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Use of Concept Mapping as a Facilitative Tool to Promote Learning in Pharmacology, Schemes and Mind Maps of Pharmacology

An analytical study for pharmacology students with example of concept map of sedative hypnotic drugs

Typology: Schemes and Mind Maps

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476 Journal of the College of Physicians and Surgeons Pakistan 2011, Vol. 21 (8): 476-481
INTRODUCTION
Pharmacology is generally perceived by the students
as a subject difficult to conceptualize and retain.
Students, therefore, resort to memorization. Rote
learning is easily forgotten and students are unable to
apply this knowledge to problem-solving situations or to
link this to previous knowledge.1Cognitive psychology
has shown that the way knowledge is structured in the
memory that determines the ability to retain, recall and
use it to solve problems.2Concept mapping is a technique
that is well established in helping students build useful
mental frameworks.3,4 According to Michael, meaningful
learning implies “acquiring useful learning which is
stored in a way that can be accessed from various
points, which is well integrated with previous knowledge
and which is accompanied by building mental models
connected with other models for many other phenomena.” 1
A big challenge for medical educators is to search for
pedagogical tools that will promote meaningful learning
and discourage rote learning.5In pharmacology
meaningful learning implies the ability to understand
the mechanism of action of drugs on the body systems
and to be able to relate these actions to systemic effects
and adverse drug effects, and in turn associate these
effects to clinical uses and contraindications to the use
of these agents. Current teaching strategies appear to
be inadequate in enhancing and improving knowledge
of pharmacology due to which students lack depth
of knowledge and experience difficulties in using
pharmacological concepts in clinical practice settings.6
Concept mapping, initially proposed by Novak, is an
innovative approach that helps the learner to organize
knowledge.7Concept maps communicate knowledge
graphically instead of relying on lengthy textual
explanations. They have been used in many disciplines
and at all levels of education to provide a very useful
and extremely appealing way of illustrating concepts.8
ABSTRACT
Objective: To assess whether students find concept mapping a useful learning methodology to conceptualize and
organize topics studied in CNS module of Pharmacology; and to evaluate whether addition of concept mapping
assignment could help to improve examination scores.
Study Design: An analytical study.
Place and Duration of Study: College of Dentistry, Jinnah Medical and Dental College, Karachi, Pakistan, from March to
May 2009.
Methodology: A class of 50 BDS students was recruited for the study. Two randomly selected groups of 12 students each,
prepared concept maps in topics from CNS pharmacology which were displayed and discussed during tutorial sessions.
The other two groups (n=25) following the traditional teaching methodology, served as controls. Scores from best choice
questions and short essay questions were compared between the investigational and control groups using the student's
t-test with significance at p < 0.05. Feedback obtained after completion of the study was evaluated as percent response.
Results: One-best-choice test of the control group showed a mean grade of 57.1 + 16.7 vs. test group mean of 58.8 + 13.
For the short essay questions, control group obtained a mean of 52.3 + 18.8 vs. test group mean grade of 53.8 + 22.5.
Both results were not significantly different (p > 0.05). However, feedback about concept mapping showed that the
technique helped the students to conceptualize difficult topics in CNS pharmacology (86.36%). Concept mapping was
particularly beneficial in preparing for exams as it provided a quick overview of the entire subject (68.68%).
Conclusion: Students found concept mapping as a useful pedagogical tool which could potentially be used to acquire
meaningful learning in Pharmacology as a supplement to traditional teaching techniques. It was not found beneficial in
improving examination grades probably because standard examinations and concept mapping measure different cognitive
domains.
Key words: Concept mapping. Medical education. Critical thinking. Teaching and learning.
1Department of Pharmacology, Liaquat National Medical
College, Karachi.
2Department of Biochemistry, Jinnah Medical and Dental
College, Karachi.
Correspondence: Dr. Farida Qadir, Department of Pharmacology,
Liaquat National Medical College, Stadium Road, Karachi.
E-mail: faridaqa100@hotmail.com
Received January 19, 2010; accepted June 13, 2011.
Use of Concept Mapping as a Facilitative Tool to Promote
Learning in Pharmacology
Farida Qadir1, Tabassum Zehra1and Imrana Khan2
ORIGINAL ARTICLE
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INTRODUCTION

