• Users Online: 237
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 

 Table of Contents  
Year : 2022  |  Volume : 12  |  Issue : 2  |  Page : 101-107

Student-centred approach in medical education: A review of the teaching-learning activities and the perceptions of educators on the students engagement and performance at the faculty of medicine and defence health, national defence university of Malaysia

1 Biochemistry Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
2 Anatomy Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
3 Physiology Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
4 Medical Parasitology and Entomology Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
5 Medical Microbiology and Immunology Unit; Centre for Tropicalization, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
6 Pathology Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
7 Pharmacology Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
8 Community Medicine Unit, Faculty of Medicine and Defence Health, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
9 Community Medicine Unit, Faculty of Medicine and Defence Health; Humanitarian Assistance and Disaster Relief Research Centre, Universiti Pertahanan, Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia

Date of Submission22-Oct-2021
Date of Decision14-Nov-2021
Date of Acceptance02-Dec-2021
Date of Web Publication20-Jan-2022

Correspondence Address:
Yasmin Anum Mohd Yusof
Preclinical Department, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kem Perdana Sg Besi, 57000 Kuala Lumpur
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aihb.aihb_150_21

Rights and Permissions

The knowledge and the beliefs on medical education influence the teaching-learning approach used by medical educators and their perception of students' ability to be active learners. This paper highlights the student-centred teaching methods used by the medical educators of the Faculty of Medicine and Defence Health, National Defence University of Malaysia for undergraduate medical student teaching, their medical education approach in teaching and their perception on students' performance.

Keywords: Medical education, perception, student-centred approach, students' performance, teaching-learning activities, teaching-learning approach

How to cite this article:
Mohd Yusof YA, Taridi NM, Mustapa M, Shaharuddin S, Abdul Hamid MW, Mohamed Shakrin NN, Rahmat F, Che Roos NA, Ahmad Zaidi NA, Lugova H. Student-centred approach in medical education: A review of the teaching-learning activities and the perceptions of educators on the students engagement and performance at the faculty of medicine and defence health, national defence university of Malaysia. Adv Hum Biol 2022;12:101-7

How to cite this URL:
Mohd Yusof YA, Taridi NM, Mustapa M, Shaharuddin S, Abdul Hamid MW, Mohamed Shakrin NN, Rahmat F, Che Roos NA, Ahmad Zaidi NA, Lugova H. Student-centred approach in medical education: A review of the teaching-learning activities and the perceptions of educators on the students engagement and performance at the faculty of medicine and defence health, national defence university of Malaysia. Adv Hum Biol [serial online] 2022 [cited 2022 Aug 19];12:101-7. Available from: https://www.aihbonline.com/text.asp?2022/12/2/101/336110

  Introduction Top

The knowledge on medical education has an influence on educators' teaching approaches. If the main objective of an educator is to ensure that students can comprehend most of what she or he teaches, then one must use the most current teaching approaches that will create interest among the students and motivate them to interact and ask questions during the teaching-learning process. Most medical universities have adopted the student-centred or problem-centred approach in their curriculum which is diametrically opposed to the philosophy underlying the conventional teacher-centred approach. Teacher-centred learning makes students devoid of the ability to engage and empower their own learning. On the other hand, student-centred learning, also known as self-directed learning, gives students greater autonomy and control over their learning methods, focusing on their needs, abilities and interests.[1] Many educators describe it as the shift in the balance of the weight of teaching-learning process from the expert teacher to the student learner: a paradigm shift from the traditional didactic and teacher-dominated medical educational atmosphere to the students-dominated learning environment where educators act as facilitators guiding the students. This approach prevents students from becoming passive and bored in the classroom and converts them into deep, competent, critical and creative thinking learners.[2] As opposed to didactic teaching-learning, in student-centred approach, students are introduced to the application of the knowledge on top of the ability to analyse, synthesise, evaluate and interpret the information they obtain. This teaching-learning approach stimulates higher thinking process among the students.

