|Year : 2015 | Volume
| Issue : 2 | Page : 130-134
Students' perception of an integrated quiz in a Malaysian Medical university
Heethal Jaiprakash1, Sarmishtha Ghosh2, Balsam M Nasir3, Soon S Chow2, Jaiprakash Mohanraj4
1 Department of Pharmacology, Faculty of Medicine, MAHSA University, Kuala Lumpur, Malaysia
2 Department of Physiology, MAHSA University, Kuala Lumpur, Malaysia
3 Department of Community Medicine, Management and Science University, Shah Alam, Selangor, Malaysia
4 Department of Biochemistry, MAHSA University, Kuala Lumpur, Malaysia
|Date of Web Publication||6-May-2015|
Faculty of Medicine, MAHSA University, Jalan Elmu, Off Jalan University, 59100 Kuala Lumpur
Context: Improvement in the quality of teaching has been one of the important items on the agenda of curriculum development in most medical schools in Malaysia. Active teaching strategies are designed to make the learning process more interesting and thought provoking.
Aims: To study the students' perception of an integrated quiz as a teaching-learning activity.
Materials and Methods: An integrated quiz was conducted among 2 nd year medical students in a Malaysian University. The quiz comprised questions on anatomy, physiology, biochemistry, pathology, microbiology, parasitology and nutrition. There were 8 teams, and four rounds with the four levels of questions according to Bloom's taxonomy were given. The students were divided into two groups. Group A consisted of students who participated in the quiz and Group B formed the audience. The perception of the students on the integrated quiz was assessed by administering a structured questionnaire of 20 questions and using a Likert-type scale. The respondents indicated their perception as scores; 5, 4, 3, 2 and 1 for options of strongly agree, agree, uncertain, disagree and strongly disagree respectively. In addition to the above scale, the students were given the option to give their comments and suggestions related to the session. The mean scores for each item were calculated and a comparison of the two groups made. Data were analyzed using descriptive statistics and t-test.
Results: A total of 103 students participated in the study. There were more females than males in both groups. The mean perception score for Group A and Group B was 3.3 ± 0.2 and 3.5 ± 0.3 respectively. When the mean scores were compared, a statistically significant result was revealed. The overall ratings for the quiz by both groups were good.
Conclusions: We found that Group B had a more positive response towards the integrated quiz as an active learning technique than Group A.
ملخص البحث :
يهدف هذا البحث لدراسة تصور الطلاب لاختبارات متكاملة كنشاط تعليم وتعلم. أجريت اختبارات متكاملة لطلاب الطب في المستوى الثاني في جامعة ماليزية. تضمنت الاختبارات أسئلة حول علم التشريح، وظائف الأعضاء، الكيمياء الحيوية، الأمراض، الأحياء المجهرية، الطفيليات والتغذية. تم تقسيم الطلاب إلى مجموعتين. المجموعة الأولى تتألف من الطلاب الذين شاركوا في هذه الاختبارات والمجموعة الثانية من الحضور. شملت الدراسة استبانه من 02 سؤالاً وباستخدام مقياس ليكرت وسمح للطلاب بالتعليق والاقتراح . شارك 301 طالب وطالبة في الدراسة وكانت الإناث أكثر من الذكور في كلا المجموعتين. كان متوسط تصور المجموعة الأولى والمجموعة الثانية 3.3±2.0 و 5.3±3.0 على التوالي. وقد بينت نتيجة المقارنة أنها ذات دلالة إحصائية وخلصت الدراسة إلى أن المجموعة الثانية كانت استجابتها أكثر إيجابية نحو الاختبارات المتكاملة.
Keywords: Integrated quiz, medical students, perception, teaching learning activity
|How to cite this article:|
Jaiprakash H, Ghosh S, Nasir BM, Chow SS, Mohanraj J. Students' perception of an integrated quiz in a Malaysian Medical university. Saudi J Med Med Sci 2015;3:130-4
|How to cite this URL:|
Jaiprakash H, Ghosh S, Nasir BM, Chow SS, Mohanraj J. Students' perception of an integrated quiz in a Malaysian Medical university. Saudi J Med Med Sci [serial online] 2015 [cited 2022 Jan 20];3:130-4. Available from: https://www.sjmms.net/text.asp?2015/3/2/130/156420
| Introduction|| |
Students have different levels of attitude about teaching/learning and responses to specific environments. The more instructors understand the differences, the better their chances of meeting the diverse learning needs of all their students.  They not only learn by simply sitting in a classroom listening to the teacher, memorizing prepackaged assignments, and reproducing the answers but must also talk about what they are learning, write about it, relate it to past experiences and apply it to their daily lives.  Students who are actively involved in learning retain information longer and better than those who are passive recipients of instructions.  Active involvement enhances students' level of understanding and their ability to integrate and synthesize material. It also improves students' conceptualization of functions of various systems and increases their levels of retention of information. , Most students spend the majority of their schooling in passive learning environments in which faculty are disseminators of information, and "solve problems."  Various teaching and learning activities used by lecturers are important in creating an active environment, which in turn develops the interest of the students.
