Vertical Integration of Teaching–Learning Methods for Clinical Tests of Hearing with the Physiology of Hearing: A Proposed Curriculum Improvisation Model for Undergraduate Medical Students

Abstract

Introduction: Early clinical exposure (ECE) is a tried and tested attempt in teaching-learning methods (TLMs) to achieve the goal of integrating basic sciences with clinical methods and helps in creating competent clinicians for health-care delivery system. Vertical integration of basic sciences with clinical subjects, which improves problem-based learning, has met with considerable success. However, there is no ECE module for otology in the 1st-year physiology curriculum at present. Clinical skills training in otology is conventionally imparted only during the initial phase of final MBBS. Hence, there is a large time gap between learning the physiology of hearing and the actual implementation of that knowledge during learning clinical of assessment of hearing. The present study tested vertical integration of knowledge of physiology of hearing with clinical knowledge of assessment of hearing with the intention to achieve certain expected outcomes like better clinical skills in students, faculty development, overall improvement in the quality of management of patients with hearing loss, and the long-term and far-reaching positive impact on the community as a whole. Materials and Methods: 150 undergraduate 3rd year students of a medical college participated in the study. They were divided into two groups of 75 each. Pilot tested validated pretest questionnaires were offered to both the groups before intervening with the TLM. Group “A” was exposed to the vertical integration module, while Group “B” served as a control. Thereafter, Group “A” and “B” were further subdivided into five smaller groups each and a 60-min tutorial on tests of hearing was conducted for each of the small groups. Pilot tested validated posttest questionnaires were then offered to both the groups. Finally, feedback on the intervention was obtained through a pilot tested validated feedback form based on a five-point Likert scale from all participants. Results: The results showed that vertical integration promotes interaction among faculty from different departments and improves decision making abilities when designing and implementing appropriate TLM. It also improves learning outcomes among students by identifying the exact need for curriculum development and designing and testing an appropriate module for a particular task at hand. Conclusion: Competency-based medical education is the need of the hour and ECE is the most important step toward this. Appropriate vertical integration of various topics across all subjects is a long drawn out and time consuming task. However, by consistent inter-departmental faculty interaction and enthusiastic approach toward curriculum designing and development, the overall goal of training a medical graduate for transiting into an asset to the society seems achievable.