What makes the learning of physiology in a PBL medical curriculum challenging? Student perceptions

Abstract

Physiology is an integral component of any medical curriculum. Traditionally, the learning of physiology has relied heavily on systems-based didactic lectures. In 2001, the Nelson R. Mandela School of Medicine (NRMSM; Durban, South Africa) embarked on a problem-based curriculum in which the learning of physiology was integrated with relevant clinical scenarios. Students are expected to gain an understanding of physiology through self-directed research with only certain aspects being covered in large-group resource sessions (LGRSs). It has gradually become evident that this approach has resulted in significant gaps in students' understanding of basic physiological concepts. A survey of student perceptions of needs for physiology was undertaken to gain a better understanding of their perceived problems and also to inform them of proposed curricular changes. Students were asked to what extent they thought physiology was essential for their understanding of pathology, interpretation of patients' clinical signs and presentation of symptoms, and analysis of laboratory results. Students were also invited to detail the difficulties they experienced in understanding in LGRSs on clinical and physiological topics. The results of the survey indicate that greater interaction of students with experts is needed. In particular, students felt that they lacked the basic conceptual foundations essential for the learning and understanding of physiology, since the difficulties that the students identified are mainly terminological and conceptual in nature.

Performance of first-year health sciences students in a large, diverse, multidisciplinary, first-semester, physiology service module

“…physiology success rates; suggestions for improvements; large service modules; diversity; first-year health science students PHYSIOLOGY is a subject that is integral to the studies of all health sciences students. Students find it difficult (8,13,22,26), resulting in high failure rates, particularly among those students who have to study physiology in their very first semester at university. In South Africa, the academic year starts in January and ends in December and is divided into two semesters.…”

Students' perceived value of physiology course activities in a Sudanese medical faculty

“…Physiology has undergone many innovative changes regarding the teaching and learning environment (3,7,15,19). Novel teaching methods that mainly depend on interactions rather than simple recall have proven to be more effective in learning physiology than traditional methods (9).…”

The Challenges of Developing a Project-Based Self-Directed Learning Component for Undergraduate Medical Education

“…The three challenges listed above (student buy-in, objectively tracking student progress, and achieving consistency among student groups) must be addressed for all small group components [12,13] and therefore are not unique to Explorations. However, in a project-based SDL component like Explorations, those three challenges are amplified due to the large degrees of freedom granted to both facilitators and students.…”

“…The faculty facilitator may unintentionally influence group dynamics in any type of small group learning [13,14], and facilitator influence was a pressing concern when we first started Explorations. Faculty in all institutions come from different backgrounds with varying levels of training, and therefore it cannot be assumed that every facilitator will set equal expectations for their groups.…”