Journal of Education and Health Promotion

Enhanced learning strategies of undergraduate medical students with a structured case presentation format

Document Type : Original Article

Authors

. Sarabmeet Singh Lehl
. Monica Gupta
. Sanjay D’Cruz
Abstract
BACKGROUND: Improvement of the learning in undergraduate bedside teaching needs to be
promoted through innovative interventions. Changes in the structured format (SF) for bedside case
discussion may help students improve their learning experience and gain insights into collaborative
self‑directed learning. The aim of the present study was to encourage collaborative and self‑directed
learning strategies by MBBS undergraduate students through a new case presentation format
structured for this purpose.
MATERIALS AND METHODS: This was an interventional study carried out in the year 2010–2011.
A new SF for bedside cases presentation was developed. A comparison with the traditional format
was done by holding one session in each format. Uniformity of topic and teaching style was ensured
by having the sessions on pulmonary medicine cases with the same teacher. The student perspective
of the educational process was analyzed using evaluation pro forma, Likert scale, and narratives.
RESULTS: Ninety final year and prefinal year MBBS students participated in this study. There was
significantly higher participation in history taking (50.7%) and clinical examination (60%) in the SF.
A higher statistically significant number of clinical possibilities were considered in the SF (85.3%
vs. 66.6%). Similarly, significantly higher number of students indulged in self‑directed learning and
referred to learning resources in the SF. The SF provided students an active role (96.9%), encouraged
access to resources (93.9%), and control of learning (75.7%). The additional interactive session was
productive (90.9%), discussions were streamlined (66.6%), and the role of a teacher was considered
important (75.7%).
CONCLUSION: The SF generated higher participation in the aspects of history taking, clinical
examination, and consideration of differential diagnoses. It led to a perceived improvement in
self‑directed and collaborative learning among students.

