Vertical teaching principles: pregnancy induced hypertension

Abstract

Background: The methodology of teaching is of three types. "Adhyapana" refers to "act of teaching" or the "teacher reads". "Adhyayan" is "self-learning" or the "student reads". "Sambhasa" or "Tatva vidya" refer to "discussion". Types of learning are again of three types: informative learning, formative learning and transformative learning. Informative learning produces experts. Formative learning produces professionals. Transformative learning in the context of health education produces leaders with global connection. Millers pyramid of competence evolves the steps in learning as knows, knows how, does and teaches how. The aim of the vertical integrated teaching programme on pregnancy induced hypertension was to enable students to comprehend and teach (sambhasa) pregnancy induced hypertension with firm and reinforced understanding of pathophysiology, biochemical markers, radiological predictors, pharmacotherapy and anesthetic consideration. Neonatal problems specific to pregnancy-induced hypertension were also discussed. Methods: Problem based and peer instruction approach was followed. The study was conducted as a one-day teaching-learning programme for final year students (168) of Saveetha Medical College, Chennai, India. All the basic sciences and their translation into clinical skills were explained pertaining to the problem of hypertension in pregnancy. Plenary discussion of each clinical case of hypertension and convulsion in pregnancy was done in a galaxy of experts from each department. The teaching faculty of the department of biochemistry, pathology, pharmacology, radiology, general medicine, anesthesia and obstetrics and gynecology and neonatal medicine provided a learning module in the web forum of university website for the final year medical undergraduate students. The students were able to comprehend pregnancy-induced hypertension (PIH) from its basics and decide on the relevant clinical implications. A case based discussion was done with the constellation of experts from all disciplines of medicine. This was followed with mind mapping of concepts developed. Pretest and posttest helped the teaching faculty to assess the impact of knowledge generated. Feedback was obtained to improvise the existing teaching method sand develop new teaching tools. Results: The median, the 25 th percentile, the 75 th percentile and extreme values in pretest and posttest group were plotted using Sigma plot. An improvement in scores was observed. Conclusions: Vertical integration of medical disciplines helps medical students to understand a clinical problem in the light of basic sciences. The modules beginning with the pathophysiology of pregnancy induced hypertension and concluded with anesthetic considerations. An elaborate module helps to translate an understanding of pharmaco therapeutics of hypertension in pregnancy. A well-trained medical student can help to reduce maternal mortality due to preeclampsia.