Vertical teaching principles: pregnancy induced hypertension

Authors

  • Nidhi Sharma Department of Obstetrics and Gynaecology, Saveetha Medical College, Saveetha University, Chennai, India
  • A. Parimala Department of Obstetrics and Gynaecology, Saveetha Medical College, Saveetha University, Chennai, India
  • Jayashree K. Shrinivasan Department of Obstetrics and Gynaecology, Saveetha Medical College, Saveetha University, Chennai, India
  • Sasireka P. Department of Obstetrics and Gynaecology, Saveetha Medical College, Saveetha University, Chennai, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20161655

Keywords:

Vertical integration, Teaching tool, Pregnancy induced hypertension, Medical student, Maternal mortality, Medical curriculum

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 25th percentile, the 75th 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.

References

Wijnen MM, Cate OT, Vander S, Borleffs JC. Vertical integration in medical school: effect on the transition to post graduate teaching. Med Educ. 2010;44(3):272-9.

Maruo T. Undergraduate and postgraduate education clinical education in Kobe university of medicine. Kobe J Med Sci. 1997;43(6):237-42.

Margolis CZ, Deckelbaum RJ, Henkin Y, Baram S, Cooper P, Alkan ML. Medical schools for international health run by international partners. Acad Med. 2004;79(8):744-51.

Barrow HS. A taxonomy of problem-based learning methods. Medical Education. 1986;20:481-6.

Wijnen MM, Cate OT, Rademakers JJ, Van DSM, Borleffs JC. The Influence of a vertically integrated curriculum on the transition to postgraduate training. Med Teach. 2009;31(11):528-32.

Wijnen MM, Cate TO, Schaaf VM, Harendza S. Graduates from vertically integrated curricula. Clin Teach. 2013;10(3):155-9.

Cave J, Goldacre M, Lambert T, Woolf K, Jones A, Dacre J. Newly qualified doctors’ views about whether their medical school had trained them well: questionnaire surveys. BMC Medical Education. 2007;7:38.

Cave J, Woolf K, Jones A, Dacre J. Easing the transition from student to doctor: how can medical schools help prepare their graduates for starting work? Med Teach. 2009;13:1-6.

Hayes K, Feather A, Hall A, Sedgwick P, Wannan G, Wessier SA, Green T, McCrorie P. Anxiety in medical students: is preparation for full-time clinical attachments more dependent upon differences in maturity or on educational programmes for undergraduate and graduate entry students? Med Educ. 2004;38:1154-63.

Dornan T, Bundy C. What can experience add to early medical education? Consensus survey. British Med J. 2004;329:834-7.

Goldacre MJ, Lambert T, Evans J, Turner G. Pre-registration house officers’ views on whether their experience at medical school prepared them well for their jobs: national questionnaire survey. British Med J. 2003;326:1011-2.

Prince KJAH, Van MWJ, Scherpbier AJJA, Van CPM, Boshuizen HPA. A qualitative analysis of the transition from theory to practice in undergraduate training in a PBL medical school. Adv Health Sci Educ. 2000;5:105-16.

Bates R. A critical analysis of evaluation practice: the Kirkpatrick model and the principle of beneficence. Louisiana Evaluation and Program Planning. 2004;27:341-7.

Downloads

Published

2017-01-05

Issue

Section

Original Research Articles