Comparing the Influence of Three Educational Methods on the Epidemiology of Occupational Diseases' learning Qualities

Introduction:

The importance of new educational methods is clear. Every university lecturer or teacher is somehow knowledgeable in that case and many of them have used one or more of these methods but may not have perfect knowledge about the specific effects of these methods (1,2).

In recent years new educational methods such as; problem based learning, evidence based medical education, and utilizing didactic assists have been used  for educational programs at university level. We know that lecturing  is a traditional method in education but with the presentation of power point, educational animation and film,  this method can be  improved and become more useful(2).

Problem based learning is a recommended educational method, in this method students try to solve a specific problem by professor’s guidance (3,4). In medical sciences this problem is a disorder, disease, or health disturbance. According to the program, students prepare themselves for class and study about the subject of next sessions .In the beginning of next session the professor presents the subject in a question or problem view (5,6). By professor guidance ,students discuss  that until solving  the problem and answering  the main question. It seems that it fits clinical problems(7-9).

Evidence based medical education is the next educational method (10,11) . In this method , some of students search about the subject of  the previous session (12)  in the educational and related journals and websites(13,14). In this study, the author  introduces some specific websites for occupational health(15-17). Students search about the title in up to date websites and other references for new lessons.

Occupational health has general, basic, and specific courses that epidemiology of occupational diseases is a base for a lot of specific courses such as epidemiology of occupational diseases, toxicology, ergonomic and occupational risk factors.

One of the main courses in occupational health is epidemiology of occupational diseases .This course  includes specific chapters on epidemiology of occupational diseases such as occupational lung diseases, occupational toxicities, musculoskeletal  disorders, occupational cancers, noise induced hearing loss , epidemiology of occupational diseases application and general epidemiology chapters such as  definitions, types of epidemiological studies, studies application in occupational health , prevention levels , prevention application in occupational health , epidemiological samples(18-20).

Some studies have  demonstrated the effectiveness of problem based learning such as Groves M. et al had been shown the influence of  tutoring in problem based learning medical curricula (3) ,Butler R.  et al had been talked about the problem based learning in the medical school (4) , Callis A.N. et al had been cleared the difference between traditional and  hybrid problem based learning in application  of basic sciences to clinical problems (5) and some studies have  shown the usefulness of evidence based medical education such as Dornan T. et al had been talked about the  identification of best evidence in medical education (10) , Ramstrand  N. et al  had considerations for developing an evidenced-based practice in orthotics and prosthetics (11). 

In this study, the  author  tries  to find the best educational method for occupational diseases' epidemiology since this course is a basic for many future courses.

The objective is the determination the effects of three educational methods on learning of occupational diseases' epidemiology .

Methods

This study has been performed as a cross-sectional study from  1389 to 1391 on occupational health students.   Group A and B included 25 students and  group C 28 students. Course plans were written according to curriculum of the  ministry of the  health website.

Each group had a special educational method for epidemiology of occupational diseases. Lecture with power point presentation was used  for  group A, problem based learning was used  for group B and evidence based medical education was utilized in  for  group C.

In problem based learning students  participated in the classes actively, before each session they  had studied the  subject and at the beginning of the classes a question was planned about the subject on which they discussed about and the professor directed them. Most of the time the professor planned a question in the case presentation at first.

Example number (1): a battery worker who had neuropathy symptoms. Is it a work related problem? Is it frequent? What can we do? This was a problem in industry and students were supposed to solve it and answer the teacher’s questions.

Example number (2): Industry worker who had low back pain. Is it a work related problem? Is it frequent? What can we do? This was a problem in industry too. These questions can be related to occupational diseases, toxicology, ergonomic, and statistics and help the future specific courses learning in occupational health students.   

In evidence based medical students participated in the classes actively. Each session at the end of the class a question was planned by the professor and the next session one or more student who had  looked for the answer  in related journals and websites, such as national institute for occupational safety and health, haz -map, international labor organization discussed the answer.

 In general epidemiology chapters there were definitions, types of epidemiological studies, studies application in occupational health , prevention levels , prevention application in occupational health , epidemiological samples .

In specific epidemiology of occupational diseases there were epidemiology of occupational lung diseases, occupational toxicities, musculoskeletal  disorders, occupational cancers, noise induced hearing loss , epidemiology of occupational diseases application.

Examinations of the three groups were at the same level at the end of term, these tests were prepared by professors’ and teachers’ opinions for  making sure about the correction and validity and there had been a pilot study with correlation of 0.85 for assigning the reliability in a sample of occupational health students. These tests were included the general and specific epidemiology of occupational diseases according to the educational programs.

The inclusion criterion was the occupational health students in three entrance year of  1388 ,1389 and 1390 in the field of occupational health  and exclusion criteria were  studying another field or having entered university in other years.

