- Email: [email protected]
Molecular and cellular biology: An integrated course of biochemistry for medical students
172
How can we help? By not demanding regurgitation of undigested information in examinations. By giving more opportunities to discuss and understand (tutorials, oral examinations). By emphasising problem-solving skills rather than memorisation. they examine. Most of all teachers need to make a positive effort to understand the difficulties students face so as to be able to help them learn. To quote from W Spady (Educational Research, January 1973, p 4-10) "The truly effective teacher must (1) have something to say of substance and interest, (2) be capable of saying it dearly and accurately, (3) be capable of saying it in a stimulating and exciting fashion, and (4) base this communication directly on a concern for the personal welfare of each student".
Molecular and Cellular Biology: An Integrated Course of Biochemistry for Medical Students JOSE CARRERAS Unitat de Bioquimica Facultat de Medicina Universitat de Barcelona Barcelona, Spain
Introduction As in most European countries, the curriculum in Spanish Medical Schools consists of two periods of three years each: the preclinical period and the clinical period. The disciplines of the first year are: Gross Anatomy I, General Physiology (which includes Biochemistry, Molecular and Cell Biophysics and Cell Physiology), Biology (which comprises Cytology, Genetics and General Embryology), Medical Physics and Biostatistics. The second year includes: Gross Anatomy II, Human Physiology, Histology
and Medical Psychology. The third year comprises: General Pathology and Clinical Propedeutics, Anatomical Pathology, Pharmacology, Physical Therapeutics, Microbiology and Parasitology. Traditionally the teaching of each discipline, extended throughout the entire course, has been developed by autonomous departments without any interrelationship or coordination. As a consequence, whereas some topics may be repeated several times in different disciplines, other topics are either treated superficially or even omitted. Before 1977 there was no limitation on entrance into Spanish Medical Schools. Due to the progressive increase in the university population since the sixties, the number of medical students increased continously, leading to massive enrolments: for example, there were more than 2700 first year medical students in the Barcelona University Medical School in 1977-78. The implementation of the numerus clausus in 1977 led to a significant reduction in the number of medical students. Therefore, in an attempt to improve teaching, a few professors especially interested in medical education decided in 1979 to organize a pilot, interdepartmental course on Molecular and Cellular Biology, which integrated as far as possible the programs of Biology, General Physiology and Medical Physics.
Integrated program The preparation of the integrated program was very laborious. We first analyzed the programs of the three disciplines in order to select the subjects which would be suitable for integration. Then we discussed the content of each subject and prepared a detailed schedule of its development. The subjects of the three disciplines not susceptible to integration were included in three independent disciplines to be taught after the course on Molecular and Cellular Biology: Human Biochemistry, Human Biophysics and General Embryology (Table 1). Table 1 Disciplines of the first year Traditional course General Physiology(Biochemistry ] and Biophysics) f Biology (Cell Biology, Genetics and General Embryology) Medical Physics Gross Anatomy I Biostatistics
Professor Carreras
BIOCHEMICAL EDUCATION 18(4) 1990
Integrated approach [ Molecular and Cellular Biology ]Human Biochemistry ~HumanBiophysics [General Embryology Gross Anatomy I Biostatistics
The content of the integrated course was distributed amongst 13 Parts, each constituted by several subjects (Table 2). It was decided to develop the course following an objective-based approach. Therefore, we prepared a set of specific instructional objectives for each subject (Table 3) in addition to the corresponding list of contents. We also prepared a specific bibliography for each subject, including the corresponding chapters of the recommended textbooks, some monographs and some suitable references from journals for first year medical students, such as
173. Table 2 Program of Molecular aml Cellular Biology I
