Impact of Computer Assisted Learning as Teaching Modality on Learning & Understanding of Pharmacology Among Undergraduate Medical Students

Computer Assisted Learning (CAL) can replace animal experiments to a large extent. The objective of this study was to assess the effectiveness of various teaching modalities including CAL over students’ learning and understanding of pharmacology. Conventional teaching of autonomic nervous system (ANS) was done. Following it, a written theory examination was conducted. CAL was demonstrated and performed during practical sessions. Students were assessed using Objective Structured Practical Examination (OSPE), CAL viva followed by general viva covering ANS. The scores of written theory were compared with written CAL and scores of CAL viva-voce with general vivavoce. There was a significant difference in mean scores obtained in written theory and written CAL quiz (30.4% vs 47%; ≤0.01). No difference in the scores was observed in CAL viva and general viva. Students scored more in CAL viva compared to CAL written (47% verses 57%). In conclusion, CAL is an effective mode of teaching pharmacology. Available software can be used in assessment of the students. Indian J P ysiol Pharmacol 2017; 61(2) : 202–207 *Corresponding author : Lalit Kumar Gupta, Department of Pharmacology, Lady Hardinge Medical College, New Delhi – 110001 (India) Email: [email protected] (Received on January 12, 2017) embraces the knowledge of the source, physical and chemical properties, compounding, physiological act ions, absorpt ion, fate, and excret ion, and therapeutic uses of drugs (1). Pharmacology deals with study of substances that interact with the living system through chemical process by binding to regulatory molecules and activating or inhibiting normal body process. Pharmacology has its power to integrate physiology, molecular and cell biology Introduction The subject of pharmacology is a broad one and Indian J Physiol Pharmacol 2017; 61(2) Impact of CAL on Pharmacology Teaching 203 simulations are more enjoyable and time saving as compared to laboratory practical. In these studies, students’ feedback regarding CAL was obtained (7, 8). In the present study, data on the psychometric and logistic characteristics of an under-graduate pharmacology-practical curriculum and assessment based on CAL is reported. Students’ knowledge was compared following conventional and CAL modalities of teaching. The objective of this study was to assess the effectiveness of various teaching modalities over students’ learning and understanding of pharmacology and to evaluate the correlation between assessment using written and viva-voce. Materials and Methods The s tudy was conducted a t Depar tment o f Pharmacology, Lady Hardinge Medical College, New Delhi during the period of 6 months from January to June 2015. The schedule of teaching was approved by Departmental Academic Committee. The study included 200 undergraduate medical students (2nd year MBBS). Conventional teaching, using blackboard and audiovisual aids, covering topics of autonomic nervous system was conducted in classes for a total duration of 14 hours. Following these, a written theory examination (first term) was conducted to assess their conceptual and factual knowledge of the autonomic nervous system. Demonstration of CAL CAL experiments were taught during practical sessions using available softwares (ExPharm T1.00 for windows and Organ bath simulation J. Dempster, University of Strathclyde 2009-11 V1.8). Experiments included were 1. Effect of histamine and antihistaminic on guinea pig ileum 2. Effects of various drugs on rabbit eye when applied topically. 3. Effect of cholinomimetics and sympathomimetic and has its application as basic science over which clinical practice of drug therapy is based. Learning pharmacology at undergraduate level involves comprehending the core concepts i.e. important pharmacological terms, information on the effect of drugs on physiological systems to gain perspectives on how drugs are administered and understanding drug dosing. Besides teaching tools like group discussions, tutorials, audio-visual aids, clinical and community pharmacology, e-learning, practical sessions are an important part of pharmacology curriculum. Laboratory based practical classes have traditionally been key aspect of both teaching and learning pharmacology (2). Theoretical concepts learnt can be strengthened by demonstrat ing the effect of drugs on isolated tissues or intact animals (3). Although use of animals for research purposes is inevitable, the same may not be the case for teaching and learning. Ethical concerns have been raised for the use of animals purely for learning purpose (4). Computer Assisted Learning (CAL) can replace laboratory based animal experiments to a large extent and prevent the unnecessary harm or killing of animals (5). Regulators of medical education across the world have been expressing their concern for this issue. Recently, the National authority that governs medical education in India, the Medical Council of India (MCI) has issued guidelines underlining that at undergraduate level, animal experiments need not be performed and instead use of CAL should be incorporated (6). Many studies have described CAL as a teaching-learning tool (7, 8). However, studies regarding its effectiveness are limited. In the earlier years animal experiments were integral part of undergraduate pharmacology-practical curriculum. However due to concerns regarding use of animals for teaching purposes these experiments were phased out. In the authors’ personal experience it was observed that many students had difficulty in learning theoretical concepts of autonomic nervous system in the absence of a robust practical curriculum. Prev ious s tud ies have shown that computer 204 Amirtha, Gupta, Rehan and Gupta Indian J Physiol Pharmacol 2017; 61(2) on blood pressure and heart rate of dog, demonstrate Dale’s vasomotor reversal and rereversal and tachphylaxis phenomenon. 4. Effect of cholinergic and anticholinergic drugs on the motility of frog’s oesophagus. 5. Effect of sympathomimmetics, cholinergics, anticholinergics, potassium and calcium on isolated preparation of frog’s heart. 6. Effect of sympathomimmetics and sympatholytics, plot graded Dose Response Curve for agonists; demonstrate competitive antagonism and noncompet i t i ve an tagon ism us ing iso la ted preparations of rabbit jejunum. Each of the CAL experiment was demonstrated to the students for one hour at a time. Then the same experiments were again demonstrated to the students in batches of 10 students each in the succeeding hour. At al l the diff icult levels students were encouraged to redo the s teps by repeated administration of the drugs. The effects of various drugs were demonstrated by observing the response on graph paper. Practical examination 200 students were divided into 5 batches (40 students each) attending practical examination on consecutive days. Students were assessed using Objective Structured Practical Examination (OSPE), CAL viva followed by general viva covering different aspects of autonomic nervous system. Each OSPE session included 20 stations which had written quizzes on spotting of drugs, clinical case charts and on computer assisted learning. The total length of each session was 40 minutes. Summative assessment of the students was done using written theory examination conducted at the end of conventional didactic teaching and after the CAL (2nd term). 2nd term assessment comprised of written CAL quiz, CAL experiments in presence of assessor followed by viva –voce and general vivavoce covering several topics in pharmacology. The scores of first term written theory were compared with 2nd term written CAL because both assessed similar knowledge domains. Further, scores of CAL viva-voce and general viva-voce were also compared. Statistical Analysis For parametric data, Student’s t test was used. For non-parametric data, Chi-square test was used. Statistical significance was considered at p<0.05.