Educational psychologists such as John Dewey, Jean Piaget and Lev Vygotsky are proponents of active students' approach to learning and they were primarily responsible for the transition towards student-centred learning.[3] They professed that classroom setting was not conducive for young learners. Students should take responsibility for their learning process and support their peers progress in a teamwork. This method gives medical students the soft skills they need as lifelong learners, especially when encountered with the changing needs of their patients.[4]

Despite this paradigm shift towards student-learner, there are some students who are surface learners and like to be told what to learn, how to think and how to answer. They prefer the traditional educational method. These students have been spoon-fed since their primary and secondary schools depriving them of the self and creative thinking and active learning process. When these students enter universities, many lecturers notice that they are passive learners during discussion-based type learning, always waiting for their peers to answer or participate in the discussion first before they are being asked to join the discussion. The questioning and probing methods by facilitators play major roles to elicit responses from such passive students.

This paper reviews the teaching-learning activities (TLAs) employed by pre-clinical lecturers of the medical faculty of the National Defence University of Malaysia (NDUM) and their perceptions on whether these TLA's managed to engage students as an active, deep and creative learners.

  Medical Curriculum of the Faculty of Medicine and Defence Health Top

The medical program offered by the Faculty of Medicine and Defence Health (FMDH) is a 5-year Doctor of Medicine (MD) program with 10 semesters and 218 weeks of TLAs. The initial 2 years cover the pre-clinical sciences while the last 3 years are focused on the clinical sciences. The general program structure for the medical curriculum is represented in [Table 1].[5]
Table 1: Doctor of Medicine program structure of the Faculty of Medicine and Defence Health, National Defence University of Malaysia

Click here to view

The curriculum is structured based on nine broad learning outcomes reflecting the Malaysian Qualifications Framework (MQF 2.0): (i) knowledge, (ii) practical skills, (iii) scientific methods, critical thinking and problem-solving skills, (iv) communication, leadership and team skills, (v) social skills and responsibilities, (vi) ethics, professionalism and humanities (vii) entrepreneurship and managerial skills, (viii) information management and (ix) lifelong learning. To achieve these learning outcomes, FMDH uses hybridised curriculum whereby all the traditional subjects in year 1 and year 2 such as Anatomy (ANA), Physiology (PHY), Biochemistry (BIO), Pathology (PAT), Medical Microbiology and Immunology (MMI), Medical Parasitology and Entomology (PAR) and Pharmacology (PHM) are introduced in synchronised manner into nine blocks according to the body systems consisting of general, musculoskeletal, cardiovascular, respiratory, haemopoietic and lymphoid, gastrointestinal, urinary system, endocrine, reproductive system and nervous system. The vertical non-block modules such as personal and professional development, early clinical exposure, population health (POP) and military medicine components run alongside the various blocks throughout the semesters.

During the 3 years of clinical phase, the medical students in FMDH are introduced to various disciplines or posting rotations. These include Internal Medicine and Medical subspecialties, Surgery and Surgical subspecialties, Paediatrics, Obstetrics and Gynaecology, Psychiatry, Orthopaedic and Rehabilitation Medicine, District Health Management and Community Health Research, Primary Care medicine as well as minor postings such as Military Medicine, Otorhinolaryngology, Ophthalmology, Radiology, Forensic Medicine, Anesthesiology and Accident and Emergency Medicine.

  Teaching-Learning Activities in the Pre-Clinical Years Top

The pre-clinical years lecturers incorporate in their teaching a hybrid approach of didactic face-to-face or online lectures with student-centred learning platforms such as problem-based learning (PBL), small group session (SGS), meet-the-expert session (MES), museum session, the Kahoot!, question-based discussion (QBD), flipped classroom, self-learning package (SLP) and directed self-learning (DSL), seminar, practical, laboratory session, computer laboratory (CLAB) practical and fixed learning resources (FLRs). These student-centred learning approaches run across the nine blocks mentioned earlier. The TLAs used by each discipline are tabulated in [Table 2].
Table 2: Teaching learning activities in the pre-clinical years

Click here to view

Small groups session and meet expert session

In SGS and MES learning, students are given questions earlier by uploading them on e-learning platform before the sessions. During the SGS, the students will be divided into small groups of 5–6. The students will be given 30–40 min to discuss in their respective groups based on the questions given. After 40 min, each group will present their answers according to the questions given by either using mahjong paper, drawing at the white board provided in the classes or by using a PowerPoint presentation in front of the expert lecturers. Biochemistry and Physiology lecturers conducted SGS or MES similarly while Medical Microbiology and Immunology, Pathology and Pharmacology lecturers uploaded questions in the form of True-False Question (TFQ), One Best Answer (OBA) and/or Essay-Type Questions format followed by discussion of the test questions. In addition, FLRs such as videos, pictures and images were also uploaded in the form of case scenarios to be discussed during SGS. Student representatives will present their answers during the session accordingly. Performance of the students was observed based on their academic results for every block.