Biological Organization (1) Levels of biological organization (2) Structure, energy and information II Atomic and Molecular Structure (3) Atomic nucleus. Radioactivity (4) Atomic structure (5) Molecular structure (6) Molecular conformation and configuration (7) Molecular interactions (8) Absorption and emission of light by molecules (9) Chemical reactions. Types and mechanisms III Separation and Characterization of Molecules (10) Characterization of molecules (11) Qualitative and quantitative analysis (12) Separation methods IV Biomolecules (13) Water (14) Inorganic ions (15) Fatty acids and derivatives (16) Simple lipids (17) Complex lipids (18) Terpenoids (19) Monosaccharides and derivatives (20) Oligosaccharides and polysaccharides (21) Amino acids and derivatives (22) Peptides (23) Proteins (24) Prosthetic groups and conjugated proteins (25) Nucleotides (26) Nucleic acids (27) Supramolecular aggregates V Study of Cells (28) Light microscopy (29) Electron microscopy (30) Microscopy of the cell (31) Cytochemistry (32) Cell culture (33) Study of cell metabolism VI Cell Structure (34) Structure of prokaryotic cells (35) Structure of eukaryotic cells (36) Nucleus and chromosomes (37) The cell cycle VII Bioenergetics and Biocatalysis (38) Conservation of energy. First law of thermodynamics (39) Entropy and free energy. Second law of thermodynamics (40) Energetics and biological systems (41) Biocatalysis (42) Types of enzymatic reactions (43) ,Molecular characteristics of enzymes (44) Mechanisms of enzymatic catalysis (45) Regulation of enzymes VIII Energy Metabolism of the Cell (46) Cells and energy BIOCHEMICAL EDUCATION 18(4) 1990
(47) Oxidative pathways (48) Respiratory chain (49) Tricarboxylic acid cycle (50) Oxidation of monosaccharides (51) Oxidation of fatty acids (52) Oxidation of amino acids (53) Gluconeogenesis (54) Glycogenesis and glycolysis (55) Lipogenesis and lipolysis IX Cell Membranes (56) Composition of cell membranes (57) Structure of cell membranes (58) Membrane metabolism (59) Functions of cell membranes (60) Cell membranes and diffusion (61) Water flux. Osmosis (62) Equilibrium between electric flux and diffusion (63) Donnan equilibrium and membrane potential (64) Mediated transport and group translocation (65) Vesicle-mediated transport. Lysosomes. Cell secretion (66) Cell-ceU interactions. Cell junctions (67) Membrane biogenesis X Motile Systems (68) Cell motility (69) Contractile proteins. Muscle contraction (70) Myofibrillar systems (71) Microtubular systems XI Molecular and Cellular Genetics (72) Genetic control of cell structure and function (73) Transfer and expression of genetic information (74) Information and codification. Genetic code (75) Composition of the genetic material. Chromatin structure (76) Structure and division of chromosomes (77) Metabolism of nucleotides (78) Transfer of genetic information. DNA duplication (79) DNA transcription. RNA synthesis and processing (80) Ribosomes and ribonucleoprotein particles (81) Biosynthesis of amino acids and prosthetic groups (82) Biosynthesis of proteins (83) Regulation of gene expression (84) Molecular basis of gene mutation (85) Degradation and turnover of proteins (86) Genome organization and interchange of genes (87) Parasexuality (88) Meiosis and Mendelian heredity (89) Genome organization (90) Mutation and chromosome alterations Xll Supracellular Regulation (91) Levels of metabolic regulation. Cellular and supracellular control (92) Mechanisms of hormone action (93) Codification and processing of neuronal information
174
Table 2 (contd) (94) (95) (96) (97)
Cell excitability Action potential. Nervous impulse Synaptic transmission. Neurotransmitters Cell differentiation
the Spanish editions of Scientific American and La Recherche. The syllabus of the course - - including lectures, seminars, laboratory sessions and tutorials - was handed to the students at the beginning of the course. A team of three teachers - - one for Biochemistry, one for Cell Biology and one for Medical Physics - - was responsible for the coordination of the teaching and for giving the lectures. Although all the lectures corresponding to some subjects were given by the same teacher, most subjects were developed by two or three different lecturers (Table 3). During the first year of implementation of the integrated course, all the teachers attended the lectures given by their colleagues in order to ensure coordination, to standardize the language and to evaluate the development of the course. After one year of experience, the integrated course was extended to all first year medical students, who were divided into four groups of 100 students each. The course extended over 20 teaching weeks, amounting to 200 lectures and 100 seminars and tutorials. As a consequence of the large number of students and the lack of sufficient laboratory facilities, the laboratory work amounted to only 20 hours per student. This was supplemented with audiovisual sessions. To evaluate the students we set two examinations: one in the middle of the course and another at the end.
