Nayak Kirtana Raghurama, Punja Dhiren, Suryavanshi Chinmay Ajit, Kamath Asha
Department of Physiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India.
Department of Medical Education, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104 India.
Med Sci Educ. 2020 May 6;30(2):869-877. doi: 10.1007/s40670-020-00967-4. eCollection 2020 Jun.
The preclinical phase of the undergraduate medical curriculum has to embed clinically relevant learning experience to bridge basic sciences with clinical disciplines. Student-centric educational methods like the readiness assurance process of team-based learning promote active learning. In this study, we report our implementation of the case-based readiness assurance process (CBRAP) as a case-based strategy for introducing early clinical exposure in the preclinical phase of the undergraduate medical curriculum in India. Four CBRAPs with individual and group readiness assurance tests (IRAT and GRAT) were conducted in four different systems taught in physiology (hematology, muscle physiology, cardiovascular physiology, and renal physiology). The multiple-choice questions for CBRAP were specifically designed to test application and problem-solving by incorporating clinical vignettes with pathophysiology and lab findings. This study was designed to involve all 250 students from the first professional year. The GRAT scores were significantly more than mean IRAT scores in all four CBRAPs ( value < 0.001). The GRAT scores in the second, third, and fourth CBRAPs were significantly better than the GRAT score of the first CBRAP ( value < 0.001). The GRAT scores correlated significantly with mean IRAT in three out of four CBRAPs and with the highest IRAT in two out of four CBRAPs. Based on the student feedback of CBRAP and other case-based strategies, it was found that students preferred CBRAP and the majority of students reported that discussion of CBRAP questions with team members was useful. In conclusion, innovative case-based teaching methods with active student involvement can be incorporated in the preclinical curriculum for improving learning outcomes.
本科医学课程的临床前阶段必须融入与临床相关的学习体验，以弥合基础科学与临床学科之间的差距。以学生为中心的教育方法，如基于团队学习的准备度保证过程，可促进主动学习。在本研究中，我们报告了基于案例的准备度保证过程（CBRAP）的实施情况，这是一种基于案例的策略，用于在印度本科医学课程的临床前阶段引入早期临床接触。在生理学教授的四个不同系统（血液学、肌肉生理学、心血管生理学和肾脏生理学）中进行了四次CBRAP，并进行了个人和小组准备度保证测试（IRAT和GRAT）。CBRAP的多项选择题经过专门设计，通过将临床案例与病理生理学和实验室检查结果相结合来测试应用能力和解决问题的能力。本研究旨在纳入一年级所有250名学生。在所有四次CBRAP中，GRAT分数均显著高于平均IRAT分数（ 值<0.001）。第二次、第三次和第四次CBRAP的GRAT分数显著高于第一次CBRAP的GRAT分数（ 值<0.001）。在四次CBRAP中的三次中，GRAT分数与平均IRAT显著相关，在四次CBRAP中的两次中，GRAT分数与最高IRAT显著相关。根据学生对CBRAP和其他基于案例策略的反馈，发现学生更喜欢CBRAP，并且大多数学生报告说与团队成员讨论CBRAP问题很有用。总之，具有学生积极参与的创新型基于案例的教学方法可纳入临床前课程，以提高学习效果。