In most medical schools in Asia, a large proportion of the teaching is in the form of lectures which is a kind of passive learning. Thus, we need to find unique ways of making learning active and interesting. This can be facilitated if the curriculum has a variety of teaching-learning activities with a strong impact on student learning. One of the techniques is by conducting quiz sessions which makes learning more active and also tests the level of knowledge and ability to recall the topic. 
We conducted an integrated quiz that was not subject-based, as our curriculum was an integrated curriculum. This was, therefore, more relevant to our students. To the best of our knowledge not many studies have been conducted on the perception of the students of an integrated quiz as a teaching-learning activity. The aim of this study was to elicit students' perception of an integrated quiz and thereby attempt to make changes towards achieving an active learning environment in our integrated medical curriculum.
| Materials and methods|| |
The quiz was given to 2 nd year medical students in a Malaysian Medical School following an integrated curriculum. The schedule and rules of the quiz were announced 8 weeks in advance. It was an integrated quiz in which questions comprised anatomy, physiology, biochemistry, pathology, microbiology, parasitology, pharmacology and nutrition in the gastrointestinal and nutrition block. ECE (early clinical skills) and epidemiology were excluded as these two subjects did not contribute to the continuous assessment for the block.
The class consisted of 130 students, 27 of whom were absent on the day of the quiz. The students were instructed to form 8 teams, each consisting of 4 members. Eight teams were formed because eight subjects were involved. This was done to prevent any team from getting questions from one subject more than once in a single round. The students who were not participating in the quiz were also divided into 8 teams, to serve as the audience. All the 16 teams were asked to prepare their own questions for the quiz. They were asked to pick papers to select the subject in which they were to prepare the questions. Hence each subject had questions from two teams, that is, one from the participants and one from the audience. All the questions were pooled together and given to the head of the respective departments. The experts were given the choice of either to selecting questions from those given by the students or make up their own questions. This was done to avoid any bias in choosing the questions.
There were four rounds in the quiz for the 8 teams and the questions included the four levels of questions according to Bloom's taxonomy. Round 1, 2, 3 and 4 were on recall, concept, case based and visual type respectively. The first and second rounds were supposed to be answered within 30 s and rounds three and four within 3 min. Each right answer was awarded 10 marks and the questions were not passed on to the next team. The visual round was a choice round with 10 marks for the right answer, and 5 marks deducted for the wrong answer. The subject on which the question was to be asked for each team was determined by getting a representative from the a udience to pick a chit. Appendix 1 [Additional file 1] shows sample questions from each round.
At the end of the session, a suitable prize was given for the 1 st , 2 nd and 3 rd places as an encouragement to the students. The perception of the students was assessed by administering a structured questionnaire of 20 questions developed by the authors and validated with a focus group. The students were also asked to give an overall rating of the session. The assessment was done by means of a Likert-type scale. The respondents indicated their agreement or disagreement as scores of 5, 4, 3, 2 and 1 for the options "strongly agree, agree, uncertain, disagree and strongly disagree" respectively. In addition to the above scale, the students were given the option to give their comments and suggestions on the session. The class was divided into Group A, who were the participants in the quiz and Group B, the audience. Groups A and B consisted of 32 and 71 students respectively. The mean scores for each item were calculated and a comparison made between the participants and the audience. A mean score of three indicated a neutral attitude while scores less or more than this indicated a negative and positive attitude respectively. The data obtained was analyzed using descriptive statistics, and t-test was done to compare the mean scores.
| Results|| |
A total of 103 MBBS students participated in the study. The mean age of the students in Group A and Group B was 20.6 ± 1.2 years and 21.2 ± 2.5 years respectively.
As shown in [Figure 1], there were more females in Group A, 19 students (59%), and Group B 45 students (63%) than males.
The perception of the students on the integrated quiz is depicted in [Table 1]. As shown in the table, the general perception of the students was neutral with a marginally positive attitude. When the mean value for each item was compared, a statistically significant result of P < 0.006 for item 5 was found. The comparison between the total mean score also showed a statistically significant result of P < 0.001.