it, by scoring from 0 to 3 points a series of advantages and disadvantages of the instructional objectives and of the integrated teaching for both students and teachers. As shown in Table 4, the students considered the advantages of the instructional objectives very substantial, mainly from their point of view. In contrast, they considered the disadvantages unimportant, either for the students or for the teachers. Similarly, the students considered that the advantages of the integrated teaching greatly outweighed the disadvantages for both students and teachers (Table
5). The students were also asked about the influence of the
Table 4 Student evaluation: instructional objectives Advantages for the students • Facilitate learning, by indicating where to focus effort • Facilitate self evaluation • Decrease stress: no need to guess what teacher wants in exam
2.5 2.1
Advantages for the teachers • Insure planning and development of teaching according to defined goals • Facilitate the evaluation of the educational system • Facilitate the evaluation of the student
2.3 1.8 1.6
Disadvantages for the students • Decrease autonomy in learning
0.7
Disadvantages for the teachers • Trivialize the educational task • Restrict autonomy
Evaluation
2.7
0.8 0.6
At the end of the course we asked the students to evaluate
Table 3 Molecular and Cell Biology: Distribution of Instructional Objectives and Lectures Part
Objectives
A
(1) Levels of biological organization (2) Atomic and molecular structure Molecular interactions and mechanisms of chemical reaction (3) Separation and characterization of molecules (4) Biomolecules (5) Cell structure (6) Study of cells (7) Bioenergetics and biocatalysis (8) Energy metabolism of the cell (9) Cell membranes (10) Motile systems (11) Molecular and cellular genetics (12) Supracellular regulation
45 95 62 82 176 96 104 213 209 78 174 369 150
-10 2
Total
2453
103
* Given by (A) Professor of Biochemistry, (B) Professor of Medical Physics, ((7) Professor of Cell Biology.
BIOCHEMICAL EDUCATION 18(4) 1990
24 -13 6 3 22 17 6
Lectures B 3 9 6 seminar --seminar 10 8 ---6 42
C* 4 ---8 -6 3 -21 6 48
175
Table 7 Would you like this to be extended to other areas?
Table 5 Student evaluation: integrated teaching Advantages for the students • Enables a conception of the human being nearer to its bio-psych-sociological unity • Facilitates learning • Increases motivation
1.7 1.6
2.5 2.0
1.0 1.0
0.9 0.7
instructional objectives and the integrated teaching on the intensity, regularity and benefit derived from personal study, and on their performance in exams. As summarized in Table 6, most students considered the integrated teaching to be more beneficial than the instructional objectives. The percentage of students who considered the educational innovations counterproductive was very low. In agreement with this, most students were favourable to the possibility of extending the instructional objectives and the integrated teaching to other areas of the curriculum (Table 7). The students' opinion of the
Table 6 Student evaluation: instructional objectives
Intensity of personal study Regularity of personal study Benefit from personal study Performance in exam
More
Same
Less
26 33 37 50
69 65 55 45
2.4 0 6 3.6
(%)
Integrated teaching
Intensity o f personal study Regularity of personal study Benefit from personal study Performance in exam
Instructional objectives Integrated teaching
84 50
7 33
8 16
integrated course was even more positive when, in the more advanced courses, they were able to compare integrated with non-integrated teaching. The most general criticism of the course derived from the fact that it entailed the substitution of three final exams (one for each discipline) by a single common exam.
Negative attitude
Disadvantages for the teachers • Requirement of excessive dedication to teaching • Decrease of autonomy and leadership
Indifferent
(%)
1.5
Disadvantages for the students • Continuous change of teachers with different educational styles • Monotony and rigidity in learning
No
2.4
Advantages for the teachers • Avoids unnecessary repetition and treats the most relevant subjects in depth • Facilitates the interrelationships between teachers and departments • Increases the flexibility of the educational system and facilitates its progressive modification with experience
Yes
However, regardless of its acceptance by the students, the course on Molecular and Cellular Biology was stopped in 1984, as a consequence of the negative attitude of several teachers. The criticism from the teachers greatly increased when people who were not very interested in teaching were engaged on the integrated course. Table 8 summarizes the most critical remarks from these teachers. Those who had introduced the course on Molecular and Cellular Biology considered it best to discontinue it while waiting for better times and fortunately it seems that these better times are coming. The Spanish Department of Education decided four years ago to modify the medical curriculum and to introduce the integrated teaching of several subjects. In the preclinical period the different disciplines will be integrated in three major areas which represent three levels of thinking in Medicine: Molecular and Cellular Biology, Human Biology, Psychology and Sociology. When the course on Molecular and Cellular Biology was introduced in 1979 it went against the structure of the existing curriculum. The Future In the near future the structure of the curriculum will demand integration. Therefore, we hope that the resist-
Table 8 Teachers' evaluation: disadvantages for the teachers Instructional Objectives • Decrease autonomy, initiative and creativity in teaching • Lecturing requires too much effort • Teachers are obliged to give too much information
Integrated Teaching More
Same
Less
54 57 39 24
37 38 38 45
7 3.6 19 27
(%)
BIOCHEMICAL EDUCATION 18(4) 1990
• • • • • • •
Demands excessive work for results obtained Decreases autonomy of the teacher Decreases productivity of the teacher Obstructs the relationships with students Decreases the leadership of the teacher Demands uniform criteria of evaluation Makes research more difficult
176 ance to integrated teaching on the part of the teachers will not be as great as it was. However, as has been stressed by the latest World Conference on Medical Education in Edinburgh, to make possible any change in medical education, it is necessary to train teachers as educators, not solely as experts in content. It is necessary to develop incentives that recognize and reward quality teaching in Medical Schools. It is essential to reward educational excellence as fully as excellence in biomedical research or clinical practice.
