Abstract:

There is a growing interest in exploring innovative learning approaches to motivate and improve integrative capacity of undergraduate students. With the aim to stimulate integrative knowledge skills in Pharmacy degree students, the teaching group work CCT-FARMA of the Faculty of Pharmacy and Food Sciences of the Universitat de Barcelona (Barcelona, Spain) introduced a transversal clinical case about tobacco smoking to second-year students of Pharmacy degree. Along four academic years, the students were taught the biochemical and pathophysiological basis necessary to understand the effects of tobacco smoking on human health as part of 8 subjects of the curricular studies of Pharmacy degree (mostly core compulsory subjects, including Molecular Biology and Genomics, Physiology and Physiopathology, Pharmacology and Therapeutics, Toxicology, and Clinical Biochemistry and Molecular Pathology). Integrative capacity, knowledge acquisition and student’s awareness of health effects of smoking were evaluated with two presential, voluntary and anonymous questionnaires:
i) A test inquiring background knowledge of basic effects of smoking on health (Questionnaire 1) that was applied to fifth-year students trained on the clinical case, non-trained fifth-year students and first-year students (before introduction of the clinical case); and
ii) a second test with more specific and integrative questions about pathophysiological consequences of tobacco smoking (Questionnaire 2) that was applied to fourth-year students after receiving most of the formation of the clinical case and non-trained fourth-year students.

The results of Questionnaire 1 showed that fifth-year students have significantly greater awareness of association of smoking with human pathologies in 4 out of 7 questions. No statistical significance was found in questions addressing issues with marked social media outreach, such as smoking association with cancer or respiratory diseases. The fact that fifth-year students obtained very high scores in all items of Questionnaire 1 (ranging from 7.4/10.0 to 10.0/10.0) indicated that the specific formation of the clinical case could not significantly improve basic knowledge that is already addressed in the Pharmacy degree programme. However, although not significant, a trend to obtain greater scores was observed for 4 out of 7 questions in fifth-year students that were trained on the clinical case.

In contrast to Questionnaire 1, some items of Questionnaire 2 significantly discriminated four-year students trained on the clinical case than non-trained four-year students. Most remarkably, a higher percentage of trained students recognised that nicotine is not the most harmful component of tobacco smoke (88 % versus 73 %; p = 0.007) and that some compounds in tobacco smoke may introduce transgenerational inherited epigenetic changes (87 % versus 58 %; p < 0.001).

Our findings suggest that implementation of the transversal clinical case about health consequences of tobacco smoking in the degree of Pharmacy may improve knowledge acquisition and integration capacity in undergraduate students.

Acknowledgements:
This study was supported by REDICE16-1461 and REDICE18-2270 grants (Institut de Ciències de l’Educació, Universitat de Barcelona, Spain).

Keywords:

Clinical case, tobacco smoking, teaching innovation, integrative learning, knowledge acquisition, Pharmacy degree.