Assessing biochemical knowledge in medical and health professional programmes: What‘s the point? – N.S. Wong

Assessment is at the centre of teaching and learning. The data that emanates from a typical assessment procedure will inform the teacher how well the student had achieved with regard to the learning outcomes of a particular learning process. Assessment on the one hand, and teaching and learning on the other mutually influence each other. Thus any assessment can only be properly designed to provide useful information if the purpose of teaching and learning of a particular subject is clearly perceived. Biochemistry has long been a core and basic discipline taught in many professional health programmes particularly Medicine. Although it appears to be self-evident that Biochemistry should be a core subject in medical (and most other health-related professional) programmes, in reality many students from time to time still have difficulties in appreciating its true relevance to their future professions. The first step to solve such a problem may be for teachers to re-think who really the end-receiver of their expertise is, and students to re-examine what their future professional roles are. A clear and accurate perception of biochemical education shared between students and teachers is essential in designing informative assessment for Biochemistry in the education for health professionals. Ultimately, it will put basic discoveries in biochemistry to societal uses in a more effective and rapid manner. Some of these ideas are further elaborated below focusing mainly on the undergraduate medical curriculum.

Of all the basic science subjects that are taught in a medical curriculum, “Biochemistry” is perhaps one that will most easily invite queries from the students concerned, as well as from those teachers who have the responsibility to design the curriculum and to keep it under constant review. One critical question that is invariably raised is the relationship and importance of biochemical knowledge in the learning and practice of clinical medicine. Biochemists think that the answer is simply straightforward and obvious. The underlying causes for any individual to be able to remain healthy or become ill with diseases can be only comprehended in the most precise ways in terms of the myriad arrays of chemical reactions that are happening within the cells of the human body. And it is only with precise understanding of the molecular principles of life that hopefully we are able to devise approaches to treat and even to cure diseases. Indeed, this has become almost a standard answer when a teacher of Biochemistry has to convince their students why they have to study biochemistry, and also to convince the teacher himself orherself why it is meaningful to teach biochemistry in a medical (and other) professional health programmes. However, the above answer may only amount to telling us why it is necessary to conduct biochemical research, rather than a statement that can explain exactly why biochemistry should be taught in a medical curriculum as one of the core subjects.

A better answer to the above question may be framed if teachers could help students to see how the ever advancing biochemical knowledge has contributed to the practice of modern medicine. Indeed the teaching of biochemistry is already proceeding along such a direction. In order to illustrate the role played by biochemistry in medicine, the current practice is to highlight the relevance of biochemical knowledge in health and diseases. Accordingly, examination questions are often designed to test the understanding of students’ knowledge and whether they are able to link the knowledge to various medical conditions. Many of us will be satisfied if the results of examination show that most of our students are in good possession of the knowledge that we want them to acquire. As such we are regarding the students as the end-receiver of our expertise. As we progress into the 21st century, we keep seeing how rapid advancement in technologies has helped tremendously the spread of basic scientific knowledge. A greater and greater percentage of the general population is now familiar with what had been regarded as scientific jargons that used to appear only in academic circles, although the degree of public understanding of these jargons varies. More people now realize that their physical wellbeing could better be safeguarded if their general knowledge of health at the molecular level could be enriched. In a sense patients are in general relatively more prepared than in the past to receive information concerning, for example, why and how a diagnosis is being made, why a particular treatment or drugs are prescribed. Provided such information is accurately and suitably conveyed such knowledge transfer will be mostly desirable since it will lead to more active involvement of a patient in the management of his other disease. For the first time, health professionals will find themselves taking up a new role as a knowledge provider in addition to the traditional role of using knowledge to provide service. The above argument has the following implications. To the students, it means that not only do they have to be proficient in biochemical knowledge but they also need to be able to communicate the knowledge to their patients in an accurate yet detailed and still easily understandable manner. They must start to prepare themselves to meet the new demands from the intelligent patients. To the teachers, the real end-receiver of their teaching effort may no longer be limited to the students, but also the patients who are the real beneficiaries of biochemical research.

The learning outcomes of biochemistry in a medical curriculum may therefore include the following: students should not only be able to use knowledge, but also possess the necessary communication skills to act as a provider of knowledge. Teachers of biochemistry also have learning outcomes to meet too. They must be able to come up with new ways to enhance the skills of the students to communicate biochemistry to the intelligent patients of the 21st century. It is hoped that with the purpose of teaching biochemistry in medical and health programmes revisited, we are now in a better position to design new methods for assessing our students.

N.S. Wong
Dr. N.S. Wong

Associate Professor
School of Biomedical Sciences
Li Ka Shing Faculty of Medicine
The University of Hong Kong

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