Pharmacology is generally perceived by the students as a subject difficult to conceptualize and retain. Students, therefore, resort to memorization. Rote learning is easily forgotten and students are unable to apply this knowledge to problem-solving situations or to link this to previous knowledge. 1 Cognitive psychology has shown that the way knowledge is structured in the memory that determines the ability to retain, recall and use it to solve problems.^2 Concept mapping is a technique that is well established in helping students build useful mental frameworks.3,4^ According to Michael, meaningful learning implies “acquiring useful learning which is stored in a way that can be accessed from various

points, which is well integrated with previous knowledge and which is accompanied by building mental models connected with other models for many other phenomena.”^1 A big challenge for medical educators is to search for pedagogical tools that will promote meaningful learning and discourage rote learning. 5 In pharmacology meaningful learning implies the ability to understand the mechanism of action of drugs on the body systems and to be able to relate these actions to systemic effects and adverse drug effects, and in turn associate these effects to clinical uses and contraindications to the use of these agents. Current teaching strategies appear to be inadequate in enhancing and improving knowledge of pharmacology due to which students lack depth of knowledge and experience difficulties in using pharmacological concepts in clinical practice settings. 6 Concept mapping, initially proposed by Novak, is an innovative approach that helps the learner to organize knowledge. 7 Concept maps communicate knowledge graphically instead of relying on lengthy textual explanations. They have been used in many disciplines and at all levels of education to provide a very useful and extremely appealing way of illustrating concepts.^8

ABSTRACT

Objective: To assess whether students find concept mapping a useful learning methodology to conceptualize and organize topics studied in CNS module of Pharmacology; and to evaluate whether addition of concept mapping assignment could help to improve examination scores. Study Design: An analytical study. Place and Duration of Study: College of Dentistry, Jinnah Medical and Dental College, Karachi, Pakistan, from March to May 2009. Methodology: A class of 50 BDS students was recruited for the study. Two randomly selected groups of 12 students each, prepared concept maps in topics from CNS pharmacology which were displayed and discussed during tutorial sessions. The other two groups (n=25) following the traditional teaching methodology, served as controls. Scores from best choice questions and short essay questions were compared between the investigational and control groups using the student's t-test with significance at p < 0.05. Feedback obtained after completion of the study was evaluated as percent response. Results: One-best-choice test of the control group showed a mean grade of 57.1 + 16.7 vs. test group mean of 58.8 + 13. For the short essay questions, control group obtained a mean of 52.3 + 18.8 vs. test group mean grade of 53.8 + 22.5. Both results were not significantly different (p > 0.05). However, feedback about concept mapping showed that the technique helped the students to conceptualize difficult topics in CNS pharmacology (86.36%). Concept mapping was particularly beneficial in preparing for exams as it provided a quick overview of the entire subject (68.68%). Conclusion: Students found concept mapping as a useful pedagogical tool which could potentially be used to acquire meaningful learning in Pharmacology as a supplement to traditional teaching techniques. It was not found beneficial in improving examination grades probably because standard examinations and concept mapping measure different cognitive domains.

Key words: Concept mapping. Medical education. Critical thinking. Teaching and learning.

(^1) Department of Pharmacology, Liaquat National Medical College, Karachi. (^2) Department of Biochemistry, Jinnah Medical and Dental College, Karachi. Correspondence: Dr. Farida Qadir, Department of Pharmacology, Liaquat National Medical College, Stadium Road, Karachi. E-mail: faridaqa100@hotmail.com Received January 19, 2010; accepted June 13, 2011.

