Is problem-based learning a better teaching-learning tool for emergency obstetric care for undergraduate medical students?

Background: Clinical emergency management requires critical thinking, interpersonal skills in addition to content knowledge of the clinical issue. Problem-based learning (PBL) as a teaching-learning method for clinical emergency case scenarios has not been analyzed separately in the medical literature. Objectives: The objectives of the study were to compare learning outcomes and perception of medical graduates for lecture-based learning (LBL) and PBL for emergency obstetric care. Materials and Methods: In a randomized controlled study, 34 medical students participated in a LBL group (n = 16) or PBL group (n = 18). Lecture class of 1 h or PBL method was used for teaching “eclampsia.” Pre-test and post-test questionnaires were administered to both groups. Perception about PBL method was collected by closed-ended (Likert scale) and open-ended questionnaire. Results: Mean pre-test score of the PBL group was significantly lower than that of the LBL group (5.5, SD 2.2 vs. 7.2, SD 2.7; P = 0.048). Mean post-test score in the PBL group was higher than that of the LBL group (13.1, SD 1.6 vs. 12.1, SD 1.1; P = 0.064). Difference in mean of pre-test and post-test score was more in the PBL group (7.6 vs. 4.9). Students perceived PBL as a better method for teaching obstetric emergencies as it promotes collaboration with fellow students (17, 94.5%) and critical thinking (15, 83.3%). Majority (16, 88.8%) of students preferred a hybrid curriculum. Conclusion: While knowledge gain in PBL is at least at par with LBL, PBL is perceived as a better and more effective method for learning obstetric emergencies.

The relationship of sonographic placental grading, biochemical pulmonary maturity and neonatal outcome in pregnancy-induced hypertension.

In a prospective study, the accuracy of placental grade in predicting pulmonary maturity was evaluated in 50 cases of pregnancy-induced hypertension (PIH) between 28 and 41 weeks of gestation. Pulmonary maturity was measured by lecithin/sphingomyelin (L/S) ratio and phosphatidylglycerol (PG) in amniotic fluid and by clinical development of respiratory distress syndrome (RDS) in the neonates. Fifty normotensive healthy primigravidae, who were matched for age and period of gestation, served as control. No difference (p > 0.05) in the placental grading was observed between normotensive and hypertensive pregnancies. The advancement of placental grade was found to be associated with an increase in L/S ratio and PG level in amniotic fluid. A mature placental grade (grade III) identified by real-time sonography corresponded to foetal lung maturity (L/S > or = 2.0, PG > or = 0.36 mg/dl) and absence of RDS in all cases. Hence, in PIH a grade III placenta appeared to be a reliable predictor of foetal lung maturity in the population examined.