Undergraduate Medical Education: Comparison of Case Based Learning (CBL) and

Didactic Lecture in Pharmacology

Dr. Mukeshkumar B Vora*, Dr.Chinmay Shah**, Dr. A.V Supe*** *Associate Professor, Pharmacology, GMERS Medical College, Vadodara, Gujarat (India)

** Associate Professor, Physiology, Govt. Medical College, Bhavnagar, Gujarat (India)

*** Dean, Sion Hospital & Director, GSMC FAIMER regional Institute , Mumbai (India),

Corresponding mail address: mukeshkrutinfaimer@gmail.com

References:

1. Meier S, Hoode R., Meier R. Problem-solving: Teacher’s perceptions, content area models and interdisciplinary

connection. School Science and Mathematics.1996; 96: 230-237.

2. Dabbagh N, Jonassen D, Yueh H. Assessing a problem-based learning approach to an introductory instructional

design course: A case-study. Performance Improvement Quarterly. 2000;13 ( 3): 60-83.

3.Williams B. Case based learning – a review of the literature: is there scope for this educational paradigm in

prehospital education? Emergency Medical Journal 2005;22:577-581

Objectives of study:-

To find out suitable teaching method amongst lecture and CBL that fulfils

the following requirements:

Self directed learning & Critical thinking of subject (Clinical Oriented)

To introduce CBL in Pharmacology subject

To check perception of teaching method CBL

Compare the effectiveness of the CBL with regular large group lectures

Introduction Method

Results

Pre-Test and Post Test Score: CBL N=34

Student’s Feedback in CBL

CBL group of students showed improved in the post test score than pre-test

score (p<0.000).

Lecture group of students also showed improved post test score than pre

test but not as much as CBL group (p<0.002, *p>0.680).

Discussion

CBL presents the most promising prospect as an effective, superior,

student centered alternative innovative method over the didactic form in

Pharmacology.

CBL is better for integration of knowledge gained in Pharmacology to

the bedside clinics.

Student’s perception on this method was positive suggesting a

success in future implementation of CBL in Pharmacology curriculum.

Acknowledgement:-

I wish to thank Dr. B.D Parmar, Dean, GMC, Bhavnagar who gave me the opportunity and permission to carry out study in

his institute. I am also very thankful to Dr. C.B.Tripathi, Professor & Head, and special mention to young, dynamic and

promising faculties & residents of Department of Pharmacology who helped me throughout study and Dr. Vikas Doshi,

Assistant Professor, PSM, SSG hospital for helped in statistical part.

Last but not least, students of Govt. medical College, Bhavnagar, Without their cooperation the study could not be

completed.

In lecture based teaching, there are certain learning issue like Passive

learning, Teacher centered, lack of self directed learning & critical thinking

(Clinical oriented), integration of subjects.

A study showed that students taught within the lecture- based disciplinary

system typically are not able to solve problems that would require

connecting between concepts and content.1

In contrast, interdisciplinary teaching (e.g CBL) that utilizes a topic,

problem or project galvanize active participation of students and higher

order thinking (Critical thinking) enabling them to reach a resolution.2

During lecture, undergraduate medical students have commented that

difficulty in applying the knowledge learnt during lecture classes in actual

clinical postings and difficult to remember the various drugs information.

- Project wasdiscussed in dept. &with FAIMERFELLOWS

- Ethics committeeApproval was taken

- Faculties andResidents weretrained for CBLsession

- Cases (Anemia, Malaria, BronchialAsthma, Epilepsy) were developed

- Written informed consents weretaken (Total 68 students consented &remained present throughout study)

- Pre-test and post-test, studentsfeedback questions were developedand validated

- Pre-test was donein whole batch(n=68)

- Divided in to Twogroups

Group A= CBLgroup (n=34),

Group B= Lecturegroup (n=34)

- Group A subdivided in four subgroup (N=34)

(G-1=8, G-2=9, G-3 =8, G-4=9)

G-1,2 = Anemia case allocated

G-3,4 = Malaria case allocated

- Group B = Lecture (N=34) (same topics were taught by traditional teaching simultaneously)

- Similar process was Cross-over (Cases were Epilepsy & Bronchial asthma)

- Two session of CBL was taken, CBL1 & CBL2

- Post-test was done after CBL2 session & lecture

- Perception of students regarding CBL was takenimmediately after end of CBL 2 session.

- Statistical analysis of Pre-test & Post test scorewas done (by Paired t-test)

- Overall Feedback towards CBL from studentsand faculties were taken.

Pre-Test and Post Test Score: Lecture N=34

CBL provides a framework for self-directed study and critical thinking

(Clinical orientation).

Understanding each clinical case requires that students bring together

information from each of the basic medical sciences, and relate it to problems

that they identify in each case.

It allows integration of Pharmacology knowledge into clinical practice and

development of learning skills3.