Keywords

Bedside learning
innovation
medical students
problem‑based learning
self‑directed learning
structured formats
1. Williams KN, Ramani S, Fraser B, Orlander JD. Improving bedside
teaching: Findings from a focus group study of learners. Acad
Med 2008;83:257‑64.
2. Spencer J. Learning and Teaching in the clinical environment. Br
Med J 2003;326:591‑4.
3. Peters M, Ten Cate O. Bedside teaching in medical education: A
literature review. Perspect Med Educ 2014;3:76‑88.
4. Irby DM. Three exemplary models of case‑based teaching. Acad
Med 1994;69:947‑53.
5. Ramani S, Leinster S. AMEE Guide no. 34: Teaching in the clinical environment. Med Teach 2008;30:347‑64.
6. Borich GD. The effective teacher. In: Borich GD, editor. Effective
Teaching Methods: Research Based Practice. 9th ed. New York,
USA: Pearson; 2016. p. 2‑35.
7. Loewen P, Legal M, Gamble A, Shah K, Tkachuk S, Zed P.
Learner: preceptor ratios for practice‑based learning across
health disciplines: a systematic review. Med Educ. 2017 Feb; 51
(2):146‑157. doi: 10.1111/medu. 13144.
8. Pront L, Gillman D. Supervisor expertise to optimize learner:
Preceptor ratios. Med Educ 2017;51:126‑33.
9. Karimi N, Saadat‑Gharin S, Tol A, Sadeghi R, Yaseri M, Mohebbi
B. A problem‑based learning health literacy intervention program
on improving health‑promoting behaviors among girl students.
J Educ Health Promot. 2019 Dec 31;8:251. doi: 10.4103/jehp.
jehp_476_19.
10. Macallan DC, Kent A, Holmes SC, Farmer EA, McCrorie P. A
model of clinical problem‑based learning for clinical attachments
in medicine. Med Educ 2009;43:799‑807.
11. Wass V, Jones R, Van der Vleuten C. Standardized or real patients
to test clinical competence? The long case revisited. Med Educ.
2001 Apr; 35 (4):321‑5. doi: 10.1046/j. 1365‑2923.2001.00928.x.
PMID: 11318993.
12. Baker KF, Jandial S, Thompson B, Walker D, Taylor K, Foster
HE. Use of structured musculoskeletal examination routines
in undergraduate medical education and postgraduate clinical
practice – A UK survey. BMC Med Educ 2016;16:277.
13. Cardozo DL, Raymond L, White B. A structured PBL tutorial
involving small teams for teaching the human nervous system.
Med Teach 2012;34:e763‑71.
14. Smith CA, Hart AS, Sadowski LS, Riddle J, Evans AT, Clarke PM,
et al. Teaching cardiac examination skills. A controlled trial of two
methods. J Gen Intern Med 2006;21:7‑12.
15. Iqbal M, Velan GM, O’Sullivan AJ, Balasooriya C. Differential
impact of student behaviours on group interaction and
collaborative learning: Medical students’ and tutors’ perspectives.
BMC Med Educ 2016;16:217.
16. Ratnani I, Fatima S, Mithwani A, Mahanger J, Surani Z. Changing
paradigms of bedside clinical teaching. Cureus 2020;12:e8099.
17. Fernandes L, Mesquita AM. Developing knowledge and clinical
competency in a respiratory system‑based practice of final‑year
medical students through a novel structured bedside teaching
module. J Educ Health Promot 2018;7:82.
18. Sultan AS. Bedside teaching: An indispensible tool for enhancing
the clinical skills of undergraduate medical students. J Pak Med
Assoc 2019;69:235‑40.
19. Couto LB, Bestetti RB, Restini CB, Faria M Jr., Romao GS. Brazilian
medical students’ perceptions of expert versus non‑expert
facilitators in a (non) problem‑based learning environment. Med
Educ Online 2015;20:26893.
20. Bestetti RB, Couto LB, Romão GS, Araújo GT, Restini CB.
Contextual considerations in implementing problem‑based
learning approaches in a Brazilian medical curriculum: The
UNAERP experience. Med Educ Online 2014;19:24366.
21. Sawatsky AP, Berlacher K, Granieri R. Using an ACTIVE teaching
format versus a standard lecture format for increasing resident
interaction and knowledge achievement during noon conference:
A prospective, controlled study. BMC Med Educ 2014;14:129.
22. Yazdankhahfard M, Ravanipour M, Mirzaei K. The gap in
the clinical learning environment: The viewpoints of nursing
students. J Educ Health Promot. 2020 Nov 26;9:311. doi: 10.4103/
jehp.jehp_438_20.
23. Young L, Orlandi A, Galichet B, Heussler H. Effective teaching
and learning on the wards: Easier said than done? Med Educ
2009;43:808‑17.
24. Cavicchia ML, Cusumano AM, Bottino DV. Problem‑based
learning implementation in a health sciences blended‑learning
program in Argentina. Int J Med Educ 2018;9:45‑7.
25. Sahu PK, Nayak S, Rodrigues V. Medical students’ perceptions of
small group teaching effectiveness in hybrid curriculum. J Educ
Health Promot. 2018 Feb 9;7:30. doi: 10.4103/jehp.jehp_71_17.
26. Kurz S, Lohse J, Buggenhagen H, Schmidtmann I,
Laufenberg‑Feldmann R, Engelhard K. Improving competence
and safety in pain medicine: a practical clinical teaching strategy
for students combining simulation and bedside teaching. BMC
Med Educ. 2021 Feb 25;21 (1):133. doi: 10.1186/s12909‑021‑02554‑6.
27. Irby DM, Wilkerson L. Educational innovations in academic
medicine and environmental trends. J Gen Intern Med. 2003 May;
18 (5):370‑6. doi: 10.1046/j. 1525‑1497.2003.21049.x.
Journal of Education and Health Promotion
Volume 11, Issue 10
November 2021
Pages 1-7

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