Use of Concept Mapping as a Facilitative Tool to Promote

Learning in Pharmacology

Farida Qadir^1 , Tabassum Zehra^1 and Imrana Khan^2

ORIGINAL ARTICLE

In constructing a concept map, the key concepts are enclosed in circles or boxes. Relationship between concepts are indicated by connecting arrows linking two concepts. Words on the arrow specify relationship between the two concepts. Concept maps are represented in a hierarchical fashion with the more general concepts at the top of the map and less general and more specific concepts below. Cross links or arrows indicate how knowledge in one domain is related to knowledge in another domain. It is best to construct concept map with reference to some particular question we wish to answer (focus question) or a situation we wish to understand. Specific examples, given at the bottom, help to clarify meaning of a map. They are not enclosed in boxes as they indicate specific situations and not general concepts. To the best of our knowledge, concept mapping as a learning methodology has not been investigated in Pakistan. The purpose of this study was to determine the usefulness of concept maps in developing pharmacological concepts and to obtain students feed back on its value and acceptability and to assess the usefulness of concept maps in improving test scores.

METHODOLOGY

This analytical study was conducted between March and May 2009, with 50 undergraduate students, enrolled in the second year of dentistry. The names of students, arranged in alphabetical order, was divided into 4 sections A, B, C, D comprising an average of 12 students each. Through randomization by ballot method, two groups A and C (n=25), were assigned to the intervention group, and groups B and D (n=25), served as controls. The intervention was in the form of a concept mapping assignment added to the tutorials. The class was taught the assigned topics by giving classical style lectures using MS power point presentations. They were instructed to study the topics covered during the week for discussion in the tutorial classes the following week. For test groups A and C, two introductory sessions were arranged. First session was a workshop in which they were explained the purpose and process of concept mapping and relevance to their education. The method of creating concept maps was explained by simple examples. The second session was followed by hands on experience during which students created concept maps of a topic from their existing knowledge. Each student in test groups A and C was asked to create concept maps on various topics from CNS pharmacology. During the tutorial class, the students presented the concept maps, elaborated on the concepts, clarified misconceptions and shared their experience with building the concept maps (example of a concept map given in Figure 1). Emphasis was placed

on the mechanism of action of drugs and how drugs alter normal physiological processes leading to their systemic effects. The actions of drugs were related to their uses and adverse effects which in turn were correlated with contraindications to their use. Pharmacokinetic and pharmacodynamic aspects of drug interactions were also emphasized. Links to related topics in physiology, anatomy or biochemistry were also elaborated upon wherever relevant. The tutor guided the students to correct their cognitive difficulties in organizing and clarifying the concepts and in removing misconceptions. Control groups B and D attended the same lecture and had the same number of tutorials comprising of discussion sessions during which an equally qualified tutor asked questions to clarify doubts. At the end of the unit, module tests based on the best choice questions (BCQs) and short essay questions (SEQs) were taken to assess the theoretical knowledge of all the students. The intervention group was asked to fill in a questionnaire in which they recorded their impression about the concept mapping assignments. For the quantitative data, statistical analysis was done using on-line Graphpad p-value calculator. Mean and standard deviation was calculated for the test scores. Student's t-test was used for determining the difference between the test scores. P-value < 0.05 was taken as significant. Proportions were computed for qualitative variables like student's degree of satisfaction with the concept mapping, usefulness of the mapping in understanding difficult concepts, benefit of extra time spent with the new method etc.

RESULTS

Results were analyzed using Student’s t-test. For best choice questions (BCQ), a mean of grade of 57.1 + 16. was obtained by the control group and 58.8 + 13 by the test group (p=0.72) which was not statistically significant. In short essay questions (SEQ) test, the average grade for the control group was 52.3 + 18.8 and for the test group it was 53.8 + 22.5 which was not found significant (p=0.84). To evaluate students’ perception regarding concept mapping, a questionnaire was filled by students at the end of the project (Table I). This showed that 86.36% of the students found concept mapping very useful in understanding the topic and 54.54% in retaining the knowledge acquired; 68.18% thought that the major benefit of the concept map was that it helped in quick revision before a test and 50% could clear misconceptions during discussion of the maps. However, 45.45% of students spent more than 2 hours and 40.9% spent more than 1 hour in making a map.

Use of concept mapping as a facilitative tool to promote learning in pharmacology

Nevertheless 68.18% felt that the extra time spent benefited them in understanding the subject. Majority (76.19%) said they preferred concept mapping over the traditional tutorial format and 68.18% favoured use of concept mapping in other subjects as well. On the other hand, 72.72% had difficulty in correlating pharmacological concepts with the knowledge acquired in previous years in other basic sciences.

