32.2.13 The Comparison of Physiology Learning in Undergraduate Medical and Dental Students

Original Article

 

Learning of Physiology in Undergraduate  in Integrated Curriculum

The Comparison of Physiology Learning in Undergraduate Medical and Dental Students

Sadaf Fatima1, Syed Tousif Ahmed2, Shazia Hashmat2, Huma Salahuddin2, Kevin Joseph Jerome Borges3 and Syed Nudrat Nawaid Shah3

ABSTRACT

Objective: To study the difficulties and problems associated with learning of Physiology in undergraduate medical and dental students in integrated curriculum.

Study Design: Cross sectional study.

Place and Duration of Study: This study was conducted at the Ziauddin Medical College and Ziauddin Dental College, Ziauddin University, July 2017 to June 2018.

Materials and Methods: The study participants included 1st, 2nd, 3rd year medical students and 1st and 2nd year BDS students. There were 225 participants, 147 MBBS and 78 BDS students. A questionnaire was distributed to each medical and dental student. There were 23 items included in the questionnaire from why is Physiology hard for students to learn? The items were related to subject, teaching and learning of Physiology. The medical and dental students were asked to select a response for each item on like rt scale from 1 to 5.

Results: Regarding the Physiology learning responses, the comparison was done between MBBS and BDS students.  A significant difference was found in factors including basic concepts (<0.001), use of scientific terms (0.01), covering large content in one lecture (0.01) and integration (0.002).

Conclusion: The medical and dental students identified the factors causing difficulties and problems in learning physiology and the reasons of these difficulties.

Key Words: Physiology, Teaching, Learning

Citation of article: Fatima S, Ahmed ST, Hashmat S, Salahuddin H, Borges KJJ, Shah SNN. The Comparison of Physiology Learning in Undergraduate Medical and Dental Students. Med Forum 2021;32(2):50-54.

 

 

INTRODUCTION

To create 21st century physicians, the prime objective is to train future doctors and dentists who can effectively integrate the new sciences and technology into humane patient care1. Medical education must progress and develop because future doctors will come across patients in quite different health care circumstances from the present2. To meet the needs of medical education, numerous medical schools have started to design innovative medical curricula in their bachelor programs2. There is now increased emphasis on developing competencies and active learning strategies3. Curriculum integration of subjects is a significant strategy in medical education4.

 

 

1. Department of Physiology, Jinnah Medical and Dental College, Karachi.

2. Department of Physiology / Anatomy3, Ziauddin Medical College, Ziauddin University,  Clifton Campus, Karachi.

 

 

Correspondence: Sadaf Fatima, Associate Professor of Physiology, Jinnah Medical and Dental College, Karachi.

Contact No: 03342476112

Email: doctorsadafnaqvi@yahoo.com

 

 

Received:  August, 2020

Accepted:  October, 2020

Printed:      February, 2021

 

 

Integration has essential importance in medical education because basic science learning placed in clinical context is considered more meaningful and relevant by students5.

In the first two years of medical school, basic science knowledge forms a foundational framework for clinical skills6. An understanding of basic science concepts helps in learning the signs and symptoms of various diseases in the clinical years7. The retention of basic science concepts has a positive correlation with clinical knowledge8. In integrated curricula, basic science educators need to focus on their teaching content according to clinical relevance9.  To more closely relate the basic and clinical sciences, early patient contact in the foundation years is provided simultaneously with basic science teaching10. For the competent medical practice, the understanding of applicability of basic science education in the establishment of diagnosis and treatment is critically important11.

Physiology is one of the basic science subjects taught at undergraduate level in medical and dental professional education12. The importance of Physiology lies in its application in clinical practice13. In the recent innovative development of preclinical curricula, Physiology is facing changing trends in teaching. The employment of student centered learning methods has been found to be valuable in building of physiological concepts14. As Physiology learning is concerned with understanding the dynamics and mechanisms of human body and it is required for good clinical practice, a questionnaire was designed to study the various aspects of Physiology learning. The objective of the study was to compare the difficulties and problems associated with learning of Physiology in undergraduate medical and dental students in integrated curriculum.