Population Health lecturers divide students into groups of 9–15, depending on the number of facilitators available. The problem-based or short-answer questions related to case studies are provided earlier, and the students are required to answer them before the session. During the session, the facilitators approach students individually so that each student has a chance to present his or her answers to questions at least once. The group discussion of each case study is prompted by the facilitator focusing on the difficulties students faced during self-preparation and questions that have emerged during the session. At the end of the session, a mini test consisting of a set of TFQ and OBA-format questions is conducted followed by a brief discussion. Each SGS or MES takes about 2 h.

Question based discussion

QBD is a modified version of the conventional tutorial session. Medical parasitology and entomology lecturers begin the session by giving a progress mini test to the students (10–15 min duration) followed by discussion of the test questions. The discussion session is conducted by the students and the lecturer acts as a facilitator. The purpose of the mini test is to encourage the students to study consistently to monitor their own progress preparing them for the examination. During the discussion session, students are challenged to develop critical thinking skills: to weigh evidence, test propositions and reach their own conclusions. Sometimes, Kahoot! which is a game-based application is used during the QBD session to encourage students to create a trusted learning space which generates more discussion, collaboration and motivation around the educational content.

Museum session

Museum session is a learning method in which students work together in a group of 8–9 to discuss on a set of questions that was given before the meeting. The types of questions given are in the form of clinical scenarios to integrate clinical knowledge in Anatomy. Students are required to submit their answers on the same day following the museum session. The lecturers will check on their answers and marks will be given to each group. Museum session usually will be held 1 day before SGS. During the SGS, students will discuss on their answers with the respective lecturers. Students are required to explain their answers in a group, using various tools such as PowerPoint presentation or as simple as using a whiteboard, depending on their creativity. Like SGS, museum session is of 2 h duration.

Flipped classroom

The flipped classroom was invented in 2007 by Jonathan Bergman and Aaron Sams who recorded their classroom lectures so that students could access them at home.[6] It is a type of blended learning whereby students are introduced to the content of the lecture at home and work through the problems during lecture hours. Physiology lecturers emphasised problems in the basic mechanism and regulation process in relation with the normal physiological function of the body and students are encouraged to use flow charts during the discussion. Students learn more deeply in this approach of a combination of face-to-face and e-learning. This method has been shown to increase students' engagement and learning process whereby students must read the learning resources or watch the video related to the lecture topics before the class and during the class they will solve problems together with their peers. Some course materials were given to students such as YouTube videos related to lecture topics a day before the lecture, while in the actual class, there will be direct interaction between lecturers and students.


A specific topic is given to the students at least a week before the actual class. The students are divided into several small groups where they must work together to prepare a class presentation for the given topic. It is the responsibility of the students to meet with the lecturer in-charge of the topic to discuss on the materials to be presented as well as searching the relevant resources for information. In the actual class, students will present their subtopics accordingly and take questions from their peers as well as the lecturers to generate discussion. Feedback and/or information is provided by the lecturers where appropriate to ensure optimum knowledge is gained by the students. This teaching-learning approach enhances students' organisation and leadership skills.

Problem-based learning

The PBL process was pioneered by Howard S. Barrows and Robyn M. Tamblyn for the medical students at McMaster University in Hamilton, Canada in the 1960s and it was first applied in the neuroscience portion of the curriculum by using inquiring strategies.[7] PBL is a student-centred approach in which students are given an open-ended clinically related problem to stimulate them to ask critical questions and solve the problem together with their working groups. The students evaluate, synthesise and analyse information critically until the problem is solved collaboratively. Each PBL problem usually takes approximately 2-h to complete. After they have gathered information, the students summarise their acquired knowledge in the last session with their peers, by constructing a concept map. Learning materials can be videos, readings or other resources (lecture notes, libraries, journal paper, Google Search, etc.). At present, at FMDH, PBL is being conducted in the 2nd year and there are six PBL problems of 18 sessions spread over the teaching blocks throughout the year. Each session is about 2 hours duration. Due to shortage of lecturers, each group consists of 10 students, even though 4–5 is the most ideal number of students per group.


