Computer-assisted learning in pharmacology MBBS curriculum: Myths and reality

Introduction Pharmacology teaching has to be more application-based as the curriculum has shifted to competency-based guidelines. Among the many innovative teaching–learning methods introduced, computer-assisted learning (CAL) has been under-utilized or inappropriately used. Since in MBBS, now all subjects are clinical sciences, the teaching–learning of pharmacology should be assisted more with computers using innovations such as artificial intelligence and alternate reality. The extensive setup of CAL lab must be used efficiently in teaching–learning, and assessment of students. The Computer-assisted Learning Setup The laboratory, like other laboratories, should have space for students as per regulations and multiple computer terminals with a screen and projector/TV screen.[1] You can have a single server attached to multiple terminals or multiple independent desktops. In case of independent desktops, you should label one as a mother desktop, having a folder that is shared with all other terminals. There should be a common folder accessible from all terminals. Ensure appropriate power backup. There should also be a big screen or an LED screen to be used during teaching–learning. The Myth It is assumed that CAL lab means we need to buy software. Again, if you split the words its “computer-assisted learning.” Hence, use it where computers can help to assist or improve learning. CAL lab is maintained by the pharmacology department; however, it should be available to all departments to use for teaching–learning, and assessment, for example, anatomy or surgery using CAL for showing video-based movements/procedures and conduct of Objective Structured Practical Examination/Objective Structured Clinical Examination (OSPE or OSCE). Hence, instead of wasting funds on software, collect free resources and national guidelines/documents for the CAL activities. Utility of Computer-assisted Learning This strategy can be used for teaching–learning strategies or for assessments. Use in teaching–learning strategies Use this laboratory and its desktops for multimedia content, video cases, recorded role plays, problem-based scenarios, and for providing immediate feedback to students and animations-simulation-based teaching, for example: Many routes of administration, free videos are available for learning (https://www.youtube.com/watch?v=Fzh8mOOYywo) You can make your own videos For sessions of problem-based learning/case-based learning/self-directed learning, this laboratory can be used for showing digital cases as “triggers” or “scenarios” PDF of important lists/documents such as National List of Essential Medicines, fixed dose combination-banned list, banned drugs list of drugs by the Central Drugs Standard Control Organisation, hospital formulary, national programs, standard treatment workflows by the Indian Council of Medical Research[1,2] Vigiflow exercises in filling and uploading Adverse Drug Reaction forms can be shown Drug interactions - case-based/free websites on drug interactions E-prescription Mechanism of action of clinically useful drugs in humans in humans-free animations (https://www.youtube.com/c/DrugsinMotion/videos). A full list has been explored in India as per the new curriculum, which shows the utility of these free resources for learning in students.[3] There is not only one competency that shows use of CAL, under the TLM column of the curriculum, but many. Table 1 shows various pharmacology competencies where CAL can be used. The list is indicative only; however, the possibilities are endless.[4-6]Table 1: Competencies for which computer assisted learning can supplement learningUse in assessment CAL can be used in formative and summative assessments [Figure 1].Figure 1: Use of computer assisted learning lab in objective structured practical examination for video-based stations. CAL: Computer assisted learning For various formats of questions: Use Kahoot, Hot Potatoes, or Socrative app to design questions in various formats, varying from short answer questions to Multiple-choice questions (MCQs). The free version is sufficient for our requirements Using these apps, anyone can make MCQ modules and self-assessment modules. The results are stored, so students can check the areas for improvement Self-assessment module for students of MBBS can be created and run in the CAL lab.[7] Once the module is made, you upload it to the common folder in laboratory, and it will be available at all terminals. Students can try these anytime; their score will be depicted to them along with feedback on correct and incorrect answers. They can also retry to improve learning. As they click on a choice in MCQs, they get reinforcement feedback for the correct answer and corrective feedback for incorrect answers Record students’ performance: where it is available to them to see in the laboratory E-Logbooks for postgraduate students: The terminals can be used to see the progress of learning of students, especially where the number of MD students is more. The advantage will be to use the institute from where they can log in, and similarly, faculty can add their comments. The same can be replicated for MBBS students for the e-logbook For attendance and internal assessment calculations, this laboratory can be used. For objective structured practical examination In many colleges, appropriate OSPE is still to start, and department struggles to get good space for conducting OSPE. This laboratory is a readymade solution for the space for OSPE and OSCE. For example, in nonobserved OSPE stations, the student is presented with an analytical task, where he/she is expected to write an inference or answer.[8] This is an unobserved station and can be designed with questions directed at a specific skill. It can include interpretation-type questions that help in assessing the higher-order thinking of the examinee. The caution to be taken here is not to include the questions that can be asked directly in the theory examination, for example, write 2 indications of the given drug. CAL lab appropriate OSPE stations can include: Filling the ADR form based on an ADR history/pictures/video.[1] This will add more realism, especially by adding videos and not just photos Colored pictures/video advertisement for drug promotional literature exercises: these advertisements are now everywhere due to the huge reach of social media, hence students must be trained for video advertisement too Animated mechanisms of action of prototype drugs using free resources Phase 3 subjects can use patient pictures and videos during OSCE If your hospital-based prescription writing software in outpatient services and in wards, then access is given to students for learning, and they can open and they do prescribe drugs using software exercises as learning. Now, we have been asked to train all budding doctors for the use of technology in improving rational prescribing practices. Opportunities Learning management systems Integrate your free/subscribed learning management system (LMS) for mapping competencies to teaching–learning methods and assessment, like MCQ, generating a question paper. This is doable these days, and you can use CAL lab that logs in easily into the institutional LMS. To develop resources This is an opportunity for all faculties and departments of pharmacology to develop resources such as animations, video for teaching–learning, then implement and publish or even get copyright on these resources. This will improve the ranking of the institute too. Many competencies in pharmacology need made in country resources, videos, and animations for drugs used in humans. Also note, there is no competency now where animal use is there even in simulations in the Pharmacology MBBS curriculum. Repository of resources We need to make a repository of these resources. One effort has been done. Imagine if 800 departments of pharmacology make one resource for CAL lab in 6 months, we can have 800 resources within 6 months in the country, much more than what we need. Get a copyright and then share in the repository. The time has come for national organizations to develop a repository of methods. Objective Structured Practical Examination Stations All institutes have started doing OSPE now in the MBBS course. The recent instructions also ask for OSPE in examinations. Over a period of time, you can develop an OSPE bank and keep on updating your stations regularly in CAL lab. It is better to include higher levels of cognitive domains and psychomotor and attitudinal domains for testing in OSPE that can be easily done on screen in CAL lab versus paper-based exercises. Internal Assessment Record Registers These can now be in CAL lab computers, and the records can be maintained electronically. Feedback can be given to students sitting in all terminals together and individually too. They can login and see their performance. And the biggest advantage will be automatic calculations, where we all spend a lot of time. Linker cases in integration Use CAL lab for case scenarios, videos for Small Group Teaching (SGT) sessions as many scenarios are needed now, but made in the country. With the introduction of 6 mandatory topics for integration for teaching–learning, and assessment, we need to integrate the related competencies in these topics. CAL lab can be used for integrated SGT sessions where the linker case can be used. Conclusion In addition to the above points, CAL can help departments a lot by expanding the utility of CAL lab for multiple purposes, varying from teaching and extending to assessment. The power of audio, video, and technology must be utilized appropriately for improving pharmacology learning, and hence it is very apt that “CAL” makes learning more enjoyable, visibly attractive/technicolor, appealing to students, and supplements learning using free resources.[2]