specific fields that are of the biological sciences. Biochemistry teaching activities cannot be dissociated from research practice. I will present an analysis of the general situation and the national context in which research and teaching activities in biochemistry have been developing in Portugal. We believe that this approach can help to reach a better characterization of the problems existing in our country and their causes. This is the first step to a good understanding of the ways to solve them in an environment of constant acquisition and adaptation of the new programs and the methods in biochemical education in each specific field.
Crossroads of Biochemical Education in Portugal MARIA C LECHNER Laborat6rio de Bioquimica Instituto Gulbenkian de Ci~ncia Oeiras, Portugal Introduction The Committee on Education of the International Union of Biochemistry organised and conducted a workshop on Biochemical Education in Portugal on 8-10 February, 1986. A rather complete picture of the situation was published in the Reports on this Meeting I describing the data and opinions presented by the participants. Those included the majority of the persons experienced in teaching Biochemistry in this country. Six sessions were held on different topics; namely on General Aspects and Difficulties in Biochemical Education, Molecular Biology Teaching, Teaching Biochemistry for Medical and for Technological Sciences, on the Coordination between Biochemistry Teaching and Related Subjects, and on Post-Graduate Teaching. I will not go over the points again here: they were discussed exhaustively in the 86 Meeting and published in the report in Biochemical Education. 1 More than any other experimental science, Biochemistry is an interdisciplinary and dynamic science which is undergoing accelerated development. Teaching biochemistry depends on a constant actualization of the scientific knowledge and experimental methods available at any given time, susceptible to answering specific questions in
Evolution of Biochemical Education and Research Activities in Portugal Biochemistry started to be taught in Portuguese Universities about half a century ago as a subject in the curricula of the Medicine and Pharmacy schools, as well as in the Faculty of Sciences of Lisbon University. However, biochemistry teaching has for long been directed towards restricted clinical biochemistry or the chemistry of natural products. Research activities were virtually absent and the programs were taught almost exclusively as a 'body of knowledge defined by textbook authors'. 2 Laboratory experimentation and the scientific spirit have not been developed until very recently. Although Portugal was one of the first countries in the world to have a University,* for a number of historical reasons Portuguese Universities did not actually develop experimental research activities to any great extent but rather, devoted themselves to the defence of more orthodox values within scholastic activities. In spite of the successive reformations - - at the time when biochemical sciences started to integrate the curricula - - the Universities did not have laboratories and infrastructures capable of supporting the research activities which would be required for the production of biochemical knowledge (or even its reproduction). Besides there being a static situation created by the very limited number of students and professors, the Law in force at that time prevented access to postgraduate degrees for all those who were not already members of the University staff. From the 1950s, more often than not people went abroad for their PhDs in order to progress in academic careers. This movement was markedly accentuated by the establishment of specific travel grants program of the Gulbenkian Foundation. The creation of the Biology Center of the Gulbenkian Institute marked a turning point through the implemen-
O
Professor Lecliner BIOCHEMICAL EDUCATION 18(4) 1990
* The first University, ' E s t u d o Geral', was founded in Lisbon by King D D Dinis in 1290. It included a school of Medicine as well as Arts, Law and C a n o n s which were transferred to Coimbra in 1308. During the XVIIIth Century, the ' R e f o r m a Pombalina', aware of the new m e t h o d s and scientific subjects, introduced changes into the study of Medicine aiming at the inclusion of experimental research. T h e interest focused on natural and exact sciences led at that time to the creation of two new Faculties, namely those of Mathematics and Philosophy, which included Natural Philosophy. These have been converted into the Faculty of Sciences, after the proclamation of the Republic in 1910 (ref 3).