The Kahoot! platform was founded in 2012 by Johan Brand, Jamie Brooker and Morten Versvik.[8] The quiz is based on research carried out by Professor Alf Inge Wang and his colleagues at the Norwegian University of Science and Technology (NTNU). The technology platform itself is based on the research conducted by Morten Versvik for his master's degree at NTNU.[8]

It is a game-based learning platform used by many lecturers from various disciplines. It is usually posed to the students at the end of each lecture to test and review students' knowledge. It is a good teaching-learning approach of making the lecture interactive as well as to test the students' attentive power during the class and whether they were able to grasp what has been taught. Students are actively engaged in this platform, and sometimes, they are asked extended questions which are related to the questions given in the Kahoot! Kahoot! Quiz triggers them to have deep understanding in the topic delivered engaging them to be deep learners through an enjoyable way.

Self-learning package and directed self-learning

The FMDH pre-clinical lecturers use SLP and DSL methods whereby students are given a set of questions pertaining to the topics in relation with the block: they are required to find the answers at their own initiative without the assistance of lecturers. The contents of the package allow the student to explore on their own, but within a framework of guides in the form of provided text, references and exercises based on the topics. They can ask the questions during the tutorial session such as SGS or MES if they cannot find or are unsure of the answers. Students are also given the opportunity to share answers with their friends, and sometimes, lecturers will be involved in the discussion by guiding them to acquire the actual concept in the discussed topics.

Practical/laboratory session/computer laboratory practical/fixed learning resources

Practical sessions from all disciplines are conducted hands-on with face-to-face teaching. Students are required to perform certain tasks based on topics of the relevant blocks. In physiology practical, students are taught on how to interpret the electrocardiogram, use the spirometer, measure the haematocrit and identify the blood grouping. Meanwhile, in biochemistry practical, students are expected to know how to use the spectrophotometer, glucometer and be able to interpret urine dipstick analysis.

All lecture topics on histology and gross anatomy are followed by practical sessions. Practical sessions are essential in anatomy because better understanding of the topics taught is achievable by looking at the human or animal structures under the microscope or by exploring the cadaver. Cadavers are the best anatomy textbook and medical students' first patients; absence of cadaveric experience deprives them from the skills needed to examine the human body.

In the laboratory of Medical Microbiology and Immunology discipline, students are exposed to basic techniques such as culturing media and examine appropriate specimens. They are given a short clinical scenario, laboratory findings and questions before the practical sessions. Then, students are required to answer the practical questions and explain their answers. Students will learn to interpret the laboratory investigations findings for diseases caused by medically important bacteria, fungi and viruses as well as diseases of immune system.

In pathology practical sessions, students are exposed to various types of specimens based on the theme of the block. Before exposing them to the jar specimens, they are given a short clinical scenario including a clinical history and physical findings. They must describe in detail the pathological appearance of the specimen such as the organ types, size of the lesion, the margin, the cut surface, the presence of necrosis, haemorrhage and the invasion to the adjacent structures. Simultaneously, students must correlate the gross descriptions with the microscopic findings. Eventually, they should analyse and associate all the clinical history, physical findings and pathological examination to achieve the most likely diagnosis.

The practical sessions of medical parasitology and entomology require students to perform and interpret thick and thin blood films and direct faecal smear as part of the approach in identifying specific parasites. Students also learn how to request laboratory tests and identify common parasites.

In pharmacology, one practical session is allocated in the general block where they are taught on the various methods of drug administration. Students have the opportunity to practice administering drugs, especially the parenteral route using mannikins and using inhalation devices by demonstration and practice.

