Effectiveness of Early Clinical Exposure as a Motivational Tool to Improve Students’ Learning in MBBS Phase 1
Vidya S Patil, Vijayetha P Patil, Deepak R Kanabur, Pravinchandra R Kangokar
Early clinical exposure, Independent learning, Integrated teaching, Learning strategies, Motivation to learn, Self-determination theory
Citation Information :
Patil VS, Patil VP, Kanabur DR, Kangokar PR. Effectiveness of Early Clinical Exposure as a Motivational Tool to Improve Students’ Learning in MBBS Phase 1. Indian J Med Biochem 2021; 25 (2):51-59.
Aim and background: Early clinical exposure (ECE) supports intrinsic motivation which is associated with deep learning and better performance. The self-determination theory of motivation in learning proposes that optimal performance of students’ results from actions motivated by intrinsic interests or by extrinsic values that are internalized. We propose an ECE module supporting students’ three basic psychological needs of relatedness, autonomy, and competence extrinsically to improve students’ learning.
Objectives: To evaluate the effectiveness of ECE module on students learning attitude and academic performance.
Materials and methods: One hundred students of 1st phase MBBS were divided into a control group of first 50 and a study group of next 50 students. Early clinical exposure module for the study group included diagnostic lab and ward visits for three cases (anemia, jaundice, renal failure) in small groups and motivational videos focusing on independent learning. Motivated strategies for learning questionnaire (MSLQ) were taken pre- and post-intervention to know its effect on students learning. The class test was conducted and scores were compared to know its effect on academic performance.
Results: Mean comparisons of MSLQ Likert scale responses showed significant improvements in learning strategies of elaboration, organization, and critical thinking among the study group (p = 0.005, 0.04, and 0.001, respectively) and also motivation for learning as improved self-efficacy compared to the control group (p = 0.01) which shows improved self-confidence in their own ability to perform the task. Mean class test score comparison after ECE module showed significant improvement among study group (p = 0.001).
Conclusion: Our study supports the inclusion of ECE as a motivational tool for learning as it is effective in improving students’ learning strategies, motivation to learn, and academic performance.
Kusurkar RA. Motivation in medical students: a PhD thesis report. Perspect Med Educat 2012;1(3):155–157.
Brewer EW, Burgess DN. Professor's role in motivating students to attend class. J Ind Teach Educ 2005;42:23–47.
Verma M. Early clinical exposure: new paradigm in medical and dental education. Contemp Clin Dent 2016;7(3):287–288. DOI: 10.4103/0976-237X.188536.
Littlewood S, Ypinazar V, Margolis SA, et al. Early practical experience and the social responsiveness of clinical education: systematic review. BMJ 2005;331(7513):387–391. DOI: 10.1136/bmj.331.7513.387.
Orsini C, Evans P, Jerez O. How to encourage intrinsic motivation in the clinical teaching environment? a systematic review from the self-determination theory. J Educ Eval Health Prof 2015;12:8. DOI: 10.3352/jeehp.2015.12.8.
Ryan RM, Deci EL. Self-determination theory and facilitation of intrinsic motivation, social development and well-being. Am Psycholog 2000;55(1):68–78. DOI: 10.1037/0003-066X.55.1.68.
Wouters A, Croiset G, Galindo-Garre F, et al. Motivation of medical students: selection by motivation or motivation by selection. BMC Med Educat 2016;16(1):37. DOI: 10.1186/s12909-016-0560-1.
Kusurkar RA, Ten Cate TJ, Van Asperen M, et al. Motivation as an independent and a dependent variable in medical education: a review of the literature. Med Teacher 2011;33(5):e242–e262. DOI: 10.3109/0142159X.2011.558539.
Cook DA, ArtinoJr AR. Motivation to learn: an overview of contemporary theories. Med Educat 2016;50(10):997–1014. DOI: 10.1111/medu.13074.
Cate T, Kusurkar RA, Williams GC. How self-determination theory can assist our understanding of the teaching and learning processes in medical education. Med Teacher 2011;33(12):961–973. DOI: 10.3109/0142159X.2011.595435Published as AMEE guide No 59.
Elizondo-Montemayor LL. Formative and summative assessment of the problem-based learning tutorial session using a criterion-referenced system. J Int Assoc Med Sci Educators 2004;14(1):8–14.
Yusoff MSB. The dundee ready educational environment measure: a confirmatory factor analysis in a sample of malaysian medical students. Int J Humanit Soc Sci 2012;2(16):313–321.
Pintrich PR, Smith DAF, Garcia T, et al. A manual for the use of the motivated strategies for learning questionnaire (MSLQ). Ann Arbor 1991;48109:1259.
Rawekar A, Jagzape A, Srivastava T, et al. Skill learning through early clinical exposure: an experience of Indian medical school. J Clin Diagnos Res 2016;10(1):JC01–JC04. DOI: 10.7860/JCDR/2016/17101.7022.
Das P, Biswas S, Singh R, et al. Effectiveness of early clinical exposure in learning respiratory physiology among the newly entrant MBBS students. J Adv Med Educ Prof 2017;5(1):6–10.
Spencer J, Blackmore D, Heard S, et al. Patient-oriented learning: a review of the role of the patient in the education of medical students. Med Educ 2000;34(10):851–857. DOI: 10.1046/j.1365-2923.2000.00779.x.
Bell K, Boshuizen HP, Scherpbier A, et al. When only the real thing will do: junior medical students’ learning from real patients. Med Educ 2009;43(11):1036–1043. DOI: 10.1111/j.1365-2923.2009.03508.x.
Dornan T, Littlewood S, Margolis SA, et al. How can experience in clinical and community settings contribute to early medical education? A BEME System Rev 2006;28(1):3–18. DOI: 10.1080/01421590500410971.
Tayade MC, Bhimani N, Kulkarni NB, et al. The impact of early clinical exposure on first M.B.B.S. students. Int J Health Biomed Res 2014;2(4):176–181.
Chari S, Gupta M, Gade S. The early clinical exposure experience motivates first year MBBS students: a study. Int J Edu Sci 2015;8(2):403–405.