Integrating Paper Chromatography with Clinical Case Analysis: A Teaching Module on Phenylketonuria for Undergraduate Medical Students

Background: Competency-based medical education (CBME) recommends the improvement of traditional laboratory-based practical curriculum by aligning with clinical case scenarios and the interpretation of results in disease diagnosis.Here, a laboratory exercise on paper chromatography was developed for undergraduate medical students by combining it with a clinical case on phenylketonuria (PKU).Materials and methods: Paper chromatography was used to detect phenylalanine (Phe) in the given unknown sample based on the calculated retardation factor (R f ) value and comparison with known amino acids (phenylalanine, proline, leucine).The diagnosis for PKU was made based on the result and clinical interpretation of the given clinical case.A multilevel voluntary questionnaire was sent to students through Google Form to evaluate the laboratory exercise.Results: We found that PKU is the best case for demonstrating chromatography to medical graduates compared to other inborn errors of amino acid metabolism.Very few students (0-2%) responded as "No" or "Little".Overall, the practical session in paper chromatography was highly effective, with over 80% of students rating their skill development, understanding, and engagement as "Good" or "Great" across all evaluated aspects. Conclusion:The integration of paper chromatography with clinical case analysis offers a robust, multidimensional approach to teaching complex metabolic disorders such as PKU.This module not only reinforces fundamental biochemical concepts through hands-on experimentation but also deepens clinical reasoning by linking laboratory data with real-world patient scenarios.Furthermore, the method has the potential to screen for PKU in the large rural population, particularly in limited settings.