The course of population health in year 2 includes an introductory block of medical statistics and data analysis. CLAB practical sessions have been introduced to enhance medical students' understanding of basic principles of descriptive and analytical statistics and enable them to interpret computerised statistical output. The formal lectures in medical statistics are followed by 'hands on' experience in data analysis using the SPSS statistical program (SPSS, Chicago, IL, USA) in the FMDH CLAB. During CLAB practical, students work with real data files provided by lecturers from their prior studies. The students acquire basic skills in coding and defining variables, using computer data analysis and interpreting the output files. At the end of the session, lecturers answer students' questions and provide data files, on which students must do the data analysis as part of their self-directed learning.

Medical Microbiology and Immunology used FLR in the practical sessions. Related materials are prepared either in the form of posters, videos or pictures that are printed or uploaded to e-learning platform (Moodle). The purpose of FLRs is to complement the practical sessions.


All learning platforms described were all formative except for Museum session conducted in Anatomy which awards students a total carry mark of 10%.

  Discussion Top

The adoption of student-centred or problem-oriented approach by many medical universities in their curricular is the central element in the pedagogy of medical education. This pedagogic shift emphasises a teacher's role as a facilitator rather than as a didactic teacher.[4] The traditional approach in teaching may be effective for disseminating a large body of content to students, however, this didactic teacher-centred learning often promotes passive and superficial learners and fails to stimulate student motivation, confidence, enthusiasm and most importantly, the students taught in the traditional classroom lacks skills for their professional success.[9],[10] The past three decades have produced many reports and evidence on the improvement in teaching approaches to undergraduate science education including medical education. These include ways that promote meaningful and active learning, problem solving, critical thinking, communications skills, leadership skills and teamwork building. Student-centred learning is resource intensive in the design, delivery and assessment process, and for the most part, staff need to be trained by the faculty. This is the pre-requisite for a successful implementation of the student-directed learning approach.

Pre-clinical lecturers of the FMDH used a hybrid of face-to-face lectures as well as student-centred learning platforms such as SGS, QBD, MES, PBL, Kahoot! flipped classroom, seminar and SLP. They found that students who were passive in the beginning of the semester become active and inquiry-oriented learners by the end of the year and it is strongly believed that the student-centred learning platforms have converted them to be deep and active learners. Some of them were good at gathering information and explaining to other members of the small group in PBL, SGS and MES. In QBD sessions, students manage to convey their thoughts, analyse the points made by the lecturers or peers and discuss any new information they have acquired. During the discussion session, students know how to disagree in a healthy and respectful manner and to arrive at a collaborative consensus outcome. Engaging students in a discussion is the answer to creating good speakers, listeners and learners.

Anatomy museum sessions previously were carried out differently in which the questions given were in the form of recalling on anatomy facts. Recently, since the introduction of clinical scenarios questions during museum sessions in the academic session 2020/2021, the lecturers from the Discipline of Anatomy found that, the student's understanding on Anatomy subject improved tremendously. This type of questions encourages the students to think critically and to apply what they have learnt clinically, converting them to be deep learners. They also noticed that the number of students that need to take remedial examination for Anatomy subject was much less compared (only 2 students in the session of 2020/21 compared to 5 students in the session of 2018/19) to the previous years when museum session has not been introduced yet. Singh et al.[11] suggested in their review article that blended teaching using TLAs and technology enhanced learning such as digital camera in Anatomy teaching can cultivate motivation, self-confidence and self-esteem among students.

The lecturers from the Discipline Of Biochemistry found that the introduction of MES and Kahoot! in addition to QBD/MES had a good impact in increasing their understanding of difficult topics, improved their attitudes in learning and they were more skilful in team work's activity in solving scenario-oriented problems. Their performance in examination showed a remarkable achievement in their grades, and there is an increase in the total number of students who passed in the second-semester examination compared to the first-semester examination of the session 2019/2020 (96.15% vs. 52.73, respectively) where MES and Kahoot! were not introduced yet. Kahoot! is a game-based student response system (SRS) where the classroom is temporarily transformed into a game show and the teacher acts as the show host, while the students are the players. SRSs have been used by educators since the sixties and started to be used in the early seventies in teaching biology[12] and chemistry.[13] SRSs have been shown to have positive effect on exams besides increasing students' attendance and learning environment in class.[14] We found that Kahoot! motivates students to engage as players in either solo or group setting. The lecturers noticed students enjoyed learning during Kahoot! with higher motivation and engagement and they feel in control of their learning process in a fun way with the background music. Game-based learning can improve students' motivation to become better learners and improve their academic grades.[8],[15] Lecturers from the pharmacology and medical parasitology and entomology discipline also found similar findings. The literature review on the effectiveness of Kahoot! in learning which includes 93 studies showed that Kahoot! can have a positive effect on learning performance, classroom dynamics, students' and teachers' attitudes and students' anxiety.[8]

