Exploring medical students’ preferences and challenges in clinical pharmacology education: insights and improvement strategies | BMC Medical Education

This study on clinical pharmacology education at the University of Jeddah uncovered significant findings. Most students expressed satisfaction with clinical pharmacology teaching, though 36.7% were neutral, indicating possible uncertainty about the teaching quality. Many felt overwhelmed by the curriculum’s extensive content (69.7%) which they had difficulty in understanding (56.7%). Students highlighted needing more case-based learning (53.4%) to address these challenges. Resources, technology and digital tools were ranked highly (38%) but were seen as secondary to face-to-face instruction (40%). Online modules and multimedia resources for self-paced learning were rated as the most effective (41%) followed by small group discussions and case-based activities.

These findings align with existing literature suggesting that pharmacology is often perceived as a complex subject due to its widely based content and the necessity to integrate complex information [3, 4]. The difficulty in understanding and preparing for exams could be attributed to pharmacological information’s dense and detailed nature, requiring significant cognitive effort to master. Of note, research on clinical pharmacology in Saudi Arabia and the Middle East is limited [13, 14] with most studies concentrating on pharmacy education and practice [16]. A study in Saudi Arabia surveyed 188 medical students and found that 48% engaged in peer-teaching clinical sessions as a learning method. It indicated that they significantly improved their clinical exam performance, clinical skills, and practical application of knowledge [17].

Over recent decades, various innovative teaching methods have emerged to address challenges in pharmacology education within medical curricula [18]. Team-based learning (TBL) and problem-based learning (PBL) promote active and collaborative learning, while personalized learning tailors instruction to individual needs. Use of integrative technology, such as video clips, online quizzes and audience response systems enhances engagement and case-based learning (CBL), applies knowledge to real-world clinical scenarios [18,19,20,21,22]. Additionally, a new approach to enhance student engagement and improve learning outcomes is a flipped classroom (FC) approach, where students engage with online materials before attending interactive, student-centered, in-person sessions has gained popularity in undergraduate medical education [23, 24]. While students generally appreciate the preparatory online activities and engaging small-group sessions, the overall reception among medical students is mixed [23,24,25]. These approaches and emphasis on early and sustained pharmacology education can improve students’ retention, clinical skills and safe prescribing practices.

In this study, 52% of respondents positively reviewed the curriculum’s effectiveness in preparing students for evidence-based medicine and critically appraising pharmacological research. No doubt evidence-based medicine is essential for medical professionals to make informed decisions based on the best available evidence [26].

Students also emphasized the importance of technology and digital resources for clinical pharmacology learning and teaching with 38% advocating for interactive simulations to enhance education. This is in line with other research conducted in the Middle East, including Saudi Arabia, where the majority of pharmacy students were familiar with AI, understood its concepts, and exhibited a positive attitude toward its use [9].

These tools can provide dynamic and engaging learning experiences facilitating a more profound understanding and retention of complex concepts [1].

However, barriers to the use of technology in medical education include inadequate information and communication technology (ICT) skills, time constraints, infrastructure issues within institutions and challenges stemming from the attitudes and communication errors of involved parties [27, 28]. While online modules and multimedia resources for self-paced learning were favoured by 41%, a significant portion (40%) still valued face-to-face instruction. A blended approach that combines the flexibility of digital learning with the interactive nature of in-person teaching could cater to diverse learning preferences [29].

Small group discussions and case-based learning were highly rated by 46% as effective modalities. These methods encourage active participation and application of knowledge in real-world scenarios, enhancing critical thinking and problem-solving skills [20].

Opinions were neutral (40%) regarding the inadequate integration of pharmacology with other disciplines affecting interdisciplinary learning. Enhancing interdisciplinary integration can promote a more holistic understanding of patient care, encouraging collaboration across various medical fields [30].

