Evaluation of the effectiveness of teaching pathophysiology in the phase II of a Problem Learning Curriculum

Abstract

The school of Medical Sciences of Universiti Sains Malaysia, Malaysia is following a Problem Based Learning (PBL) Curriculum. In Phase II [comprising of year 2 and year 3] the PBL is c entered around twelve organ system blocks. Each organ system block runs for five weeks and in each week a clinical problem acts as a trigger for teaching and learning, which through the week is mainly achieved by small group discussion, fixed learning modules, self study and lectures. One organ system block which consistently showed poor results (in terms of higher failure rate and poor grades), was nervous system (NS) block. A critical appraisal of the objectives and course content highlighted that our students, through self directed learning were unable to grasp the nuances of the functioning of the nervous system in health and disease. Thus in an endeavour to facilitate and guide students learning, six broad based lectures covering pathophysiology were delivered at appropriate time slots. The performance of the students in the end-of-block examination (in two consecutive years) was compared with the performance of the students before the introduction of pathophysiology lectures. The data revealed a marked over all improvement in the students grades and a drop in failure rate (from more than 20% to less than 8%) of students who attended pathophysiology lectures. A comparison of the students performance in NS with endocrine and gastro-intestinal (GIT) blocks (which ran concurrently) revealed a better performance in NS than GIT and similar performance as that of endocrine block. Thus, it is concluded that our medical students need assistance in the comprehension of successive links of chain of events which depict how normal function would present as physiological dysfunction in disease state. This is especially so in system blocks which require a proper understanding of their homeostatic regulatory function.