Journal of Education and Health Promotion

Promotion of higher order of cognition in undergraduate medical students using case-based approach

Authors

. Suparna Dubey
. Ashok Kumar Dubey

Departments of Pharmacology, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh, India

Abstract
BACKGROUND: The curriculum of pathology is conventionally “taught” in a series of didactic lectures,
which promotes learning by rote. In this study, case-based learning (CBL) was introduced to assess
its effect on higher order cognition and problem-solving skills in undergraduate medical students.
SUBJECTS AND METHODS: The prescribed syllabus of hepatobiliary system was delivered to the
undergraduate medical students of the fourth semester by conventional didactic lectures. A pretest,
which contained questions designed to test both analysis and recall, was administered, followed
by CBL sessions, in the presence of a facilitator, encouraging active discussion among students.
Students were then assessed using a similar posttest. The perceptions of the students and the faculty
were gathered by means of feedback questionnaires. The scores obtained by the students in the
pre- and post-test were compared by paired t-test.
RESULTS: Eighty-one students participated in CBL sessions, with 95.06% expressing a desire for
more such sessions, preferably in all the topics. The faculty members also felt that CBL would be
benefi cial for the students but opined that it should be restricted to some topics. CBL was found
to cause a highly signifi cant (P < 0.0001) improvement in the students’ higher levels of cognition,
whereas the lower orders of cognition remained unaffected (P = 0.2048).
CONCLUSIONS: CBL promotes active learning and helps in the development of critical thinking and
analysis in undergraduate medical students. Although it is resource-intensive, an attempt should be
made to incorporate it along with lectures in clinically important topics.

Keywords

Case-based learning
higher order cognition
pathology
undergraduate medical education
1. Medical Council of India Regulations on Graduate Medical
Education; 1997. Available from: http://www.mciindia.org/
Rules-and-Regulation/GME_REGULATIONS.pdf. [Last accessedon 2016 May 30].
2. Klemenc-Ketis Z, Kersnik J. Defi ciency areas in decision making
in undergraduate medical students. Adv Med Educ Pract
2014;5:223-7.
3. Williams B. Case based learning – A review of the literature:
is there scope for this educational paradigm in prehospital
education? Emerg Med J 2005;22:577-81.
4. Srinivasan M, Wilkes M, Stevenson F, Nguyen T, Slavin S.
Comparing problem-based learning with case-based learning:
Effects of a major curricular shift at two institutions. Acad Med
2007;82:74-82.
5. Ciraj AM, Vinod P, Ramnarayan K. Enhancing active learning in
microbiology through case based learning: Experiences from an
Indian medical school. Indian J Pathol Microbiol 2010;53:729-33.
6. Jamkar AV, Burdick W, Morahan P, Yemul VY, Sarmukadum AV,
Singh G. Proposed model of case based learning for training
undergraduate medical student in surgery. Indian J Surg
2007;69:176-83.
7. Nair SP, Shah T, Seth S, Pandit N, Shah GV. Case based learning:
A method for better understanding of biochemistry in medical
students. J Clin Diagn Res 2013;7:1576-8.
8. Gupta K, Arora S, Kaushal S. Modifi ed case based learning: Our
experience with a new module for pharmacology undergraduate
teaching. Int J Appl Basic Med Res 2014;4:90-4.
9. Ghosh S, Pandya HV. Implementation of Integrated Learning
Program in neurosciences during fi rst year of traditional medical
course: Perception of students and faculty. BMC Med Educ
2008;8:44.
10. Srinivas V, Kotwal A, Tekian A. Effect of Case Based
Learning on Undergraduate Medical Students in Pathology.
Available from: http://www.faimer.org/education/fellows/
abstracts/10Srinivas.pdf. [Last accessed on 2016 May 30]
11. MCI-Vision; 2015. Available from: http://www.mciindia.org/
tools/announcement/MCI_booklet.pdf. [Last accessed on
2016 May 30].
12. ten Cate O, Scheele F. Competency-based postgraduate training:
Can we bridge the gap between theory and clinical practice? Acad
Med 2007;82:542-7.
13. Kassebaum DK, Averbach RE, Fryer GE Jr. Student preference
for a case-based vs. lecture instructional format. J Dent Educ
1991;55:781-4.
Journal of Education and Health Promotion
Volume 7, Issue 4
July and August 2017
Pages 1-7

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us