by Michael A. Ferenczi
s LKCMedicine is a new medical school we had the
privilege to import the best pedagogies and practices
from around the world, and to build on the proven
curriculum developed over the years at Imperial College London.
A decision was taken to include Science Practical classes in the
curriculum during the first two years of the five-year MBBS
course. The purpose of the practicals is to reinforce the principles
and theories learned during our Team-Based-Learning (TBL)
classrooms and to augment the learning experience with handson
access to real laboratory and clinical equipment.
Having the advantage of selecting activities for an initially
empty teaching laboratory, we had the freedom to purchase new
equipment to focus on activities that are closely linked to the TBL
learning outcomes, thus enriching the TBL process, and also on
activities of direct clinical relevance wherever possible.
Many of the practicals were inspired by the practicals used
in the two early years in the Imperial College MBBS course,
especially in the Medical Sciences course 'Molecules, Cells and
Disease'. However new practicals were also developed. In year 1, 16
practicals lasting 3 hours each are offered to our students, with 6
practicals in year 2. Students are asked to work individually, in pairs
or in small groups, depending on the task. Our current teaching
laboratory holds 42 students. All practicals are repeated twice
as the laboratory only holds half the cohort at a time. Our new
laboratory to be completed in August 2015 will hold 100 students.
Students are provided with an online Practical Guide which they
are asked to study in advance. The Practical Lead usually provides
a short introduction to the practical at the beginning of the class
to highlight safety issues, dress code, proper behaviour etc, as well
as a demonstration of some of the procedures, aided with cameras
and projector screens. One microscope in every three is equipped
with a digital camera and Wi-Fi connection to the students' iPads.
Practicals are followed by a one or two-hour data analysis
session. For these, students are given access to the compiled
experimental data recorded by the whole cohort. The data provides
the opportunity for the development of analytical and statistics
skills in a way that is directly relevant to the students. They explore
sources of experimental variation and the meaning of significance.
The laboratory results provide rich material for discussion, for
example to explore the importance of experimental evidence. The
results are discussed in the light of the TBL Learning Outcomes.
Scheduling of the practicals is in sync with the TBL topics. The
practicals demonstrate key scientific principles, explore important
technologies used in clinical pathology laboratories and give
insight into clinically relevant techniques.
Examples of Practicals
In Year 1, practicals include:
- Determination of the relationship between contraction of the sum and frequency of stimulation of the median nerve in the wrist using surface stimulating electrodes, and observation
of the electrical activity of the muscle induced by voluntary
contractions. This is an opportunity for students to explore
features of nerve and muscle conduction, twitch and tetanic
contractions as well as motor unit recruitment.
- Measurement of the left ventricle ejection fraction using
ultrasound on volunteer male students, under the guidance
of professional sonographers. A modern imaging technique
is used here to provide understanding of the dynamics of
cardiac contraction in healthy subjects, illustrate important
physiological features of the heart and provides the opportunity
to measure cardiac output.
- Exploration of 12-lead and 3-lead electrocardiograms on
healthy volunteers to determine features of the electrical
activity of the heart. This practical gives a first taste of this
important clinical tool, to illustrate the relationship between
cardiac function and the detectable electrical signals at the
surface.
- Diagnostic microbiological characterization of commonly
encountered pathological bacteria. This practical illustrates
the role of the clinical pathology laboratory in the hospital, as
well as giving students their first opportunity to observe a
range of bacteria under the microscope.
- Assessment of breathlessness in which volunteer students use
cycle ergometers to determine their VO2max. Students measure
parameters of lung function at rest as well as during and after
exercise.
In Year 2, student practicals include:
- Examination of gall-bladder size by ultrasound in volunteer
male students, before and after ingestion of ice cream. This
is the third practical in which ultrasound is used to explore
the dynamics of healthy organs.
- Study of age-related impairments on activities of daily living
in which student volunteers wear a variety of contraptions (e.g.
goggles, ear mufflers, weights, splints) which simulate aspects
of the impairments that develop in ageing. This practical is
relevant to the patient demographics our students will
encounter in their career.
All practicals have undergone a rigorous risk assessment, and
approval by the school ethics committee was obtained when
necessary. All volunteers have agreed to the procedures and signed
consent forms.
Assessment of the Practicals
For four of the Year 1 practicals, students are asked to submit
a summary of their work in the form of a 1000-word scientific
abstract submitted online. This is designed to develop scientific writing skills as well as the ability to synthesize and summarize
their laboratory experiences. The write-ups are doubly marked and
feedback is provided to the students on the quality of their work.
The assessment is formative only. Unsatisfactory or late write-ups
require a second or third attempt.
Are practicals well received?
All practical classes, as well as all our other teaching sessions
are assessed through the collection of prompted anonymous
student feedback through our ¡®Student Voice¡¯ web portal. A
random fraction of the cohort is asked to score seven important
characteristics of the practicals, such as ¡®the learning experiences
helped me to develop understanding of important concepts and/or
skills¡¯. In addition, free-text comments are encouraged. Responses
were generally positive. Examples of responses are shown below
for the Year 1 ¡®cardiac ultrasound¡¯ practical:
Illustrative Comments: Science Practical Process
Click here to download the full issue for USD 6.50
|