American Journal of Pharmaceutical Education 2019; 83 (2) Article 6505.

RESEARCH
Using a Novel Student-centered Teaching Method to Improve Pharmacy
Student Learning
Xin Meng, PharmDa, Lianrong Yang, PharmDa, Hui Sun, PharmDa, Xiaowei Du, PharmDa,
Bingyou Yang, PharmDa, Hongwei Guo, PhDa
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a
School of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, China
Submitted May 4, 2017; accepted October 24, 2018; published March 2019.

Objective. To improve students’ learning and develop their learning skills in pharmacy education.
Methods. A novel teaching method composed of Self-study, Test, Question and Discussion (STQD)
sessions uses self-, peer-, co-learning, active learning, inductive teaching, and formative assessment to
promote student-centered teaching in pharmacy education. STQD has been implemented within
courses focusing on instrumental analysis and analytical chemistry. In a four-year study, qualitative
and quantitative approaches were used to evaluate the effectiveness of STQD in facilitating students’
learning.
Results. Students positively evaluated their experience in STQD class with an overall mean and
standard deviation of 4.35 (0.64) in a 5-point Likert scale, where a score of 1 is "strongly disagree"
and a score of 5 is "strongly agree." The final examination results showed students’ average score in an
STQD class was higher than students’ average score in a traditional class. Most students indicated that
the STQD improved their learning ability, communication ability and facilitated their learning.
Conclusion. The use of STQD in an integrated basic science curriculum has the potential to develop
students’ learning skills and improve their learning in pharmacy education.
Keywords: pharmacy education, student-centered teaching, formative assessment, active learning, inductive
teaching

