Narratives as Active Learning Strategy to Emphasise the Clinical Relevance of Enzymology in Medicine

Abstract

Introduction: Student learning is dictated by the learning environment rather than the inherent qualities of the learner. Mode of curriculum delivery heavily influences the learning environment and pushes the learner towards rote learning or meaningful learning. In every curriculum, there are areas which are perceived by students as unappetising and demanding. In biochemistry, enzymology is not a favourite among students since it entails learning kinetics and related equations and graphs. However, enzymology is important in the medical curriculum because of its clinical relevance in the diagnosis, prognosis and treatment of diseases. The present study employs an active learning strategy using a themed narrative and case scenarios to make the learning experience more interesting and meaningful. Aim: The objective of this study was to revise and integrate the core concepts in ‘enzymology’ and to bring home the clinical relevance of enzymology in medicine. In addition, the study would also facilitate active learning, thus promoting knowledge retention. Materials and Methods: A narrative on enzymology with specific numbered blanks, to be filled in by students was designed. Five case scenarios containing pictures and text, highlighting the clinical aspects of enzymology were constructed and validated. MBBS students (n=82) of the first year were asked to fill in the gaps in the narrative. Case scenarios were narrated to the students using PowerPoint slides containing pictures and text. Students responded to specific questions relating to the case scenarios. The marks obtained in both the activities were tabulated and students’ opinion on the activity based on predefined indicators was assessed using a questionnaire. Results: Students (43%) scored distinction marks (>75%) in the narrative on enzymology. They opined that it helped them to recall and integrate (81%) and retain knowledge (88%). They also felt that case scenarios were clinically relevant (82%) and helped to bridge the gap between theory and actual practice of enzymology in medicine (85%). Conclusion: Narratives and case scenarios can be used effectively to improve learning by medical students, especially when the subject matter is not easy to comprehend and is perceived as challenging.

Keywords

• case scenarios
• knowledge retention
• narrative
• problem solving