Many students reported feeling overwhelmed by the volume of information, which hindered their focus on critical concepts (n = 62, 69.7%), their ability to differentiate essential from non-essential pharmacological details ensures a focus on the most relevant and impactful aspects of the pharmacology course (n = 60, 67.7%) and their integration of theoretical concepts with clinical practice. Cognitive load theory suggests that excessive information can overwhelm students’ working memory, preventing learning and retention [31]. Educators can address this by using strategies like segmenting content, providing work examples, incorporating dual coding (using visuals and words), and reducing extraneous information. These methods help manage cognitive load, allowing students to process information more effectively and enhance comprehension and retention [19, 22].

At the University of Jeddah, clinical pharmacology is introduced within the basic medical sciences curriculum during the second and third years alongside subjects such as anatomy, pathology and microbiology. Although problem-based learning sessions with clinical scenarios are included in the University curriculum, it is expected that students at this stage may still feel uncertain about essential and non-essential topics and clinical applications. This observation aligns with findings from an Australian study which showed that medical students in later years achieved higher discipline-specific and overall scores than those in Year two [32]. Their progress seemed to continue through medical school as they tended to prioritize essential topics and view the clinical relevance of foundational sciences more critically with this perceived clinical relevance aiding in the retention of basic science knowledge [30,31,32].

Study strengths and limitations

This study, a significant contribution to the field, is the first to collect and analyze the opinions of medical students in Saudi Arabia on their preferences and challenges in clinical pharmacology education. It fills a crucial gap in the existing literature and provides valuable regional insights. The study gathered detailed information on various aspects of the curriculum, including theoretical integration, the complexity of pharmacokinetics and pharmacodynamics and interactive teaching methods offering a comprehensive understanding of students’ experiences and challenges.

The response rate of 22.8%, while higher than a previous study at the same University (Tobaiqy et al., 2021), was within the ideal range of 20%−25% for sample sizes under 500 as suggested by Fosnacht et al. [34]. However, it is still a low response rate, potentially limiting the generalizability of the findings. A higher response rate could provide more comprehensive insights that may contextualize the results [33, 34].

Furthermore, the predominance of third-year students and the higher number of female respondents could introduce bias which may have influenced respondents’ experiences and study conclusions.

Lastly, conducting the study at a single institution may restrict the applicability of the findings to other medical schools in Saudi Arabia or globally. Despite the study’s limitations, it offers groundbreaking insights into clinical pharmacology education in Saudi Arabia. It identifies specific areas for improvement and provides practical recommendations for enhancing the curriculum and preparing students for clinical practice. The potential impact of these findings is significant as they can guide future educational reforms and improve the quality of medical education in the country.

Future directions

Pharmacology is a swiftly evolving field requiring a dynamic curriculum integrating the latest knowledge, innovations and technologies. The clinical pharmacology curriculum should be updated regularly to develop more detailed learning outcomes and improve educational resources to enhance delivery. The review process should also promote inclusive pharmacology education ensuring alignment with contemporary educational standards and incorporating inclusive teaching strategies [32]. A robust educational component is essential to support these goals featuring poster sessions, oral presentations and workshops that showcase innovative teaching methods and foster networking among educators.

Of note, integrating case-based learning into clinical pharmacology improves critical thinking and practical application. It can be implemented through real-world scenarios, group discussions, and virtual cases that connect theory with practice. Technology helps manage cognitive overload by offering personalized learning through digital tools, adaptive platforms, and simulations, allowing students to revisit material at their own pace and improve retention [30,31,32, 35]. The study’s findings are based on a single institution, potentially limiting their applicability to other medical schools in Saudi Arabia. Further multi-institutional research would enhance clinical pharmacology teaching and learning in the country.

In Saudi Arabia, revising the clinical pharmacology curriculum is essential to enhance integration, real-world relevance, and case-based learning. College of Medicines have roles in prioritizing interactive teaching strategies, such as simulations and small-group discussions, and including multimedia resources and online modules for self-paced learning to cater to diverse learning preferences. Regular formative assessments and a balanced approach to exams will support students in mastering content and performing well in assessments. Additionally, providing faculty training in modern teaching methods and offering academic support services will enhance learning outcomes and reduce student stress.