to cannabis use confidently.

Assessment of the effectiveness of the BOPPPS model combined with case-based learning on nursing residency education for newly recruited nurses in China: a mixed methods study

BACKGROUND

Expanding new nurse training and education is a priority for nursing educators as well as a critical initiative to stabilize the nursing workforce. Given that there is currently no standardized program for the training of new nurses in China, we investigated the effectiveness of the bridge-in, objective, pre-assessment, participatory learning, post-assessment, and summary model combined with case-based learning ((BOPPPS-CBL) for the standardized training of new nurses.

METHODS

The mixed method approach with explanatory sequential (quantitative-qualitative) method was used. A questionnaire was used to compare the impact of the BOPPPS-CBL model and the Traditional Learning Model (TLM) on the core competencies of 185 new nurses for two years of standardized training. Quantitative data were analyzed using SPSS 22.0. Focus group interviews were used with four groups of new nurses and perceptions of BOPPPS-CBL training were recorded. Qualitative data were analyzed thematically.

RESULTS

According to the quantitative data, more new nurses agreed that the BOPPPS-CBL model stimulated their learning and improved their core nursing competencies than the TLM. The BOPPPS-CBL group outperformed the TLM group on theoretical knowledge tests. Qualitative data revealed that 87.5% of new nurses agreed on the value of BOPPPS-CBL training, and three themes were extracted: (1) role promotion; (2) formation of new thinking to solve clinical problems; and (3) suggestions for improvement.

CONCLUSION

BOPPPS-CBL training had a significant impact on improving new nurses' core competencies and promoting the transition of new nurses to clinical practice nurses in China. The study recommends BOPPPS-CBL training as an effective teaching model for the standardized training and education of new nurses.

Pharmacology education in the medical curriculum: Challenges and opportunities for improvement

The knowledge and application of pharmacology is essential for safe prescribing and administration of drugs. In this narrative review, the challenges to pharmacology education in the medical curricula were broadly identified to include issues around content and pedagogies. The increasing number of approved drugs and drug targets, expanding field of pharmacology and the often-changing treatment guidelines and board-defined competencies can make pharmacology education in the medical curriculum daunting. There has been a consensus around the deployment of innovative medical curricula with emphasis on vertical and horizontal integration. This strategy, effective as it has been, presents new challenges to pharmacology education. As a discipline often perceived by students to be hard-to-learn, the future of pharmacology education must include heavy reliance on active learning strategies. The continuing utilization of problem-based, team-based and case-based learning can be complemented with personalized learning which aims to identify the learning gaps in individual students. Technology-inspired student engagement can foster pharmacology learning and retention. Early exposure to pharmacology from premedical preparation through an enduring across-the-level integration can be an effective way to enhance pharmacology learning in the medical curricula.

Educational Interventions for Medical Students to Improve Pharmacological Knowledge and Prescribing Skills: A Scoping Review

Introduction

Medication-related errors place a heavy financial burden on healthcare systems worldwide, and mistakes are most likely to occur at the stage of prescribing. Junior doctors are more likely to make prescribing errors, and medical graduates also lack confidence and preparedness towards prescribing. Thus, this review aimed to evaluate the existing educational approaches to improve pharmacological knowledge and prescribing skills among medical students.

Methods

CENTRAL, CINAHL, ERIC, Ovid Embase, Ovid MEDLINE, Ovid PsycINFO, and Scopus were searched with keywords related to "pharmacological knowledge", "prescribing skills", "educational interventions" for articles published since 2016.

Results

3595 records were identified, and 115 full-text articles were assessed for eligibility. Eighty full-text articles were eligible and included in this review. Thirty-seven studies focused on improving prescribing skills, whilst 43 targeted pharmacological knowledge. A broad range of interventions was implemented, including e-learning, case-based, interprofessional, and experiential learning. Pharmacological knowledge and prescribing skills were measured in various ways, and all studies reported one or more positive findings at Kirkpatrick level 1 or 2. No study reported outcomes at Kirkpatrick levels 3 and 4.