INTRODUCTION a student can engage that will allow them to learn at

Lecture-based learning, a teacher-centered tradi- different rates of retention. Dale’s study illustrated the
tional pedagogy, is the most common teaching method percentage of learner recall that was associated with var-
in pharmacy education around the world.1-3 In pharma- ious approaches.8,9 Lectures, reading, audiovisuals and
ceutical courses, the traditional teaching methods consist demonstrations are passive learning methods. In contrast,
of lectures and direct instructions conducted by teachers. discussion groups, practice by doing and teaching others
Students are expected to listen to lectures and learn from are active learning methods. The active participation in
teachers instead of encouraging them to interact and take the learning process results in a higher retention of learn-
the initiative to analyze problems.4,5 Most pharmaceuti- ing. When students are actively involved and collaborate
cal basic science courses involve rote learning, in which with others, their retention rate dramatically increases.10-
13
students depend on memorization without having a com- Therefore, it is best to design lessons and activities
plete understanding of the subject. Students complete the using active learning methods to ensure learners are ac-
curriculum by passing the tests, consisting of descrip- tively engaged in the learning process.
tions, matching and other forms of indicators. Little or Many pharmacy schools and colleges have introduced
no attention is paid to what practical problems students innovative web-, problem-, project-, case-, and game-based
can solve with the knowledge they have learned. Long strategies to improve students’ learning.14-16 In most cases,
lectures and little interaction in traditional pharmacy ed- there is an explicit need to choose instructional approaches
ucation often leave students less attentive and engage that promote student-centered teaching. Student-centered
with low retention.6,7 However, there are various methods teaching has repeatedly been shown to be superior to the
Corresponding Author: Xin Meng, School of Pharmacy, traditional teacher-centered approach to instruction because
Heilongjiang University of Chinese Medicine. 24 Heping Rd., it allows students to solve problems, cooperative learning,
Harbin 150040, China. Tel: 186-045187267040. Fax: 186- and inductive learning.17-20 Inductive teaching is an effec-
045182193000. E-mail: [email protected] tive method of linking theory with practice and involves
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students discussing questions and solving problems in class, courses in the third and fourth years. Lecture-based learn-
with much of the work in and out of class being done by ing was used in the traditional class while STQD was used
students learning in groups.21,22 Student-centered teaching in the experimental class. Students were provided self-
methods include active learning, which involves students learning materials and feedback to guide them in their
participating in all three phases of the learning process (in- self-study. STQD was implemented in two different sub-
put, operations, and feedback).23 This type of learning is jects, instrumental analysis and analytical chemistry.
more apt to stimulate critical thinking, taking levels of indi- Qualitative and quantitative approaches were used to
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vidual students into consideration to enable development of evaluate the effectiveness of STQD in facilitating student
their learning ability and investigative skills.24 From 2013 to learning. Figure 1 shows a schematic illustration of
2016, a novel student-centered teaching method named Self- STQD.
study, Test, Question and Discussion (STQD) was designed Before the first class, the experimental class students
and implemented within courses focusing on instrumental completed the Catell 16 Personality Factor Question-
analysis and analytical chemistry. Self-, peer-, co-learning, naire. At the time of grouping, the results of Primary
active learning, inductive teaching, and formative assess- Factor Warmth (Factor A) in the Catell questionnaire
ment were used to promote student-centered teaching in were used to determine whether a student was introverted
pharmacy education. or extroverted. Students may also inform the instructors
The objectives of this study were to improve stu- whom they would like to study with. The students were
dents’ learning and develop their learning skills in phar- divided into learning groups based on their college en-
macy education. trance scores, personality, interpersonal relationship and
classmates they’d like to study with. Each group was
METHODS composed of students who had different college entrance
From 2013 to 2016, there were 60 students enrolled scores (high, medium and low scores) and different per-
each year in the pharmacy program at Heilongjiang Uni- sonalities (introverted and extroverted). Each group chose
versity of Chinese Medicine. Among the 60 students, 30 and took turns to be a leader for each lesson. Each semes-
were randomly assigned to the experimental class (inter- ter, the students were re-grouped based on their last se-
vention group), while the other 30 were assigned to the mester scores, personality and wishes with whom they’d
traditional class (control group) (Table 1). All students like to study with. Re-grouping created a new group-
voluntarily agreed to participate in the study. This study learning environment and allowed students to play differ-
was approved by the Heilongjiang University of Chinese ent roles in the new group.
Medicine Review Board and Ethics Committee. Two days before each lesson in the experimental
At Heilongjiang University of Chinese Medicine, the class, the teacher marked the scope of study, key points
undergraduate pharmacy education program is a four- and difficulties. Animation courseware, video, academic
year program in which basic science instruction is deliv- paper were created into web pages for student self-study.
ered in the first two years followed by professional Students could preview and review the materials by them-
selves. There was no time limit in the self-study process.
Table 1. Demographic Data of the Experimental Class vs Students could discuss questions and problems with their
Traditional Class groupmates. If the problem was still not resolved, it would
Novel Teaching be discussed in class. Each student prepared three ques-
Evaluation Sub- Method Class Traditional tions for class discussion.
Categories categories N=120 Class N=134 Formative assessment was used in STQD. At the
Number of 2013 30 32 beginning of each class, there was a 5- to 10-minute test
students 2014 30 34 to evaluate student learning. Students received their test
2015 30 35 results for their self-assessment at the beginning of the
2016 30 33 next lesson. The STQD feedback, a central function of the
Gender Male 39 46 formative assessment, focused on the detailed content of
Female 81 88 what was being learnt, rather than simply a test score or
Age 18-19 35 40 other measurement of how far a student was not meeting
20-21 79 86 the expected standard. Students received feedback, in-
22-23 6 8 cluding which areas they need to improve and how they
College 500-540 12 14
could improve. Based on the feedback, students could
entrance 541-580 99 107
scores 581-620 9 13 adjust their learning strategies to improve their grades
in the experimental class.
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Figure 1. Schematic Illustration of the Novel Student-centered Teaching Method

