Vasudha Devi

Effects of problem-based learning along with other active learning strategies on short-term learning outcomes of students in an Indian medical school

Background: Problem-based learning (PBL) is reported to improve general competencies such as problem solving. It also fosters the development of a scientific attitude in medical students. The present study explored perceptions of students at Melaka Manipal Medical College (MMMC), Manipal Campus, India regarding the extent to which PBL along with other active learning strategies has succeeded in improving a few short-term learning outcomes. We also determined graduation and attrition rates of seven and six batches of first- and second-year students, respectively, who were enrolled in MBBS program before and after the implementation of PBL. Materials and Methods: Students (n = 120) were requested to indicate their responses on a Likert scale in a questionnaire focusing on the 12 short-term learning outcomes. Additionally, a retrospective analysis of graduation and attrition rates of seven batches of first year and six batches of second-year students who were enrolled in MBBS program was done. Results and Conclusion: Out of the 12 learning outcomes, all were found to have a median score of 4, except time management, motivation for lifelong learning, and interest in pursuing medical profession. The graduation and attrition rates were found to be significantly high and low respectively for PBL students compared to non-PBL students in first year. In the second year too, PBL students outnumbered non-PBL students in terms of graduation rate. The attrition rate was found to be low for PBL students compared to non-PBL students. The present study revealed that PBL along with other active learning strategies such as self-directed learning (SDL) sessions employed in the curriculum right from first year culminated in improvement of almost all short-term outcomes.

A rare case of myocardial infarction due to parathion poisoning.

Organophosphorus poisoning occurs very commonly in southern India where farmers form a significant proportion of the population who commonly use organophosphorus compounds like parathion as insecticides. Awareness of the complications caused by parathion poisoning is essential for proper monitoring and treatment. We report a case of suicidal parathion poisoning in a farmer who was treated with atropine and oximes. He subsequently developed myocardial infarction, to the treatment of which, he showed no response and succumbed. In conclusion, myocardial infarction is a rare complication of parathion poisoning. Awareness of this complication of parathion poisoning, proper monitoring and treatment could prevent fatalities.

Development of a teaching module for parenteral drug administration and objective structured practical examination stations in pharmacology.

Objectives: Safe parenteral drug administration includes preparation of safe medication for administration. Training medical students is crucial to minimize medication administration errors. The study aims to develop a module to teach drug preparation skills and to develop objective structured practical examination (OSPE) stations to assess these skills. Students’ perceptions regarding the module were also assessed. Materials and Methods: A module was developed to teach following skills to 2nd year medical students: Aspiration of a drug from the ampule, aspiration of the drug from the vial, aspiration of the drug in powdered form from vial (reconstitution), and setting up an intravenous (IV) infusion. A randomized case control study design was used to establish the validity of OSPE stations. Student volunteers were grouped into case (n = 20) and control groups (n = 20) by simple randomization. The test group watched videos of skills and received demonstration of skills and a practice session before OSPE, whereas the control group watched videos before the OSPE and received demonstration and a practice session only after the OSPE. Each student was assessed by two faculty members during OSPE using a validated checklist. Mean OSPE scores of control and test groups were compared using independent samples t-test. Interrater reliability and concurrent validity of stations were analyzed using interclass correlation coefficient (ICC) and Pearson correlation, respectively. Students’ responses were expressed as median and interquartile range. Results: The response rate in the questionnaire was 100%. Significant difference between mean scores (P < 0.05) of test and control groups revealed fulfillment of construct validity of OSPE stations. Interrater reliability (ICC > 0.7) and concurrent validity (r value > 7) of all the stations was high. Perceptions revealed acceptability of module and OSPE stations by students (median 4, scale 1-5). Conclusions: A module to teach drug preparation skills was developed and along with valid and reliable OSPE stations that were acceptable to students. The study demonstrated that students acquire better skills through teaching than merely watching these skills in videos.