How can we help? By not demanding regurgitation of undigested information in examinations. By giving more opportunities to discuss and understand (tutorials, oral examinations). By emphasising problem-solving skills rather than memorisation. they examine. Most of all teachers need to make a positive effort to understand the difficulties students face so as to be able to help them learn. To quote from W Spady (Educational Research, January 1973, p 4-10) "The truly effective teacher must (1) have something to say of substance and interest, (2) be capable of saying it dearly and accurately, (3) be capable of saying it in a stimulating and exciting fashion, and (4) base this communication directly on a concern for the personal welfare of each student".
Molecular and Cellular Biology: An Integrated Course of Biochemistry for Medical Students JOSE CARRERAS Unitat de Bioquimica Facultat de Medicina Universitat de Barcelona Barcelona, Spain
Introduction As in most European countries, the curriculum in Spanish Medical Schools consists of two periods of three years each: the preclinical period and the clinical period. The disciplines of the first year are: Gross Anatomy I, General Physiology (which includes Biochemistry, Molecular and Cell Biophysics and Cell Physiology), Biology (which comprises Cytology, Genetics and General Embryology), Medical Physics and Biostatistics. The second year includes: Gross Anatomy II, Human Physiology, Histology
and Medical Psychology. The third year comprises: General Pathology and Clinical Propedeutics, Anatomical Pathology, Pharmacology, Physical Therapeutics, Microbiology and Parasitology. Traditionally the teaching of each discipline, extended throughout the entire course, has been developed by autonomous departments without any interrelationship or coordination. As a consequence, whereas some topics may be repeated several times in different disciplines, other topics are either treated superficially or even omitted. Before 1977 there was no limitation on entrance into Spanish Medical Schools. Due to the progressive increase in the university population since the sixties, the number of medical students increased continously, leading to massive enrolments: for example, there were more than 2700 first year medical students in the Barcelona University Medical School in 1977-78. The implementation of the numerus clausus in 1977 led to a significant reduction in the number of medical students. Therefore, in an attempt to improve teaching, a few professors especially interested in medical education decided in 1979 to organize a pilot, interdepartmental course on Molecular and Cellular Biology, which integrated as far as possible the programs of Biology, General Physiology and Medical Physics.
Integrated program The preparation of the integrated program was very laborious. We first analyzed the programs of the three disciplines in order to select the subjects which would be suitable for integration. Then we discussed the content of each subject and prepared a detailed schedule of its development. The subjects of the three disciplines not susceptible to integration were included in three independent disciplines to be taught after the course on Molecular and Cellular Biology: Human Biochemistry, Human Biophysics and General Embryology (Table 1). Table 1 Disciplines of the first year Traditional course General Physiology(Biochemistry ] and Biophysics) f Biology (Cell Biology, Genetics and General Embryology) Medical Physics Gross Anatomy I Biostatistics
Professor Carreras
BIOCHEMICAL EDUCATION 18(4) 1990
Integrated approach [ Molecular and Cellular Biology ]Human Biochemistry ~HumanBiophysics [General Embryology Gross Anatomy I Biostatistics
The content of the integrated course was distributed amongst 13 Parts, each constituted by several subjects (Table 2). It was decided to develop the course following an objective-based approach. Therefore, we prepared a set of specific instructional objectives for each subject (Table 3) in addition to the corresponding list of contents. We also prepared a specific bibliography for each subject, including the corresponding chapters of the recommended textbooks, some monographs and some suitable references from journals for first year medical students, such as
173. Table 2 Program of Molecular aml Cellular Biology I
