Effectiveness of two different innovative teaching learning methods: A comparative analysis among phase 1 MBBS students

Technical Summary: Effectiveness of Two Different Innovative Teaching Learning Methods

Problem Statement
Medical education in India has shifted toward Competency-Based Medical Education (CBME), which emphasizes active learning, collaboration, and higher-order cognitive skills over traditional didactic instruction. While active learning strategies like cooperative learning and flashcard-based retrieval are known to enhance engagement and retention, there is a scarcity of comparative evidence evaluating different active learning methods within the same educational setting. Specifically, limited data exists comparing the Jigsaw technique (a structured cooperative learning method) against student-generated flip flashcard learning for teaching conceptually challenging topics like Biochemistry to Phase I MBBS students. This study addresses the gap by directly comparing the immediate learning outcomes and student perceptions of these two innovative teaching-learning methods (TLMs).

Methodology
The study employed a quasi-experimental comparative design conducted at a teaching medical college in India involving 75 consenting Phase I MBBS students.

• Participants & Allocation: Students were allocated into two comparable groups using stratified alternate allocation based on previous formative assessment scores to ensure baseline equivalence. Group JSM (n=38) received the Jigsaw intervention, while Group FCM (n=37) received the Student-Generated Flip Flashcard intervention.
• Intervention: The study focused on competency BI 7.2 (Protein Biosynthesis) from the National Medical Commission (NMC) curriculum.
  • Jigsaw Group: Students were divided into "home groups" and assigned subtopics. They formed "expert groups" to master their specific subtopic under faculty facilitation, then returned to home groups to teach peers, ensuring all members learned the full topic through peer instruction.
  • Flashcard Group: Students were divided into subgroups and instructed to create flip flashcards covering key concepts, mechanisms, and clinical relevance. They subsequently used these cards for peer discussion.
• Assessment: Immediate post-intervention learning outcomes were measured using a validated 30-mark questionnaire (Multiple Choice, Fill-in-the-blanks, Short Answer) covering Bloom's taxonomy levels C1 to C3. Student perceptions were collected via a structured 5-point Likert scale questionnaire and open-ended questions.
• Ethical & Statistical Considerations: The study received Institutional Ethics Committee approval. To ensure educational equity, a crossover session was conducted the following week where groups received the alternate intervention, though data from this session was excluded from the analysis. Data normality was assessed via the Shapiro–Wilk test; due to non-normal distribution of post-test scores, the Brunner–Munzel test was used for group comparisons.

Key Results

• Baseline Equivalence: The two groups were statistically comparable at baseline regarding previous formative assessment scores (p = 0.33).
• Learning Outcomes: The Jigsaw group demonstrated significantly superior immediate learning outcomes compared to the Flashcard group.
  • Mean post-test score: 15.0 (Jigsaw) vs. 9.86 (Flashcard).
  • Statistical significance: p < 0.001.
  • Effect size: The magnitude of the difference was large (Rank-biserial correlation = 0.525).
• Student Perceptions:
  • Jigsaw: Students reported higher levels of engagement, peer interaction, and conceptual understanding. They valued the collaborative nature and peer teaching but noted limitations regarding time consumption and potential unequal participation.
  • Flashcard: Students viewed this method as an effective, portable revision tool for self-paced learning. However, they noted it required significant preparation effort and offered less interaction compared to small-group teaching.

Key Contributions

1. Direct Comparative Evidence: This study provides rare direct comparative data between two distinct active learning strategies (Jigsaw vs. Student-Generated Flashcards) within the same CBME framework, moving beyond comparisons against traditional lectures.
2. Contextualized Findings: It highlights that while student satisfaction with flashcards was positive, the immediate knowledge gain was significantly lower than the Jigsaw method, likely due to the intervention design emphasizing card construction over repeated retrieval practice within a single session.
3. Pedagogical Insight: The findings suggest that for conceptually difficult topics requiring deep cognitive processing, structured cooperative learning (Jigsaw) may be more effective for immediate acquisition than self-directed resource creation, though both methods serve complementary roles.

Significance and Claims
The authors claim that the Jigsaw technique is a more effective strategy than student-generated flip flashcards for improving immediate learning outcomes in undergraduate medical biochemistry. The study posits that the Jigsaw method's success stems from principles of social constructivism, requiring learners to retrieve, organize, and explain information, thereby fostering deeper cognitive processing.

Furthermore, the paper claims that the Jigsaw method aligns well with the broader goals of CBME by simultaneously developing academic performance and essential competencies such as communication, teamwork, leadership, and peer-learning skills. The authors suggest that while Jigsaw is superior for initial conceptual understanding of complex topics, student-generated flashcards may be better suited for subsequent revision and long-term retention through self-directed practice.

The study concludes that incorporating structured cooperative learning into the CBME curriculum can enhance both academic performance and collaborative skills. However, the authors remain modest regarding the generalizability of these findings, acknowledging limitations such as the single-center design, small sample size, and the assessment of only immediate post-test performance. They call for future multicentric studies to evaluate long-term knowledge retention and the application of these skills.