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 Table of Contents  
REVIEW ARTICLE
Year : 2021  |  Volume : 9  |  Issue : 4  |  Page : 147-150

Inclusion of scenario-based teaching in undergraduate medical education


1 Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission08-Apr-2021
Date of Decision04-Jun-2021
Date of Acceptance14-Jun-2021
Date of Web Publication26-Nov-2021

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjhs.mjhs_26_21

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  Abstract 


The process of medical education delivery and training of medical students with regard to making them competent in discharging a wide range of activities are a challenging task. The purpose of the current review was to explore the introduction of scenario-based teaching in the delivery of medical education in the undergraduation period. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of 8 articles were selected based upon the suitability with the current review objectives. The keywords used in the search include scenario-based teaching, coronavirus disease-2019, case scenario, and medical education in the title alone only. Scenario-based teaching has emerged as a useful and effective teaching-learning approach in the field of medical education for imparting the desired complex skills to the undergraduate medical students. These scenarios can be created either using a simulation with an aim to expose the medical students to a complex and an authentic scenario, which they are expected to encounter in the daily clinical practice. In the process of resolving the given scenarios, the students develop critical thinking, clinical reasoning, teamwork, leadership, and communication skills, which help them to be better in their roles. In conclusion, the scenario-based teaching is an effective approach to prepare the fresh crop of undergraduate medical students to the rapidly advancing needs of the branch of medicine. The best approach will be to incorporate scenario-based teaching along with other instructional strategies across different professional years and supplement the same with timely constructive feedback.

Keywords: Case scenario, coronavirus disease-2019, medical education, scenario-based teaching


How to cite this article:
Shrivastava SR, Shrivastava PS. Inclusion of scenario-based teaching in undergraduate medical education. MRIMS J Health Sci 2021;9:147-50

How to cite this URL:
Shrivastava SR, Shrivastava PS. Inclusion of scenario-based teaching in undergraduate medical education. MRIMS J Health Sci [serial online] 2021 [cited 2022 Jan 19];9:147-50. Available from: http://www.mrimsjournal.com/text.asp?2021/9/4/147/331239




  Introduction Top


The process of medical education delivery and training of medical students with regard to making them competent in discharging a wide range of activities is a challenging task.[1] It is not a hidden fact that the medical tasks in itself are quite complex and unpredictable, thereby requiring a combination of knowledge, skills, attitude, values, professionalism, teamwork, etc., from the side of health-care professionals to produce the desired outcome. In-fact, in the high-performance settings of a health-care facility, the health-care professional is expected to take a multi-component decision, that has to be dynamic depending upon the changing patient parameters.[1],[2] Further, the medical professional has to also be prepared to simultaneously deal with the information overload (being wise to rule out), time constraints, patient load, adverse working environments, and the stress resulting because of all the above parameters.[1],[2] The purpose of the current review was to explore the introduction of scenario-based teaching in the delivery of medical education in the undergraduation period.


  Methods Top


An extensive search of all materials related to the topic was carried out in the PubMed search engine. Relevant research articles focusing on scenario-based teaching in undergraduate medical education published in the period 2008–2020 were included in the review. A total of 10 studies similar to the current study objectives were identified initially, of which two were excluded due to the unavailability of the complete version of the articles. Overall, eight articles were selected based upon the suitability with the current review objectives and analyzed [Figure 1]. The keywords used in the search include scenario-based teaching, coronavirus disease-2019 (COVID-19), case scenario, and medical education in the title alone only (viz. scenario-based teaching [ti] AND medical education [ti]; COVID-19 [ti] AND medical education [ti]; case scenario [ti] AND medical education [ti]). The articles published in only the English language were included for the review. The collected information is presented under the following sub-headings, namely ground reality, scenario-based teaching in medical education, COVID-19 and Scenario-based teaching, planning for scenario-based teaching, Assessment and Feedback component, implications for practice, and implications for research.
Figure 1: Flowchart for selection of studies

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Ground reality

Acknowledging the involved complexities and the speed with which medicine is changing with each day, it becomes a huge responsibility on teachers to prepare the medical students for the changing world. Future doctors will be expected to demonstrate adaptive expertise and there arise the role of medical training offered to the students.[2] It won't be wrong to document that it is difficult to provide different learning experiences to the medical students, as most of the medical emergencies require prompt action and teamwork, which becomes costly and difficult to provide.[2],[3] However, with the passage of time, the research activities focusing on education and training have shown that the learning experiences can be significantly modified through the use of technology.[1]

Scenario-based teaching in medical education

Scenario-based teaching has emerged as a useful and effective teaching-learning approach in the field of medical education for imparting the desired complex skills to the undergraduate medical students.[1] These scenarios can be created either using a simulation (preferable) or by means of formulation of case vignettes, with an aim to expose the medical students to a complex and an authentic scenario, which they are expected to encounter in the daily clinical practice.[3],[4],[5] In the process of resolving the given scenarios, the students develop critical thinking, clinical reasoning, teamwork, leadership and communication skills, which eventually play an important role in enabling them to effectively discharge their roles.[1],[2],[3] Case scenarios have been widely used in heterogeneous settings in different medical institutions for facilitating learning. Case scenarios have been used in training students about chest trauma and for the management of laryngospasm among children.[4],[5]