Discussion

The World Health Organisation's Good Guide to Prescribing was the foundation of the development of prescribing educational interventions. Emerging interventions such as experiential and interprofessional learning should be incorporated into the prescribing curriculum. Innovative approaches such as game-based learning can be considered for clinical pharmacology teaching. However, there was a lack of outcomes at Kirkpatrick levels 3 and 4. Robust methodology and reliable outcome measures are also needed in future studies.

Emotional intelligence is more important than the learning environment in improving critical thinking

PURPOSE

To examine the association of critical thinking (CT) and emotional intelligence (EI) versus CT and learning environment (LE) in order to investigate which has the greatest influence EI or LE.

MATERIALS AND METHODS

A cross-sectional study was conducted with 340 s-year healthcare university students in two nursing and one medical schools from three universities in Greece, between October and December 2020. Critical Thinking Disposition Scale, Dundee Ready Education Environment Measure, and Trait Emotional Intelligence Questionnaire-Short Form were administered. Hierarchical multiple linear regression analysis, with five steps, was used to compare the associations of CT and EI to CT and LE.

RESULTS

Participants' mean age (years) was 20.9 (6.6 SD); 82.6% female; 86.8% studying nursing. Students mean scores were moderate to high for CT disposition (44.7 ± 4.68). The general characteristics (age, gender, and school) were not significantly associated with CT (p > 0.05). However, CT was positively associated with LE (UCB = 0.064 & p < 0.001) and EI (UCB = 1.522 & p < 0.001). Moreover, CT seems to be associated in a higher degree (R² change adj = 0.036 & p < 0.001) with emotional intelligence (UCB = 1.522) than with learning environment (UCB = 0.064).

CONCLUSIONS

Our findings suggest a different more optimal pathway for educators to improve the CT of their students through EI and not with LE as believed till now. By focusing on improving EI, educators may help their students become critical thinkers, who will provide better quality of care.

Linking Learning Environment and Critical Thinking through Emotional Intelligence: A Cross-Sectional Study of Health Sciences Students

Background: Health sciences educators should increase the critical thinking of their students as this may improve the quality of care. However, this is rarely considered as a critical point in teaching, despite studies identifying factors such as the learning environment and emotional intelligence as increasing critical thinking at an undergraduate level. Thus, there is a need to better explore these factors and investigate interrelations and ways of improving critical thinking, especially in the critical field of healthcare students (nursing and medicine). Objectives: The present study aimed to examine the potential relationships between critical thinking with emotional intelligence and the learning environment. Method: This was a descriptive cross-sectional study with 208 first year health sciences university students of two nursing departments and one medicine department from three universities in Greece. The Critical Thinking Disposition Scale, Dundee Ready Education Environment Measure, and Trait Emotional Intelligence-Short Form questionnaires were used to assess critical thinking, the education environment, and emotional intelligence, respectively. Results: The results demonstrate that critical thinking was positively related to emotional intelligence (β = 0.82, p < 0.001), but not to the learning environment (β = 1.06, p = 0.30). However, a structural equation modeling analysis supported the indirect relationship between the learning environment and critical thinking through emotional intelligence (M = 1.10, CI = 0.13–2.17, p < 0.05). Conclusions: Emotional intelligence may be the underlying mechanism for achieving critical thinking if it is well applied and cultivated in a learning environment. Therefore, universities could modify their curricula and place emotional intelligence at the epicenter of teaching.

The Value of CBL-Based Teaching Mode in Training Medical Students' Achievement Rate, Practical Ability, and Psychological Quality

In order to improve the quality of medical student training, the clinical case-based learning (CBL) teaching mode is analyzed in the aspect of the rate of achievement, practical ability, and psychological effect. A total of 86 medical students who came to our hospital from March 2020 to December 2021 are selected and divided into the CBL group and the control group according to the random number table method. The psychological quality of medical students is evaluated by observing their movements and expressions during their internship. In addition, the questionnaire is used to evaluate the scores of a medical student in future planning, occupational health, and teamwork spirit. The compliance evaluation results show that CBL teaching mode can significantly improve the compliance rate of medical students in training and promote the confidence of future role change to a certain extent.