MATERIALS AND METHODS

The study design was cross sectional. The study was conducted at Ziauddin Medical and Ziauddin Dental College. The study participants included 147 MBBS students and 78 BDS students. The participants were selected by convenient sampling technique. The duration of the study was one year, from July 2017 to June 2018. The study was approved by Ethics review board of Ziauddin University. The participants were enrolled in the research study after getting the ethics approval. Informed consent was obtained from each participant.

To find out the difficulties and problems associated with Physiology learning, the questionnaire was distributed to 147 medical and 78 dental students. The questionnaire contained 23 items from why is Physiology hard for students to learn? The medical and dental students were asked to select a response for each item on likert scale from 1 to 5. The MBBS and BDS students provided their perspective about the difficulties and problems in learning physiology and the reasons of these difficulties. The questionnaires were collected and the data was analyzed.

The data were analyzed using SPSS version 20. The results of the quantitative data were expressed as mean ± SD. The comparison of qualitative data was expressed by Chi Square test. In all statistical analysis, only p-values ≤ 0.05 were considered significant.

RESULTS

There were 147 MBBS and 78 BDS students in the study. The mean age of students was 19.3± 1.4 years (male 34% & female 66%). The group comparison is shown in table I. Figure I showed Physiology learning response comparison of groups on the basis of individual items 1 to 12 in the questionnaire. Figure II showed score comparison of groups based on individual items 13 to 23.

Table I showed comparison of Physiology learning responses between MBBS and BDS students. It included items related to basic concepts, new researches  in medical science, scientific terms, interaction between systems, well defined physiology syllabus, understanding physiology, commitment of time, case study, passing physiology by using short books, teaching by using concepts, correlating different topics, guiding students about learning resources, using graphs and flow charts, integration of physiology teaching, covering large content in lecture, responding to student questions and use of active learning methods. The frequency, percentage and chi square value for each item is mentioned in the table.

In figure 1, the x-axis showed the 12 individual items in Physiology learning response section and the y axis showed the individual score of each item.

In figure 2, the x-axis showed the 11 individual items in Physiology learning response section and the y axis showed the individual score of each item.

 

 

Table No.1: Comparison of Physiology learning response between MBBS and BDS students

Q.No.

n

Program

Frequency

Percentage

Chi Square

 

 

 

A

B

C

A

B

C

 

1

225

MBBS

95

22

30

57.6

88

85.7

<0.001

 

 

BDS

70

3

5

42.4

12

14.3

2

224

MBBS

125

13

8

63.5

76.5

80

0.336

 

 

BDS

72

4

2

36.5

23.5

20

3

225

MBBS

116

14

17

63.7

58.3

89.5

0.06

 

 

BDS

66

10

2

36.3

41.7

10.5

4

225

MBBS

109

27

11

65.3

62.8

73.3

0.761

 

 

BDS

58

16

4

34.7

37.2

26.7

5

225

MBBS

125

16

6

62.2

88.9

100

0.014

 

 

BDS

76

2

0

37.8

11.1

0

6

225

MBBS

122

19

6

64.6

70.4

66.7

0.835

 

 

BDS

67

8

3

35.4

29.6

33.3

7

225

MBBS

131

9

7

64.2

69.2

87.5

0.38

 

 

BDS

73

4

1

35.8

30.8

12.5

8

225

MBBS

132

10

5

63.8

83.3

83.3

0.247

 

 

BDS

75

2

1

36.2

16.7

16.7

9

225

MBBS

119

21

7

63.3

75

77.8

0.347

 

 

BDS

69

7

2

36.7

25

22.2

10

225

MBBS

100

28

19

62.5

65.1

86.4

0.08

 

 

BDS

60

15

3

37.5

34.9

13.6

11

225

MBBS

58

25

64

67.4

59.5

66

0.66

 

 

BDS

28

17

33

32.6

40.5

34

12

225

MBBS

130

12

5

64.8

63.2

83.3

0.632

 

 

BDS

70

7

1

35.2

36.8

16.7

13

225

MBBS

77

42

28

66.4

71.2

56

0.238

 

 

BDS

39

17

22

33.6

28.8

44

14

225

MBBS

71

35

41

70.3

67.3

56.9

0.18

 

 

BDS

30

17

31

29.7

32.7

43.1

15

225

MBBS

113

19

15

62.8

67.9

88.2

0.104

 

 

BDS

67

9

2

37.2

32.1

11.8

16

225

MBBS

116

19

12

64.8

90.5

48

0.01

 

