Original Research Article http://doi.org/10.18231/j.ijpo.2019.045 Indian Journal of Pathology and Oncology, April-June, 2019;6(2):233-236 233 Reverse teaching- A strategy for undergraduate medical education in pathology Hari Kumar Darnal 1* , Hematram Yadav 2 , Sowmya Ramakrishnappa 3 , Barani Karikalan 4 1,2 Professor, 3,4 Lecturer, 1,4 Dept. of Pathology, 2,3 Dept. of Community Medicine, 1-3 Mahsa University, Bandar Saujana Putra, 42610 Jenjarom, Selangor, Malaysia, 4 Perdana University, MARDI Complex Jalan MAEPS Perdana, 43400 Seri Kembangan, Selangor, Malaysia *Corresponding Author: Hari Kumar Darnal Email: hkdarnal891@gmail.com Received: 23 rd November, 2018 Accepted: 7 th January, 2019 Abstract Objectives: The purpose of this study was to explore the effectiveness of reverse teaching in learning the basic medical sciences in undergraduate pathology course. Materials and Methods: Study design was interventional case –control. Participants were 150 first year medical students of University of MAHSA, Malaysia 2017-18. We used quantitative content analysis in pre and post teaching sessions and a delayed test score after 5 months. This result was compared with control group who were exposed to traditional pathology teaching. Results: There was no significant difference in the pre test scores between control group and test group (independent sample t – test, t= - 0.836, p=0.404). There was a significant increase in the test scores between the two groups for the immediate post- test (independent sample t – test, t= -23.705, p<0.001), test group performed much better when compared to control group. A significant difference in the test scores between the two groups was noticed in the delayed post- test after 5months (independent sample t – test, t= -6.440, p<0.001), test group performed slightly better that the control group. Conclusion: Reverse teaching based on clinical scenarios has significantly increased score compared to control group (P<0.001 vs P> 0.072). Keywords: Backward class room, Flip class, Inverted teaching, Marketing class, Integration. Introduction The central role of science in medical education is fundamental and indisputable. 1 It is essential that the medical students understand the principles of basic sciences and appreciation role of translational research in basic sciences to uplift the quality of life. The science of medicine is the basis of paradigm shift in integrative medical education. 2 In most medical schools in Malaysia, a modified hybrid integrated curricula has been adopted in which the undergraduate pathology course is taught in first two years together with other basic science subjects. The whole gamut of teaching-learning process is primarily based on traditional lecture format catering to large cohort of students. This is followed by pathology-practical and tutorial classes in different time slots. Students are expected to connect the theory-knowledge taught in the lecture classes with the gross and histological features shown in the practical and tutorials. This naturally creates a wide gap in the students’ understanding of the basic pathophysiological mechanism behind the disease process. This leads to serious difficulty for students in understanding and providing the correct responses for a particular clinical scenario in the integrated summative assessment. 3 there is an obvious disconnect in teaching and assessment. Further, over the years pathology has advanced as highly complex diagnostic discipline involved in personalized targeted therapeutics for patient care. Highly complex clinical medicine has been incorporated in teaching and assessment of pathology. This created a context of disinterest on the part of students in understanding the complex underlying biochemical basis of the disease process or learning about the histological or molecular diagnostic criteria of the disease. 4 According to traditional pathology teaching, more emphasis is given on the gross and microscopic histological changes related to a particular disease. There is no attempt on discussion on the molecular or biochemical changes responsible for a particular clinical case scenario. Further there no attempt to create space in the tight teaching schedule in preclinical basic science course to expose the students in such exercise. These clinical case scenarios can be best discussed by involving students to take part actively in reverse teaching sessions. This is what this research attempted do. Of late much attention is targeted towards reverse teaching as tool of integrated medical education. These studies have focused on the application of digital technology rather than exploring the students’ knowledge on a particular topic. 5 This lacuna in teaching and assessment system is realized by many medical educationists who have devised their own innovation and conceptualization in their field of specialization leading to many innovative teaching and learning methods that have been described and incorporated successfully into the medical education curriculum leading to better outcome. One such important breakthrough is integration of pre-clinical and clinical subjects for better understanding of the disease process. It is usually done in separate sessions in the pre-clinical years where clinical students and clinical lecturers are invited to share the applied part of the basic science knowledge that is being taught to pre-clinical students in their current medical curriculum. This vertical integration is highly appreciated by our students. The above method was found to be very