Teaching LGBT+ Health and Gender Education to Future Doctors: Implementation of Case-Based Teaching

Improving the education of medical students and physicians can address the disparities in LGBT+ (lesbian, gay, bisexual, transgender, and others) health care. This study explored how teachers used case-based teaching to teach medical students about gender and LGBT+ health care and discussed the implementation and effectiveness of case-based teaching from the perspective of the teachers and students. This study employed the case study method and collected data through semi-structured interviews. This study used two gender courses in clinical psychiatric education as case studies. Two teachers and 19 medical students were recruited as participants. The findings of this study were as follows: (1) effective cases links theory to clinical practice and competency learning; (2) experience sharing by LGBT+ is highly effective; (3) discussions promote the effectiveness of case-based teaching; and (4) the challenges of case-based teaching included time limitations, the multiplexity of the cases, and multilevel learning. This study also found that using narrative cases is a form of narrative pedagogy, which can help students to integrate medicine, gender, and LGBT+ competency education. A successful narrative case–based teaching strategy involves teachers integrating knowledge related to gender, guiding students through the cases to understand the importance of these cases, and reflecting on the medical profession to make improvements. However, teachers face challenges in this approach, such as changes in the school’s teaching culture and a lack of institutional support.

Perceptions of medical students in Pakistan, KSA, and the US regarding the significance of case-based learning

Objective

This study aims to determine the perceptions of medical students in Pakistan, KSA, and the US regarding the significance of case-based learning (CBL).

Methods

For this cross-sectional study, data were collected by administering an online questionnaire to students in medical schools across Pakistan, KSA, and the US.

Results

A total of 344 medical students participated in this study, the great majority of whom agree that CBL paves the way for developing a sound understanding of the core subject, provides insight into real-life experiences, helps them transform from fact memorisers into problem solvers, and keeps them engaged during sessions, which motivates them to attend more of these. A comparison of respondents from Pakistan and KSA shows that CBL promotes deep learning and fostered their critical thinking; however, there was a difference in perception in some categories, including CBL as a tool used for grasping key concepts (p = 0.004), providing insight into real-life experiences (p = 0.001), offering a platform for self-directed learning (p = 0.000), nurturing collaborative abilities (p = 0.004), and maintaining students’ engagement (p = 0.002).

Conclusion

Our study shows that the selected cohort of medical students perceive CBL as an effective learning tool, as the majority feel overwhelmingly positive towards it. This study thus proposes the introduction of clinical exposure for medical students early in MBBS programmes, which will help promote collaborative skills and self-directed learning among them.

Can an interactive case-based activity help bridge the theory-practice gap in operative dentistry?

INTRODUCTION

A theory-practice gap in pre-doctoral dental education is a common source of stress for dental students. An interactive, small-group, case-based activity was designed to bridge the gap between pre-clinical and clinical experiences. The aim of our study was to assess the effectiveness of the case-based activity by evaluating students' comfort level in operative procedures.

MATERIALS AND METHODS

Over 5 years, a total of 172 second-year students from the classes of 2017 through 2021 participated in the case-based activity delivered after the completion of the core operative dentistry course. The exercise included a pre-activity online quiz, an in-class case-based session and a laboratory exercise. Students' self-reported comfort levels in performing operative procedures were collected by surveys at three different times. They included the post-course survey distributed after the completion of the core operative dentistry course, the post-activity survey distributed after the completion of the case-based activity, and the follow-up survey distributed after students completed their first operative procedures in clinic.

RESULTS

There was a 93% response rate. The average rating of all eight statements revealed statistically significant increase in students' comfort level after completing the case-based activity and after performing their first operative procedures in the teaching practice.

CONCLUSION

This observation suggests that the case-based activity was effective in raising students' comfort levels. The activity may serve as an important tool in bridging the theory-practice gap between pre-clinical and clinical operative experiences.