Biological Organization (1) Levels of biological organization (2) Structure, energy and information II Atomic and Molecular Structure (3) Atomic nucleus. Radioactivity (4) Atomic structure (5) Molecular structure (6) Molecular conformation and configuration (7) Molecular interactions (8) Absorption and emission of light by molecules (9) Chemical reactions. Types and mechanisms III Separation and Characterization of Molecules (10) Characterization of molecules (11) Qualitative and quantitative analysis (12) Separation methods IV Biomolecules (13) Water (14) Inorganic ions (15) Fatty acids and derivatives (16) Simple lipids (17) Complex lipids (18) Terpenoids (19) Monosaccharides and derivatives (20) Oligosaccharides and polysaccharides (21) Amino acids and derivatives (22) Peptides (23) Proteins (24) Prosthetic groups and conjugated proteins (25) Nucleotides (26) Nucleic acids (27) Supramolecular aggregates V Study of Cells (28) Light microscopy (29) Electron microscopy (30) Microscopy of the cell (31) Cytochemistry (32) Cell culture (33) Study of cell metabolism VI Cell Structure (34) Structure of prokaryotic cells (35) Structure of eukaryotic cells (36) Nucleus and chromosomes (37) The cell cycle VII Bioenergetics and Biocatalysis (38) Conservation of energy. First law of thermodynamics (39) Entropy and free energy. Second law of thermodynamics (40) Energetics and biological systems (41) Biocatalysis (42) Types of enzymatic reactions (43) ,Molecular characteristics of enzymes (44) Mechanisms of enzymatic catalysis (45) Regulation of enzymes VIII Energy Metabolism of the Cell (46) Cells and energy BIOCHEMICAL EDUCATION 18(4) 1990
(47) Oxidative pathways (48) Respiratory chain (49) Tricarboxylic acid cycle (50) Oxidation of monosaccharides (51) Oxidation of fatty acids (52) Oxidation of amino acids (53) Gluconeogenesis (54) Glycogenesis and glycolysis (55) Lipogenesis and lipolysis IX Cell Membranes (56) Composition of cell membranes (57) Structure of cell membranes (58) Membrane metabolism (59) Functions of cell membranes (60) Cell membranes and diffusion (61) Water flux. Osmosis (62) Equilibrium between electric flux and diffusion (63) Donnan equilibrium and membrane potential (64) Mediated transport and group translocation (65) Vesicle-mediated transport. Lysosomes. Cell secretion (66) Cell-ceU interactions. Cell junctions (67) Membrane biogenesis X Motile Systems (68) Cell motility (69) Contractile proteins. Muscle contraction (70) Myofibrillar systems (71) Microtubular systems XI Molecular and Cellular Genetics (72) Genetic control of cell structure and function (73) Transfer and expression of genetic information (74) Information and codification. Genetic code (75) Composition of the genetic material. Chromatin structure (76) Structure and division of chromosomes (77) Metabolism of nucleotides (78) Transfer of genetic information. DNA duplication (79) DNA transcription. RNA synthesis and processing (80) Ribosomes and ribonucleoprotein particles (81) Biosynthesis of amino acids and prosthetic groups (82) Biosynthesis of proteins (83) Regulation of gene expression (84) Molecular basis of gene mutation (85) Degradation and turnover of proteins (86) Genome organization and interchange of genes (87) Parasexuality (88) Meiosis and Mendelian heredity (89) Genome organization (90) Mutation and chromosome alterations Xll Supracellular Regulation (91) Levels of metabolic regulation. Cellular and supracellular control (92) Mechanisms of hormone action (93) Codification and processing of neuronal information
174
Table 2 (contd) (94) (95) (96) (97)
Cell excitability Action potential. Nervous impulse Synaptic transmission. Neurotransmitters Cell differentiation
the Spanish editions of Scientific American and La Recherche. The syllabus of the course - - including lectures, seminars, laboratory sessions and tutorials - was handed to the students at the beginning of the course. A team of three teachers - - one for Biochemistry, one for Cell Biology and one for Medical Physics - - was responsible for the coordination of the teaching and for giving the lectures. Although all the lectures corresponding to some subjects were given by the same teacher, most subjects were developed by two or three different lecturers (Table 3). During the first year of implementation of the integrated course, all the teachers attended the lectures given by their colleagues in order to ensure coordination, to standardize the language and to evaluate the development of the course. After one year of experience, the integrated course was extended to all first year medical students, who were divided into four groups of 100 students each. The course extended over 20 teaching weeks, amounting to 200 lectures and 100 seminars and tutorials. As a consequence of the large number of students and the lack of sufficient laboratory facilities, the laboratory work amounted to only 20 hours per student. This was supplemented with audiovisual sessions. To evaluate the students we set two examinations: one in the middle of the course and another at the end.