The lecturers from the Discipline of Physiology found that 99% of students passed in the end of first and second-semester examinations for the session year 2020/21 which is greater compared to 80% of students who passed from the previous professional examination in 2019. They strongly believe that the increase in the number of students who passed is mainly contributed by the introduction of flipped classroom in conjunction with SGS. The flipped classroom methods help to build students interest in the learning process. It is an innovative learning model, different from the face-to-face didactic teaching, encouraging students to learn at home and be prepared before appearing in the class for discussions on the assignments collaboratively with their peers. Before the flipped classroom was introduced in late 2019, the lecturers noticed that many students were not able to participate well during the SGS discussion and showed less interest in the learning process. The flipped classroom thus has an effect in causing students to focus and become motivated during SGS sessions. A study by Talan and Gulsecen[16] on the effect of flipped classrooms compared to the didactic classroom on computer science students' achievements and academic engagement and satisfaction level revealed that the scores for the students in the flipped classroom with regard to academic achievement and engagement were higher than the scores for those in the didactic teaching classroom group and the differences between the groups were statistically significant. They also recorded that the students were also generally satisfied with the flipped classroom and the student-teacher interaction was enhanced compared to didactic teaching group. Flipped classroom model has also been found to increase achievements of students from other fields including mathematics, science, medicine and engineering.[17],[18],[19],[20]

The lecturers from the Discipline of Medical Microbiology also observed a remarkable increment of students grade as well as the number of students who passed in comparison to the previous years when teaching platforms were geared to student-centred learning. A total of 50 students passed and only 2 students failed with 16 students scored the highest grade (A). In the previous year, 47 students passed, 6 students failed and only 4 students scored A. The average of scored marks by the students also increased from 60.57% (year 2020) to 67.55% (year 2021). This achievement is mainly attributed by the student-centred learning PBL and SGS.

The lecturers from the discipline of Pathology found that students benefit from SLP, PBL and practical sessions. The SLP was especially helpful to the students towards the end of the block, where they used the SLP package as part of their revision material. Some of the good and hardworking students are motivated to go to the museum to observe the jar specimens. They work in a group collaboratively in learning how to describe the specimens displayed. They enjoyed the session in the museum because they can see the real pathological specimens compared to photographs or images seen in their textbooks.

As for the Discipline of Medical Parasitology and Entomology, the lecturers found that during the QBD sessions, good challenging questions tend to spark the students to participate in thought-provoking class sessions that lead them to communicate effectively with their peers. During the session, students are thoroughly engaged in the discussion, sharing of ideas, exploring thoughts and actively practicing skills such as communication, critical thinking, collaboration, creativity and problem solving.

The lecturers from the Discipline of Pharmacology found that SGS sessions help to strengthen students' understanding of the subject by doing practice questions and discussion around the topic. Incorporation of game element such as Kahoot! during SGS further stimulate the students' interest and create a casual learning environment. In addition, PBL sessions provide a platform where students can apply their knowledge of pharmacology in a real-world setting.

Students consistently reported that student-centred platforms were more helpful than didactic lectures in learning the concepts of epidemiology and medical statistics based on the analysis of the population health feedback forms conducted in 2013-2021. Reflecting the desires of the students, the number of SGS has been gradually increased from 14 h in the academic session 2012/2013-20 h in the session 2020/2021.

  Conclusion Top

The pedagogic shift from the traditional teacher-centred approach to a student-centred approach undertaken by the lecturers at FMDH has led to a fundamental change in the role of the educator from that of a didactic teacher to that of a facilitator of learning. Meanwhile, the students have evolved to be deep and active problem-solving learners.