Coronavirus disease-2019 and scenario-based teaching

The emergence of COVID-19 pandemic has jeopardized all the sectors and the same stands true for medical education.[6] In order to interrupt the transmission of the disease, number of measures have been taken, including closure of educational institutions (and continuing teaching-learning through the adoption of online mode of teaching and assessment), initiation of tele-consultation, and discouraging non-COVID like patients to visit hospitals (unless it is necessary).[6],[7] The closure of educational institutions, a significant reduction in the normal patient flow to the hospital, and the excessive workload on the medical teachers has immensely impacted the clinical teaching and training.[7]

Under these difficult and testing times, a multiple number of curricular reforms have been introduced by different medical institutions based on the extent of administration support and the resources/logistics available.[6],[7],[8] These educational innovations have targeted teaching-learning, assessment (of all the three learning domains) and training of even attitude-ethics and communication module.[6],[7],[8] Scenario-based teaching can be considered a vital introduction under the present circumstances and it can remarkably help the medical students to continue their learning, including the development of clinical reasoning, problem-solving, critical thinking, and other essential skills required for successful clinical practice.

Planning for scenario-based teaching

The framed scenario should be such that it gives more emphasis toward higher order skills, including problem solving and decision-making. Unlike a case, scenario-based teaching is quite interactive, wherein timely inputs are given to make it a long-term learning experience.[2] It is always an encouraging practice to formulate the learning objectives, in the sense like after being exposed to the given scenario, what the students will learn which they were not knowing earlier. The added advantage of these objectives is that it guides the teachers about the relevance of the same to the type of learners. These scenarios should have a trigger event within them so that the learners can start working in the right direction and eventually accomplish the learning objectives.[1],[2],[3],[4],[5]

Assessment and Feedback component

In order to precisely measure the performance of the students, it is must that the criteria for the assessment of performance are laid down well in advance.[1],[2] The presence of precisely defined criteria makes it easier for the teachers to assess the performance, provide feedback and suggest remedial measures, if required. Moreover, we have to decide an appropriate instructional strategy for the scenario-based teaching to ensure that it is implemented smoothly.[2] After the completion of the task in the given scenario, the teacher must give constructive feedback about what was done well and how it could have been made better. Finally, it is recommended to record the performance of the students, so that it can be shown to them in the subsequent training sessions and to monitor their overall learning progression.[2],[3],[4] We must give due attention toward the capacity building of the teachers so that effective scenarios can be designed.

Implications for practice

Scenario-based teaching is expected to offer a wide range of benefits to the medical students, especially in terms of improvement of their skills. However, the outcomes of the same cannot prove to be encouraging or sustainable unless it is supplemented with a lot of planning and ground work. The first and foremost thing will be to sensitize the faculty members about the scope and the ways in which scenario-based teaching can be planned and carried out. The Medical Education Unit of the institution can take the lead and plan sessions for the training of the faculty members in a phase-wise manner. On a similar note, it is a must that the medical students are also sensitized about the same and the ways in which scenario-based teaching can help them to become a better and efficient health care professional. Further, the guidance from the members of the Curriculum Committee can also be obtained for the seamless implementation of scenario-based teaching. Further, as the success of the complete initiative depends on the quality of framed scenario, a lot of ground work has to go for the initial draft and eventual finalization based on the inputs received from the different faculty members of the concerned department. The support of the information technology team is indispensable in the present settings affected by COVID.

Implications for research

There is ample scope for research to explore the utility of scenario-based teaching in the current set-up. The research work can primarily focus toward the identification of topics/themes in which scenario-based teaching can be adopted. Moreover, in the present settings, wherein face-to-face teaching has been interrupted, a study can be planned to identify the ways in which scenario-based teaching can be integrated in the online mode of teaching-learning. In addition, feedback from the students can be obtained about the pros and cons of scenario-based teaching. Further, a qualitative study can be planned to gain insights about the ways in which scenario-based teaching can be improved.


  Conclusion Top


In conclusion, the scenario-based teaching is an effective approach to prepare the fresh crop of undergraduate medical students to the rapidly advancing needs of the branch of medicine. The best approach will be to incorporate scenario-based teaching along with other instructional strategies across different professional years and supplement the same with timely constructive feedback.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Patel K, El Tokhy O. Scenario-based teaching in undergraduate medical education. Adv Med Educ Pract 2017;8:9-10.  Back to cited text no. 1
    
2.
Cannon-Bowers JA. Recent advances in scenario-based training for medical education. Curr Opin Anaesthesiol 2008;21:784-9.  Back to cited text no. 2
    
3.
Hannah V, Oliver JS. Teaching principles of assessment, data collection, and prioritization: Using a case scenario. J Nurs Educ 2011;50:235-6.  Back to cited text no. 3
    
4.
Michelet P, Boussen S. Case scenario-Thoracic trauma. Ann Fr Anesth Reanim 2013;32:504-9.  Back to cited text no. 4
    
5.
Orliaguet GA, Gall O, Savoldelli GL, Couloigner V. Case scenario: Perianesthetic management of laryngospasm in children. Anesthesiology 2012;116:458-71.  Back to cited text no. 5
    
6.
Sahi PK, Mishra D, Singh T. Medical education amid the COVID-19 Pandemic. Indian Pediatr 2020;57:652-7.  Back to cited text no. 6
    
7.
Tabatabai S. COVID-19 impact and virtual medical education. J Adv Med Educ Prof 2020;8:140-3.  Back to cited text no. 7
    
8.
Newman NA, Lattouf OM. Coalition for medical education-A call to action: A proposition to adapt clinical medical education to meet the needs of students and other healthcare learners during COVID-19. J Card Surg 2020;35:1174-5.  Back to cited text no. 8
    


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