[Figure 2] shows that most of the students 20 (63%) in Group A and 38 (54%) in Group B, felt that the quiz session was good overall.
The students commented that the quiz session was interesting. They felt that such sessions should be conducted on the other blocks as well. They also felt that as the quiz was conducted close to the block exams they found it difficult to concentrate. The students suggested that it should be conducted in the middle of the block so that it would not interfere with their preparation for the exams.
| Discussion|| |
Most of the teaching/learning activities in medical schools are in the form of didactic lectures and some small group sessions. In order to maintain the interest and focus of students, there is a need to introduce new teaching and learning activities. Creating innovative educational methods that enhance and supplement lectures has been a challenge for medical educators. 
In our study, we had more females than males since more female students than males enroll in the medical course in our institution. A study conducted in Nepal by Shankar et al. had more males than females.  In both groups the mean scores for most of the items were in the range of 3-4. This showed that the perception of the students regarding the quiz session was between neutral to positive for both groups. This was the observation in studies of medical students in Nepal and India. , In item 5, Group A had a more positive response perhaps because their active participation in the quiz had a greater impact on their self-learning skills than it did on Group B. There was a statistically significant difference in the perception between the two groups. Item 6 asked the students whether the quiz session reduced their stress for the upcoming end block test since they could have studied the block subjects while preparing for the quiz. Most students in both groups were negative in their response to this question.
A comparison of the overall mean score between the two groups revealed a more positive response in Group B which was statistically significant. This could be because Group B were just the audience and were not under stress to perform. Hence, they were more relaxed and enjoyed the quiz more. When the students were instructed to give an overall rating for the quiz session, we found that a good number of students in both groups felt that the quiz was good. This shows that most students were favorably inclined to the quiz session, which could thus be used as an effective teaching learning tool. A study conducted in Australia used a quiz followed by a class discussion as a learning experience. This format was beneficial to both students and teachers. It also served as an additional teaching learning method acceptable to the students.  In a study conducted by Finley et al., the quiz format was used to find out about learning about auscultation of heart sounds through computer-based independent learning compared with classroom teaching. Both methods were highly rated by the students. 
Faculty is often reluctant to incorporate active learning activities in the class. The reasons include the inability to cover as much content in the time available, excessive preparation time and the large number of students.  If solutions to the above shortcomings are found, integrated quizzes could serve as a tool for incorporating information from various subjects, which may then help in developing a holistic approach to medicine.
| Conclusion|| |
The Integrated quiz has been perceived as an enjoyable learning tool for students. The students had a positive view on this form of active learning technique. The students who did not participate in the quiz, especially had a more positive attitude than those who had participated. We plan to conduct integrated quizzes in the same block for future batches of students. This may be included as an active learning strategy in the curriculum. It is hoped that it would bring a fresh positive change to the monotony of lectures and make the learning process more interesting.
| References|| |
Richard M. Felder, Rebecca Brent. Understanding student differences. Journal of Engineering Education 2005;94:57-72.
Chickering AW, Zelda FG. Seven principles for good practice. Am Assoc High Educ Bull 1987;7:3-7.
Cross PK. Teaching for learning. Am Assoc High Educ Bull 1987;8:3-7.
Elliott DD. Promoting critical thinking in the classroom. Nurse Educ 1996;21:49-52.
Modell HI. Preparing students to participate in an active learning environment. Adv Physiol Educ 1996;15:S69-77.
Sujit SS, Monali B. Students attitude toward power point timed quizzes. Am J Pharm Educ 2004;68:1-5.
Shankar PR, Sen PK, Dawka S, Barthakur R. Student particpants' perception about medical quiz at the Manipal College of Medical Sciences. Pokhara, Nepal. J Inst Med 2007;29:30-3.
Manorama V, Tejinder S. Attitudes of medical students towards IAP pediatric quiz. Med Educ 1993;30:403-7.
Jamison JR. Innovations in education: A case study of a novel teaching/learning format. J Manipulative Physiol Ther 1996;19:92-8.
Finley JP, Sharratt GP, Nanton MA, Chen RP, Roy DL, Paterson G. Auscultation of the heart: A trial of classroom teaching versus computer-based independent learning. Med Educ 1998;32:357-61.
Bonwell CC, Eison JA. Active Learning: Creating Excitement in the Classroom. Washington DC: George Washington Univsity Press; 1991.
[Figure 1], [Figure 2]