DISCUSSION

The pharmacology curriculum is loaded with information which the teachers expect the students should know. This makes the student simply memorize the facts without acquiring a deep understanding of the subject. A review of a concept map made by a student on pharmacology of sedative hypnotics like benzodia- zepines and barbiturates (Figure 1), shows that students after thoroughly reading through the topic analyzed the content to identify key concepts and structured the information such that a glance shows the key concepts and their relationships thereby allowing a holistic understanding of the topic. This is reflected in the students’ response where majority found that concept maps effectively summarize the subject and is very useful in revision before exams when not enough time is available to go through lengthy texts. Summarizing is important because it aids memory, makes review more efficient and encourages high level critical thinking. Concept maps encourage creativity as each map is unique and reflects the thinking process of the builder. Different colours used to group sections of the map

Use of concept mapping as a facilitative tool to promote learning in pharmacology

Table I: Students’ opinion about concept mapping (CM). Questions Number of Percentage students

  1. How much did CM help you in understanding the topic? A. Not at all 0 0% B. Somewhat 3 13.63% C. Very useful 19 86.36%
  2. Did CM help you in retaining information? A. Not at all 0 0% B. Somewhat 10 45.45% C. Very useful 12 54.54%
  3. How much information did you retain during the test? A. < 25% 0 0% B. 25-50% 6 27.27% C. 50-75% 12 54.54% D > 75% 4 18.18%
  4. Did CM help you in correlating this knowledge to your past knowledge? A. Not at all 3 13.63% B. Somewhat 16 72.72% C. Very useful 3 13.63%
  5. How much time did you spend in making CMs? A. < 1hour 3 13.63% B. 1-2 hours 9 40.9% C. > 2 hours 10 45.45%
  6. Did this extra time spent benefit you in under- standing the subject? A. Not at all 0 0% B. Somewhat 7 31.81% C. Very useful 15 68.18%
  7. Did the extra time spent benefit you in attempting the test? A. Not at all 0 0% B. Somewhat 11 50% C. Very useful 11 50%
  8. Did you use the concept maps to prepare for the test? A. Not at all 1 4.54% B. Somewhat 11 50% C. Very useful 10 45.45%
  9. Did CM help you in attempting the BCQ test? A. Not at all 1 4.54% B. Somewhat 14 63.63% C. Very useful 7 31.81%
  10. Did CM help you in attempting SEQ test? A. Not at all 2 9.09% B. Somewhat 12 54.54% C. Very useful 8 36.36%
  11. Would you like to use the concept maps in other topics/subjects? A. Not at all 3 13.63% B. Probably 4 18.18% C. Very much 15 68.18%
  12. Do you prefer concept mapping over the traditional tutorial format? A. Not at all 0 0% B. Probably 5 23.80% C. Very much 16 76.19%

Open ended questions: What in your opinion are the main disadvantages of making concept maps?

  1. Very time consuming. 18 students (81.81%).
  2. Sometimes difficult and confusing to make. 5 students (23.80%)
  3. Precise, have to refer to text for details. 4 students (18.18%)
  4. Not helpful in attempting tests. 5 students (23.80%) What in your opinion are the main advantages of making concept maps?
  5. Helpful in revision before tests. 15 students (68.18%)
  6. Helpful in understanding the subject. 14 students (63.63%)
  7. Classroom discussion helped to clear concepts and remove misconception. 11 students (50%)
  8. Useful for a quick overview of the subject. 7 students (31.81%)

make it visually appealing. Information is structured in a manner which allows the students to see how complex ideas fit together - how the mechanism of action relates to the systemic effects which in turn relates to adverse effects and indications for use of sedative hypnotics. Concept maps also provide an opportunity for holistic understanding of a subject as it discern overlaps and commonalities allowing cross-disciplinary linking, for example between physiology of action potential and mechanism of action of sedatives as shown in Figure 1. Also links were discerned to other topics in pharmacology - pharmacokinetics, pharmacodynamics, drugs of abuse, antiepileptic and general anaesthetic agents, this encourages highly divergent lateral thinking.