Effectiveness of case-based teaching of cardiovascular physiology in clinical pharmacy students

OBJECTIVE

This study aimed to formulate and implement a case-based cardiovascular physiology module for second year clinical pharmacy (CP) students. We also evaluated the students' feedback and compared the academic performance between a case-based teaching (CBT) group and a traditional didactic lectures (TDL) group.

METHODS

This descriptive quantitative study was conducted on 181 students who were divided into two groups. Group 1 (77 students) underwent TDL and the same topics were delivered to Group 2 (94 students) through CBT. A written examination was conducted at the end of both modules. A validated questionnaire was used to obtain feedback from the CBT group regarding CBT and their assessment grades (response rate - 93.6%).

RESULTS

Students' feedback about CBT was positive. The majority of students, 63 (72%), preferred learning and understanding through CBT, finding it an enjoyable experience. Participants stated that CBT stimulated critical thinking (67; 76%) and linked theory to practice (69, 78%). Furthermore, 70 (80%) preferred this type of teaching and assessment in the future and 70 (80%) agreed to include CBT in all preclinical subjects. Students feedback was supported by exam results: the mean percentage of exam scores in the CBT group was significantly higher in comparison to the TDL group (81.2% vs. 79%, p value <0.05). Further comparison within the CBT group revealed improved student performance in "case-based" as compared to "conventional" questions (82.75% vs. 80%, p value <0.05).

CONCLUSION

Students greatly appreciated CBT, as it stimulated logical thinking and active participation in the class, resulting in improved performance in exams.

Trainee doctors in medicine prefer case-based learning compared to didactic teaching

BACKGROUND

Sustaining interest and promoting deep learning is a challenge in any teaching method. The purpose of the study is to find the perception of trainee doctors in Internal Medicine and teaching faculty on the usefulness of case-based learning (CBL) and to compare assessment knowledge outcome with didactic seminars.

METHODS AND MATERIALS

We developed and conducted a CBL teaching program on eight topics in infectious diseases. First group had CBL and second group had didactic seminars. In step 1, a clinical case was introduced in stages. Learning objectives were formulated and topics were divided among the trainees. At step 2, trainees shared what they had learnt from self-directed learning. Faculty summarized the case and learning points. In the seminar group, trainees made presentations on the given topics. Trainees who had CBL underwent a questionnaire survey. Multiple choice questions-based test was administered for both the groups.

RESULTS

The trainee doctors and staff overwhelmingly found CBL to be more interesting, stimulating, and useful compared to didactic seminars. There was no statistical difference in the test scores.

CONCLUSIONS

CBL is a useful and interesting method of learning and should be employed more often in teaching for trainee doctors.

Case-Based Learning as an Effective Tool in Teaching Pharmacology to Undergraduate Medical Students in a Large Group Setting

BACKGROUND

The need for case-based learning in basic subjects is being recognized world over. Early clinical illustrations and actual clinical exposure enable students to associate basic science and real patient situations, probably increasing their retention of knowledge. The study was conducted to introduce an alternate method of teaching-learning in pharmacology in a large classroom setting to integrate pharmacology into clinical setting for better learning and understanding of the subject.

METHODS

Ninety-four students of second professional MBBS of a medical college in Punjab were divided into 2 groups and were taught a 2-hour topic in pharmacology using case-based learning (CBL) method and didactic lecture (DL) method using a crossover design. Their attendance and written test score at the end of teaching session were compared. Feedback from students and faculty was taken by prestructured questionnaires.

RESULTS

There was an increase in students' attendance (P = .008) in CBL sessions but insignificant difference in their performance (P = .98) in the tests. Most (84%) of the students felt that CBL is a better method of teaching-learning than traditional DL. The teaching faculty felt that the students looked more interested and were themselves more motivated for the newer method of teaching.

CONCLUSIONS

Case-based learning led to improvement in student motivation, satisfaction, and engagement. Most students and faculty accepted that CBL was an effective learning tool for pharmacology teaching in a large group setting and supported the incorporation of CBL into traditional DL teaching.