ENHANCING THE METHODOLOGY OF TEACHING PEDIATRICS THROUGH AN INTEGRATIVE CLINICAL CASE-BASED APPROACH

ABSTRACT

This research investigates an integrative teaching approach in pediatric education, using clinical case studies. Acknowledging traditional didactics fall short in addressing this complexity, the study introduces a new model integrating real-life pediatric cases with teamwork and simulation techniques.[9,10] The study was performed over one academic year with third/fourth year medical students and was divided into control and experimental groups. The integrated group was involved in clinical case analysis, practical classes, and interdisciplinary seminaries as well.

АННОТАЦИЯ

Данное исследование посвящено интегративному подходу в обучении педиатрии с использованием клинических кейсов. Признавая недостаточность традиционных дидактических методов для решения сложных задач в этой области, исследование представляет новую модель, интегрирующую реальные педиатрические случаи с методами командной работы и симуляции. Исследование проводилось в течение одного академического года с третьими и четвертыми курсами студентов медицинских вузов и было разделено на контрольную и экспериментальную группы. Интегрированная группа участвовала в анализе клинических кейсов, практических занятиях и междисциплинарных семинарах.

Keywords: Pediatrics education, integrated approach, clinical cases, multidisciplinary, simulation, medical students, clinical reasoning, competency-based education.

Ключевые слова: обучение педиатрии, интегрированный подход, клинические кейсы, междисциплинарность, симуляция, медицинские студенты, клиническое мышление, компетентностный подход.

Introduction. The development of medical education in the last decades has demanded the change from traditional lecture-based teaching to dynamic, student-centred and practice-based methods. The important clinical discipline of pediatrics presents special challenges for teaching because patients vary in age and stage of development.[1] Pediatric patient path is so complex that motivation to acquire a sound knowledge and experience also the capability to transfer knowledge in a variety of different contexts, i.e. clinical based practice. Yet traditional teaching methods frequently do not ensure that necessary competencies such as clinical reasoning, problem solving skills, and interprofessional collaboration are developed.[2] In this regard, the implementation of clinical case-based teaching is presented as an appealing approach in an interdisciplinary context. The purpose of this study is to determine the efficacy of an integrative pediatrics curriculum that is taught through a series of clinical case based simulations with an emphasis on an interdisciplinary approach, and the students' union to the cognitive learning process is also assessed.

Materials and Methods. This educational activity took place during the 2023-2024 school year at an academic medical center. The subjects consisted of a total of 128 undergraduate medical students who are in the third or fourth year of pediatrics classes. Students were randomly assigned to two groups; the control group (n=64) who was taught using classroom and textbook method and the experimental group (n=64) who was taught using the integrative teaching model. This format comprised interactive clinical cases, multidisciplinary seminars (pharmacology, pathology, neonatology, pediatric psychology), small group sessions, and workshops with standarized patients application. All clinical case scenarios were based on typical pediatric cases like bronchopneumonia, neonatal jaundice, growth retardation and congenital malformations. Evaluations were based on pre- and post-intervention tests, Objective Structured Clinical Examinations (OSCEs) and structured student feedback questionnaires. SPSS was used for statistical analysis to test the differences in academic achievements, skills learning and student’s satisfaction.

 Results. The patients in the experimental group performed significantly better (both academically and clinically) than the control. For the experimental group, between pre- and post-tests, knowledge gain was statistically significant (p<0.01). Based on OSCE assessments, 87% of the integrative group reached a high level of competence in history taking, physical examination, and clinical decision-making, as compared to 62% in the control group. Students did also rated that the learning was more interesting, real and realistic and their clinical practice in the future. Most (91%) students in the experiemental group felt more confident manageing paediatric patients and understanding disease mechanisms as a result of the interfaith format. Additionally, the incorporation of simulationbased education was particularly successful in improving procedural competence and team communication.

Picture 1. "Comparative Outcomes of Control and Experimental Groups in Clinical Education Indicators"

Discussion. These results support the educational effectiveness of the clinical case studies based IP learning in paediatric teaching. The inclusion of clinical examples supports the integration of abstract knowledge with a patient's experience. Crosstalk between disciplines guarantees a comprehensive approach to the whole child—bio-psycho-social—and promotes comprehensive clinical judgment. Furthermore, group discussions and simulations encourage teamwork, empathy and communication skills – skills which are necessary for contemporary healthcare providers. In contrast to more traditional approaches benefiting from the rote memorization, the integrated model promotes active learning, critical reflection, and retention of knowledge, eliciting deep learning tendencies.[3,4] The favourable student feedback also highlights the motivational impact of this approach as they appreciate the clear relevance to their clinical duties. This approach to teaching is in line with worldwide shift toward competency based medical education and may be an example for other clinical disciplines to follow.[5]

Conclusion. The use of clinical case presentations as part of pediatrics instruction, along with interdisciplinary and simulation approaches, brings about a significant improvement on student learning.[6,7] It enhances not only academic achievement, but also clinical reasoning, communication, and readiness for professional practice.[8] This study provides evidence in support of the potential value of integrating integrative pediatrics into undergraduate curriculum in pediatrics to better prepare future physicians for the challenges of pediatric practice. Conclusions Longitudinal studies are recommended to evaluate the lasting effects of this teaching approach on clinical practice, residency performance, and patient care quality.

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