The corresponding author is grateful to Professor Mainul Haque for his contribution in providing useful advice in the final revision of the manuscript.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Hasan T, Ageely H. The scope of student-centered learning in medicine. J Basic Appl Sci Res 2011;1:638-43.  Back to cited text no. 1
Rogers CR. As a teacher, can I be myself? In: Freedom to Learn for the 80's. Ohio: Charles E. Merrill Publishers; 1983. p. 11-5.  Back to cited text no. 2
Williams MK. John Dewey in the 21st century. J Inq Action Educ 2017;9:91-102.  Back to cited text no. 3
Spencer JA, Jordan RK. Learner centred approaches in medical education. BMJ 1999;318:1280-3.  Back to cited text no. 4
Student Handbook MD Program, Academic Session 2021/2022, Faculty of Medicine and Defence Health, National Defence University of Malaysia; 2021.  Back to cited text no. 5
Tucker B. The flipped classroom: Online instruction at home frees class time for learning. Educ Next 2012;12:82-3.  Back to cited text no. 6
Schmidt HG. A brief history of problem-based learning. In: O'Grady G, Yew E, Goh K, Schmidt H, editors. One-Day, One-Problem. Singapore: Springer; 2012. Available from: https://doi.org/10.1007/978-981-4021-75-3_2. [Last accessed on 01 Oct 2021].  Back to cited text no. 7
Wang AI, Tahir R. The effect of using Kahoot! For learning – A literature review 2020. Comp Educ 2020;149:103818.  Back to cited text no. 8
Bransford JD, Brown AL, Cocking RR. How People Learn: Brain, Mind, Experience, and School. Committee on Developments in the Science of Learning in: Washington, DC: National Academic Press; 2000.  Back to cited text no. 9
Weimer M. Learner-Centered Teaching: Five Key Changes to Practice. San Fancisco CA: Jossey-Bass; 2002.  Back to cited text no. 10
Singh K, Gaur U, Hall K, Mascoll K, Cohall D, Majumder MA. Teaching anatomy and dissection in an era of social distancing and remote learning. Adv Hum Biol 2020;10:90-4.  Back to cited text no. 11
  [Full text]  
Bessler WC, Nisbet JJ. The use of an electronic response system in teaching biology. Sci Educ 1971;55:275-84.  Back to cited text no. 12
Casanova J. An instructional experiment in organic chemistry. The use of a student response system. J Chem Educ 1971;48:453.  Back to cited text no. 13
Caldwell JE. Clickers in the large classroom: Current research and best-practice tips. CBE Life Sci Educ 2007;6:9-20.  Back to cited text no. 14
Wang AI. The wear out effect of a game-based student response system. Comp Educ 2015;82:217-27.  Back to cited text no. 15
Talan T, Gulsecen S. The effect of a flipped classroom on students' achievements, academic engagement and satisfaction levels. Turk Online J Dist Educ 2019;20:31-60.  Back to cited text no. 16
Bhagat KK, Chang CN, Chang CY. The impact of the flipped classroom on mathematics concept learning in high school. Educ Tech Soc 2016;19:134-42.  Back to cited text no. 17
Gonzalez-Gomez D, Jeong JS, Rodriguez DA. Performance and perception in the flipped learning model: An initial approach to evaluate the effectiveness of a new teaching methodology in a general science classroom. J Sci Educ Technol 2016;25:450-9.  Back to cited text no. 18
Mason GS, Shuman TR, Cook KE. Comparing the effectiveness of an inverted classroom to a traditional classroom in an upper-division engineering course. IEEE Transac Educ 2013;56:430-5.  Back to cited text no. 19
Morgan H, McLean K, Chapman C, Fitzgerald J, Yousuf A, Hammoud M. The flipped classroom for medical students. Clin Teach 2015;12:155-60.  Back to cited text no. 20


  [Table 1], [Table 2]


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  Medical Curricul...Teaching-Learnin...
  In this article
Article Tables

 Article Access Statistics
    PDF Downloaded148    
    Comments [Add]    

Recommend this journal