 Data had been gathered in SPSS 11.5 and analyzed for calculation of means,  standard deviation, ANOVA and P<0.05.

 In research ethics; the researcher got oral satisfaction from participants and the names of the students were kept confidential.

Results:

The total grade of epidemiology of occupational diseases in group A ( lecture and presentation with power point) was 16.71±1.16, (Min: 13.25 and Max: 19.25), in group B( problem based learning)  was 18.52±1.03,( Min:16.50and Max: 20) and in group C(evidence based medical education) was 18.46±1.20 ,(Min: 14.00and Max: 20) , ANOVA (F) =14.752 and P=0 had significant differences.

 Table 1 shows the comparison of grades in specific epidemiology of occupational diseases chapters between the three groups.

Table 1 –The  comparison of grades in specific epidemiology of occupational diseases chapters between  the three groups (P<0.05)

Table 2 shows the comparison of grades in general epidemiology chapters between  the three groups.

Table 2 – The comparison of grades in general epidemiology chapters between three groups (P<0.05)

In specific epidemiology of occupational diseases ,there was a significant difference between the grade of epidemiology of occupational lung diseases, occupational toxicities, musculoskeletal  disorders, occupational cancers, noise induced hearing loss , epidemiology of occupational diseases application  were significantly different  among the  three groups with P=0.001 and the highest grade related to group( B) with problem based learning. The mean of grades were more in musculoskeletal disorders and epidemiology of occupational diseases applications.

In general epidemiology ,the  grades of definitions, types of epidemiological studies, studies application in occupational health , prevention levels , prevention application in occupational health , epidemiological samples were significantly different  among the three groups with P=0.001 and the most in group( C )with evidence based medical education. The mean of grades were more in definitions and types of studies.

Discussion:

According to the results; the total grade was the best with problem based learning educational method.

 The specific epidemiology of occupational diseases learning levels had been promoted in teaching with problem based learning than evidenced based medical education and the general epidemiology learning levels had been promoted in teaching with evidenced based medical education than problem based learning.

In specific epidemiology of occupational diseases: the grade of epidemiology of occupational lung diseases, occupational toxicities, musculoskeletal  disorders, occupational cancers, noise induced hearing loss , epidemiology of occupational diseases application  had significant differences and the highest grade related to  in  group (B)with problem based learning.

In general epidemiology :the  grade of definitions, types of epidemiological studies, studies application in occupational health , prevention levels , prevention application in occupational health , epidemiological samples had significant differences and the most in group( C )with evidence based medical education.

Group (B ) got the highest  mean grade of this course with problem based learning but it seems that this method is the best for specific epidemiology of occupational diseases. In general epidemiology evidence based medical education is the best educational method. Health ministry' curriculums can be helpful in teaching and learning and writing the course plans, educational standards help as well.

Groves M. et al. had shown the usefulness of problem based learning in medical education and had found the effectiveness of this method (3). Butler R. et al. had demonstrated the same results in another study about problem based learning (4).

Professors can use problem based learning in methods of teaching but they should write it in the course plans and share their educational experiences with other professors. 

 In this study students were satisfactied with problem based learning method and could participate and were active in classes and experienced scientific discussion with other students.

Callis A.N. et al. had found  out that problem based learning was a fit educational method in dental education (5) also Von Bergmann H.C had shown  the effectiveness of problem based learning in another study and they had been investigated  the  relationship between problem based learning process grades and content acquisition performance in a problem based learning dental program (6), Savery R. et al had been talked about the overview of problem based learning was included the definitions and distinctions (7), Hur Y had been shown the difference between the outcomes of active and reflective students in problem-based learning (8), Alghasham  A.  had study about  effect of problem-based learning on students’ performance. (9)  This article has demonstrated the importance of problem based learning.  

In another studies had been shown  the effectiveness of evidence based medical sciences education. McGuckin C. et al  had been searched the best evidence medical education in psychiatry training (12) , Assadi S.N. et al had been demonstrated the effectiveness of evidence based morning report (13), Patrício M. et al had systematic review of evidence in medical education and clinical medicine (14).This article has shown the usefulness of evidence based medical sciences education.

This study had some limitations; the number of students with three entrance years to university and searching on internet which was provided. Another study is recommended with more students with the same entrance year.

This study recommend that for teaching the specific epidemiology of occupational diseases or some clinical chapters ,teacher can use problem based learning and for teaching the general epidemiology they can  use evidence based medical education but overall problem based learning is the best educational method for epidemiology of occupational diseases. 

Conclusion:

According to the total grade; the problem based learning was the best educational method. Problem based learning was more effective for specific epidemiology of occupational diseases and evidence based medical education was more effective for general epidemiology.

Conflict of interest statement:

 The author declares no conflict of interest.

Acknowledgement:

The author would like to express his thanks from Mashhad University of Medical Sciences for all the supports.