 

BDS

63

2

13

35.2

9.5

52

17

225

MBBS

107

22

18

63.3

73.3

69.2

0.515

 

 

BDS

52

8

8

36.7

26.7

30.8

18

225

MBBS

93

25

29

72.1

67.6

49.2

0.009

 

 

BDS

36

12

30

27.9

32.4

50.8

19

225

MBBS

126

10

11

63.3

83.3

78.6

0.206

 

 

BDS

73

2

3

36.7

16.7

21.4

20

225

MBBS

126

16

4

62.4

88.9

100

0.059

 

 

BDS

76

2

0

37.6

11.1

0

21

225

MBBS

115

20

12

62.3

74.1

85.7

0.122

 

 

BDS

69

7

2

37.7

25.9

14.3

22

225

MBBS

117

20

9

64.6

60.6

90

0.31

 

 

BDS

64

13

1

35.4

39.4

10

23

225

MBBS

61

44

42

66.3

65.7

63.6

0.939

 

 

BDS

31

23

24

33.7

34.3

36.4

 

 

Figure No.1: The comparison of individual Physiology learning response items 1 to 12 between MBBS and BDS students

Figure No. 2: The comparison of individual Physiology learning response items 13 to 23 between MBBS and BDS students

 

 

 

DISCUSSION

In this study, difficulties and problems related to Physiology learning were revealed. As shown in Table I, there was a significant difference in Physiology learning response items 1, 5, 16 and 18 between MBBS and BDS students. Item 1 was related to knowledge of basic concepts of physics and chemistry. The finding related to item 1 in our study is consistent with Michael15’s study. In this study, it is mentioned that the ability to employ something learned in one context in the other context, is a difficult task, and this accounts for students’ incapability to use their prerequisite knowledge (chemistry and physics) in learning physiology. In Michael’s study the physiology faculty was asked to fill a questionnaire regarding difficulty in studying physiology. In a study done by Calthorpe et al16 students were asked to identify the difficult topics according to the modules. Item 5 was regarding the ability to understand the scientific and medical terms. In our study, there was a marked difference in MBBS and BDS students regarding the understanding of scientific terms. Item 16 was related to teachers presenting large subject content in one lecture17. It is evident that active learning, student-centered strategies to teaching physiology work better than passive strategies18. Item 18 was regarding the integration of Physiology teaching with other skills. For preparing students it is important for educators to use teaching strategies that makes the students involve in active learning, which increases their motivation, enhances their thinking, deepens learning and builds up collaboration in the classroom19. Although no single teaching method ensures a thorough understanding of a topic, various methods are being used in many institutes to reinforce lectures in teaching physiology, such as case-stimulated learning, problem-based learning and patient-centered learning19. In rest of the table items, there was no significant difference observed.

Physiology is a segment of core curriculum for all students studying in medicine and related professions20. It needs to be studied effectively so as to be placed in the context of disease when the students graduate and practice in the community21. The medical students rated the discipline of Physiology as one of the most difficult and toughest course20. Causal reasoning, use of graphs and sectionalize were remarkably important than any other aspect of teaching in making physiology hard to learn15. 

There is a remarkable difference between teaching and learning. In reality, there is excessive teaching and inadequate learning22. Teaching is not only passing the information to students but it is to make students understand the content that is taught. Physiology is a complex and continuously evolving subject, and teaching it, is not an easy task23. A substantial body of knowledge about cognitive processes and teaching and learning methods has gathered over the years23. Even with an active learning approach, physiology is hard to learn22.

The duty of Physiology teachers is to help students learn the subject in an effective way. An urgent need of reforms is required to improve the teaching efficacy of human physiology in medical schools.

CONCLUSION

The medical and dental students identified the factors causing difficulties and problems in learning physiology and the reasons of these difficulties.

Author’s Contribution:

Concept & Design of Study:

Sadaf Fatima

Drafting:

Syed Tousif Ahmed, Shazia Hashmat

Data Analysis:

Huma Salahuddin, Kevin Joseph Jerome Borges and Syed Nudrat Nawaid Shah

Revisiting Critically:

Sadaf Fatima, Syed Tousif Ahmed

Final Approval of version:

Sadaf Fatima

Conflict of Interest: The study has no conflict of interest to declare by any author.

 

 

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