Mentored student project for inculcating research skills

Context and setting Most medical schools in India do not emphasise the importance of scientific research skills in the undergraduate medical curriculum despite the fact that it is essential for students to understand scientific methods of critically evaluating the evidence that will assist their decision making during their medical careers. In recognition of this need on the part of medical students, a mentored student project (MSP) programme was implemented in an Indian medical school in 2008 for a batch of medical students. Why the idea was necessary It is essential to inculcate critical thinking and reasoning skills and to develop a positive attitude among medical students towards scientific research from the beginning of their medical careers. As scientific research is rapidly evolving from its status as a largely individual endeavour to that of a highly collaborative, interdisciplinary activity, research training for undergraduate medical students should also inculcate the spirit of teamwork. At present, there is no formal path by which medical students in India can become doctor-scientists or academicians. What was done In the MSP programme, students (n = 113), guided by a teaching faculty member (mentor), were required to undertake a project involving in-depth study of an area of their interest, write a scholarly report and present the work as a poster presentation. To encourage the spirit of teamwork, students were grouped (n = 3–5) and each group was asked to select a research project in the form of a library study, laboratory research, medical records study, case study or field project. To examine the students’ perceptions regarding improvements in their research skills after participating in the MSP, a questionnaire consisting of 16 items related to the research skills gained by undertaking projects and the guidance received from the mentor (using a 5-point Likert scale) was developed. Students were requested to indicate their responses on the questionnaire and to describe their previous research experience, if any. Student responses were summarised using percentages. The median grade and interquartile range were reported for each item. A comparison of overall research skills gained with those based on previous research experience was performed using the chisquared test. Evaluation of results and impact The median grade for all items related to improvements in research skills was 4, which indicates that the majority of students felt the MSP had increased their research skills. Type of project and previous research experience were not significantly related to the improvement in overall skills. It was encouraging to find that 80% of the respondents had received appropriate guidance from their mentors. A total of 61% of students agreed that the MSP should be a mandatory requirement for the completion of the MBBS degree at our institution, which suggests that the non-funded MSP programme was successful in fostering a positive attitude towards scientific research. The present study provided scope for the further refinement of the MSP programme based on students’ perspectives.

Teaching and assessing reflecting skills among undergraduate medical students experiencing research

INTRODUCTION Reflection is the integral component of lifelong learning. Hence, there is a need for incorporating opportunities for students in the curriculum, to develop these skills. AIM To evaluate the feasibility of incorporating teaching-learning activity on reflection early in the undergraduate medical curriculum using research experience as a context, and, to determine whether the reflective skills of students improve upon training. MATERIALS AND METHODS The study was experimental with test and control groups and was conducted at Melaka Manipal Medical College, India. Senior batch of medical students in the second year of the course, about to complete their research project were considered as the test group and subsequent junior batch which was in middle of the research activity was the control. The test group was provided with a teaching-learning activity on reflection. Following this, students were asked to write reflective summary on experience of doing research. The control group who did not receive any training on reflection were also requested to write reflective summaries. Reflective summaries were graded by two authors independently using a newly developed rubric. Later, the grades were designated with scores. Perspective regarding this teaching-learning activity was collected from the test group. Feasibility was examined during teaching-learning activity and assessment. Mean reflective summary scores of control and test groups were expressed as mean±standard deviation and compared using independent samples t-test. A p-value of <0.05 was considered as statistically significant. Inter-rater reliability of the rubric was analyzed using Kappa statistics. RESULTS The teaching-learning activity lasted for two hours. It took an average of five minutes for researchers to assess each reflective summary. There was a statistically significant (p<0.001) difference in the mean reflective summary scores between control (26.45±9.43) and test (51.66±6.56) groups. Kappa for inter-rater reliability was 0.784 denoting substantial agreement between two raters. Perceptions revealed acceptability of module (median 4, scale 1-5). CONCLUSION Teaching and assessing reflecting skills among students using research experience as context was feasible. This study demonstrated that students acquire better reflecting skills after undergoing training.

Undergraduate pharmacology curriculum at an international medical college in India

Pharmacology is an important aspect of rational therapeutics. There has been a long-standing need for a change in the undergraduate medical curriculum of pharmacology. A review of literature throws up different approaches to improve the curriculum and to provide more importance to conceptualization and relevance to clinical practice. This article describes the undergraduate pharmacology curriculum which is revised to meet the needs of our unique status as an international medical college in India. We highlight how our curriculum prepares the students for future clinical practice by inculcating higher cognitive skills and soft skills. This article also provides a model for program evaluation and also challenges faced by our department while executing the planned curriculum.