it, by scoring from 0 to 3 points a series of advantages and disadvantages of the instructional objectives and of the integrated teaching for both students and teachers. As shown in Table 4, the students considered the advantages of the instructional objectives very substantial, mainly from their point of view. In contrast, they considered the disadvantages unimportant, either for the students or for the teachers. Similarly, the students considered that the advantages of the integrated teaching greatly outweighed the disadvantages for both students and teachers (Table
5). The students were also asked about the influence of the
Table 4 Student evaluation: instructional objectives Advantages for the students • Facilitate learning, by indicating where to focus effort • Facilitate self evaluation • Decrease stress: no need to guess what teacher wants in exam
2.5 2.1
Advantages for the teachers • Insure planning and development of teaching according to defined goals • Facilitate the evaluation of the educational system • Facilitate the evaluation of the student
2.3 1.8 1.6
Disadvantages for the students • Decrease autonomy in learning
0.7
Disadvantages for the teachers • Trivialize the educational task • Restrict autonomy
Evaluation
2.7
0.8 0.6
At the end of the course we asked the students to evaluate
Table 3 Molecular and Cell Biology: Distribution of Instructional Objectives and Lectures Part
Objectives
A
(1) Levels of biological organization (2) Atomic and molecular structure Molecular interactions and mechanisms of chemical reaction (3) Separation and characterization of molecules (4) Biomolecules (5) Cell structure (6) Study of cells (7) Bioenergetics and biocatalysis (8) Energy metabolism of the cell (9) Cell membranes (10) Motile systems (11) Molecular and cellular genetics (12) Supracellular regulation
45 95 62 82 176 96 104 213 209 78 174 369 150
-10 2
Total
2453
103
* Given by (A) Professor of Biochemistry, (B) Professor of Medical Physics, ((7) Professor of Cell Biology.
BIOCHEMICAL EDUCATION 18(4) 1990
24 -13 6 3 22 17 6
Lectures B 3 9 6 seminar --seminar 10 8 ---6 42
C* 4 ---8 -6 3 -21 6 48
175
Table 7 Would you like this to be extended to other areas?
Table 5 Student evaluation: integrated teaching Advantages for the students • Enables a conception of the human being nearer to its bio-psych-sociological unity • Facilitates learning • Increases motivation
1.7 1.6
2.5 2.0
1.0 1.0
0.9 0.7
instructional objectives and the integrated teaching on the intensity, regularity and benefit derived from personal study, and on their performance in exams. As summarized in Table 6, most students considered the integrated teaching to be more beneficial than the instructional objectives. The percentage of students who considered the educational innovations counterproductive was very low. In agreement with this, most students were favourable to the possibility of extending the instructional objectives and the integrated teaching to other areas of the curriculum (Table 7). The students' opinion of the
Table 6 Student evaluation: instructional objectives
Intensity of personal study Regularity of personal study Benefit from personal study Performance in exam
More
Same
Less
26 33 37 50
69 65 55 45
2.4 0 6 3.6
(%)
Integrated teaching
Intensity o f personal study Regularity of personal study Benefit from personal study Performance in exam
Instructional objectives Integrated teaching
84 50
7 33
8 16
integrated course was even more positive when, in the more advanced courses, they were able to compare integrated with non-integrated teaching. The most general criticism of the course derived from the fact that it entailed the substitution of three final exams (one for each discipline) by a single common exam.
Negative attitude
Disadvantages for the teachers • Requirement of excessive dedication to teaching • Decrease of autonomy and leadership
Indifferent
(%)
1.5
Disadvantages for the students • Continuous change of teachers with different educational styles • Monotony and rigidity in learning
No
2.4
Advantages for the teachers • Avoids unnecessary repetition and treats the most relevant subjects in depth • Facilitates the interrelationships between teachers and departments • Increases the flexibility of the educational system and facilitates its progressive modification with experience
Yes
However, regardless of its acceptance by the students, the course on Molecular and Cellular Biology was stopped in 1984, as a consequence of the negative attitude of several teachers. The criticism from the teachers greatly increased when people who were not very interested in teaching were engaged on the integrated course. Table 8 summarizes the most critical remarks from these teachers. Those who had introduced the course on Molecular and Cellular Biology considered it best to discontinue it while waiting for better times and fortunately it seems that these better times are coming. The Spanish Department of Education decided four years ago to modify the medical curriculum and to introduce the integrated teaching of several subjects. In the preclinical period the different disciplines will be integrated in three major areas which represent three levels of thinking in Medicine: Molecular and Cellular Biology, Human Biology, Psychology and Sociology. When the course on Molecular and Cellular Biology was introduced in 1979 it went against the structure of the existing curriculum. The Future In the near future the structure of the curriculum will demand integration. Therefore, we hope that the resist-
Table 8 Teachers' evaluation: disadvantages for the teachers Instructional Objectives • Decrease autonomy, initiative and creativity in teaching • Lecturing requires too much effort • Teachers are obliged to give too much information
Integrated Teaching More
Same
Less
54 57 39 24
37 38 38 45
7 3.6 19 27
(%)
BIOCHEMICAL EDUCATION 18(4) 1990
• • • • • • •
Demands excessive work for results obtained Decreases autonomy of the teacher Decreases productivity of the teacher Obstructs the relationships with students Decreases the leadership of the teacher Demands uniform criteria of evaluation Makes research more difficult
176 ance to integrated teaching on the part of the teachers will not be as great as it was. However, as has been stressed by the latest World Conference on Medical Education in Edinburgh, to make possible any change in medical education, it is necessary to train teachers as educators, not solely as experts in content. It is necessary to develop incentives that recognize and reward quality teaching in Medical Schools. It is essential to reward educational excellence as fully as excellence in biomedical research or clinical practice.