To our knowledge, use of concept maps as a pedagogical tool in Pharmacology has so far not been reported. However, in other medical disciplines, like physiology, microbiology internal medicine, and medical research, 11-14^ concept mapping has been used effectively. It has been shown that concept maps can promote meaningful learning in medical education.15, Several health-related fields like veterinary medicine,^9 and nursing,^10 have also found concept mapping to be a successful learning strategy.

This study found no significant difference in scores of one best choice and essay type tests between the intervention and control groups. However, average grades were generally higher for intervention than control group. This result is consistent with findings of various other studies which have found no correlation between conventional measures of learning like grades of standardized tests and concept mapping assessment scores. 17,18^ This could be due to the fact that the assessments do not test concepts rather they rely on memorization of trivial facts not covered in the concept maps. Students learning physiology by concept mapping have performed significantly better at problem- solving exams, but the difference was not significant in multiple-choice exams.^19 However, concept mapping was found to benefit students in the lower percentiles in acquiring significantly higher grades in MCQ tests, this difference was not observed in high-achievers. 19 Moreover, comparative study of classical teaching method with concept mapping technique has shown to produce a significant improvement in OSCE scores in a plastic surgery course.^20

The questionnaire designed to evaluate perception of the students at the end of the project showed that students found constructing concept maps to be helpful in understanding CNS pharmacology. A majority of the students agreed that concept maps assisted and enhanced thinking and learning of Pharmacology, however, they found the process time intensive. It was found that the response was less favourable when asked about establishing interrelationships between other basic sciences. This might reflect difficulty faced

by the students in moving from simpler and basic subjects to subjects involving greater conceptualization and application. It would probably be more useful to expose students to a wide range of maps at the beginning of the project in order to better familiarize the students to the techniques of concept mapping. Also much time could be saved by using computer-based concept mapping software like Inspiration or CMap. The most encouraging aspect of this study was that most students stated that they would like to use concept maps as a learning tool for future studies in Pharmacology and other subjects. We suggest that concept mapping as a pedagogical tool could be applied to the entire subject of Pharmacology. It could also be included in text books of Pharmacology as an explicit overview at the end of each chapter.

CONCLUSION

Students found that concept maps enhanced their capacity to develop clear concepts in Pharmacology and in getting a comprehensive and accurate overview of the entire topic. This helped in quick revision before exams. This learning methodology did not help to improve scores of one best-choice and essay-type tests likely to be due to differences in cognitive domains involved.

REFERENCES

  1. Michael J. In pursuit of meaningful learning. Adv Physiol Educ 2001; 25 :145-58.
  2. Schimidt HI. Alternative approaches to concept mapping and implications for medical education: commentary on reliability, validity and future research directions. Adv Health Sci Educ Theory Pract 2006; 11 :69-76.
  3. Driver R, Asoko J, Leach J, Mortimer E, Scott P. Constructing scientific knowledge in the classroom. Educ Res 1994; 23 :5-12.
  4. Novak JD, Gowin DB. Learning: how to learn. New York: Cambridge University Press ; 1984.
  5. Silverthorn DU. Teaching and learning in the interactive class room. Adv Physiol Educ 2006; 30 :130-40.
  6. Manias E, Bullock S. The educational preparation of under- graduate nursing students in pharmacology: clinical nurses perceptions and experiences of graduate nurses Medication Knowledge. Int J Nurs Stud 2002; 39 :773-84.
  7. Novak DJ, Canas AJ. The theory underlying concept maps and how to construct and use them: Technical Report IHMC CmapTools 2006-01. Pensacola (FL): Florida Institute of Human and Machine Cognition ; 2008.
  8. Novak JD. Learning creating and using knowledge: concept maps as facilitative tools in schools and corporations. New York: Routledge ; 1998.
  9. Edmondson KM, Smith DF. Concept mapping to facilitate veterinary students' understanding of fluid and electrolyte disorders. Teach Learn Med 1998; 10 :21-33.
  10. Jitlakoat Y. The effectiveness of using concept mapping to improve primary medical care nursing competencies among 4th year Assumption University nursing students. AU J T 2005; 9 :111-20.

Farida Qadir, Tabassum Zehra and Imrana Khan