specific fields that are of the biological sciences. Biochemistry teaching activities cannot be dissociated from research practice. I will present an analysis of the general situation and the national context in which research and teaching activities in biochemistry have been developing in Portugal. We believe that this approach can help to reach a better characterization of the problems existing in our country and their causes. This is the first step to a good understanding of the ways to solve them in an environment of constant acquisition and adaptation of the new programs and the methods in biochemical education in each specific field.
Crossroads of Biochemical Education in Portugal MARIA C LECHNER Laborat6rio de Bioquimica Instituto Gulbenkian de Ci~ncia Oeiras, Portugal Introduction The Committee on Education of the International Union of Biochemistry organised and conducted a workshop on Biochemical Education in Portugal on 8-10 February, 1986. A rather complete picture of the situation was published in the Reports on this Meeting I describing the data and opinions presented by the participants. Those included the majority of the persons experienced in teaching Biochemistry in this country. Six sessions were held on different topics; namely on General Aspects and Difficulties in Biochemical Education, Molecular Biology Teaching, Teaching Biochemistry for Medical and for Technological Sciences, on the Coordination between Biochemistry Teaching and Related Subjects, and on Post-Graduate Teaching. I will not go over the points again here: they were discussed exhaustively in the 86 Meeting and published in the report in Biochemical Education. 1 More than any other experimental science, Biochemistry is an interdisciplinary and dynamic science which is undergoing accelerated development. Teaching biochemistry depends on a constant actualization of the scientific knowledge and experimental methods available at any given time, susceptible to answering specific questions in
Evolution of Biochemical Education and Research Activities in Portugal Biochemistry started to be taught in Portuguese Universities about half a century ago as a subject in the curricula of the Medicine and Pharmacy schools, as well as in the Faculty of Sciences of Lisbon University. However, biochemistry teaching has for long been directed towards restricted clinical biochemistry or the chemistry of natural products. Research activities were virtually absent and the programs were taught almost exclusively as a 'body of knowledge defined by textbook authors'. 2 Laboratory experimentation and the scientific spirit have not been developed until very recently. Although Portugal was one of the first countries in the world to have a University,* for a number of historical reasons Portuguese Universities did not actually develop experimental research activities to any great extent but rather, devoted themselves to the defence of more orthodox values within scholastic activities. In spite of the successive reformations - - at the time when biochemical sciences started to integrate the curricula - - the Universities did not have laboratories and infrastructures capable of supporting the research activities which would be required for the production of biochemical knowledge (or even its reproduction). Besides there being a static situation created by the very limited number of students and professors, the Law in force at that time prevented access to postgraduate degrees for all those who were not already members of the University staff. From the 1950s, more often than not people went abroad for their PhDs in order to progress in academic careers. This movement was markedly accentuated by the establishment of specific travel grants program of the Gulbenkian Foundation. The creation of the Biology Center of the Gulbenkian Institute marked a turning point through the implemen-
O
Professor Lecliner BIOCHEMICAL EDUCATION 18(4) 1990
* The first University, ' E s t u d o Geral', was founded in Lisbon by King D D Dinis in 1290. It included a school of Medicine as well as Arts, Law and C a n o n s which were transferred to Coimbra in 1308. During the XVIIIth Century, the ' R e f o r m a Pombalina', aware of the new m e t h o d s and scientific subjects, introduced changes into the study of Medicine aiming at the inclusion of experimental research. T h e interest focused on natural and exact sciences led at that time to the creation of two new Faculties, namely those of Mathematics and Philosophy, which included Natural Philosophy. These have been converted into the Faculty of Sciences, after the proclamation of the Republic in 1910 (ref 3).