There was a 10- to 15-minute introduction to the another group representative to answer. To be fair, teachers
lesson and the frontiers in the field to broaden students’ should give equal chances for each group.
knowledge and to introduce them to practical problems The teacher randomly selects students to raise questions
that could be solved by what they have learned. This was prepared before class. After a 5-minute discussion, the
followed by a question and discussion session in which teacher selects a student to answer the question posed by
inductive teaching was used. During this session, students the other students. If the student answers correctly, he or she
raised the problems they encountered during their self- would receive points. In the first and third parts of the ques-
study and remained unsolved during their group discus- tion and discussion session, most of the time, the teacher
sion. Groups had 1-2 minutes to discuss and solve the would call on the student who raised his or her hand first.
problem. If the students answered correctly, they received Sometimes the teacher would also let several students an-
points. If no student could solve the problem, the teacher swer a question, with each student answering a part of the
would solve the problem. STQD could improve class- question. Although this approach may leave some students
room teaching efficiency by allowing the teacher to focus with a negative experience if they were not selected, the
on solving the problems that students could not solve by teacher gives every student an opportunity to answer a ques-
themselves. The teacher does not have to teach students tion in class as often as possible. This is also a potential area
what they had mastered in self-study. This method en- of improvement that needs to be researched using novel
couraged students to think actively about their peers’ educational technologies. For example, smartphone applica-
problems, which perhaps they did not find in self-study. tions can be used for student participation. The point-award-
Problem situations, designed by teachers, were given ing system, a formative assessment, encouraged students to
to each student. After a 5-minute discussion, the teacher learn and improve performance because they were in com-
would randomly choose a student to answer on behalf of petition with their peers. In this session, students would take
the group to ensure that each member of the group formed a the initiative to think and learn by looking for problems,
consistent answer by communication and learning from preparing and answering questions. This practice could im-
each other. It is important for the teacher to randomly prove the breadth, depth and retention of student knowledge.
choose a student to answer, so that all students would be There was a summary session at the end of each class
prepared. If the group representative answered correctly, the wherein the students summarized what they learned. The
group would receive points. If the group representative gave teacher would randomly choose a group, and then the
the wrong answer, the other members of the group could group would choose a member to summarize the lesson
answer on behalf of the group. If the answer was correct, the and assess the performance of each group including
group would be rewarded with half of the original points. If theirs. At the end, the teacher would give a summary of
no group member could answer, the teacher would choose the lesson.
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After class, feedback would be sent to every student survey was 97% (116/120 the experimental class stu-
by email. The feedback consisted of five sections: the dents). Because the annual sample size was small, the
classroom performance of the student, class scores, ad- response rates were high. Table 1 shows the demographic
vantages, disadvantages, how to improve. Students would data of both cohorts. In the four-year study, there were 120
also provide their own self-assessment, group assessment students in the experimental class, and 134 students in the
and suggestions to the teacher by email. traditional class. The proportions of gender, age and col-
In a traditional class, lecture-based learning is used lege entrance scores of the students in the experimental
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where the teacher would give a lecture while the students class were the same as that of students in the traditional
listened and took notes. At the end of each class, the class.
teacher would give homework. Deductive teaching and The results of the questionnaire showed strong ac-
summative assessment were used in the traditional class. ceptance and positive attitudes toward the utilization of
Both cohorts participated in the same final examination to STQD to facilitate learning of basic science in pharmacy
assess the retention of basic science knowledge. education. Students positively evaluated their experience
Questionnaires with closed- and open-ended items using the STQD with an overall mean score 4.35 (SD
were designed to determine student perceptions. A 5- 0.64). High ratings were received for the different evalu-
point Likert scale, where 1 was strongly disagree and 5 ation categories that were used to assess the effectiveness
was strongly agree, was used to quantify responses in the of the STQD. Students perceived that the use of graphics
closed-ended items. There were two kinds of question- and animations stimulated their interest and enhanced
naires; a non-STQD-related and a STQD-related. The their learning process. They believed that the STQD pro-
questionnaires had been piloted in 15 STQD students vided the basic knowledge needed to prepare for in-class
and 15 traditional class students. discussion, the test had played a role in supervising the
In non-STQD-related questionnaire, closed-ended extracurricular self-study, the mode of classroom discus-
questions were grouped into three categories: learning sion and group competition stimulated their enthusiasm
process, skill development and learning enthusiasm. for active learning.
The non-STQD-related questionnaire was administered Table 2 provides examples of student responses on
in both cohorts. The STQD-related questionnaire, includ- each of the themes in non-STQD-related questionnaires.
ing closed- and open-ended question items, was designed Results of non-STQD-related questionnaire showed both
to collect opinions and perceptions on the effectiveness of STQD and traditional teaching methods could improve
the STQD in improving basic science learning, to identify student core knowledge. Compared with the traditional
the preferred elements of the STQD, and to collect stu- class, students in the experimental class were more will-
dents’ suggestions for improving the STQD. The STQD- ing to learn and spend more time preparing for lessons.
related questionnaire was only administered in STQD Both teaching methods could improve research and judg-
class. Both STQD-related questionnaire and non- ment skills. The traditional class students believed that
STQD-related questionnaire were administered during traditional teaching method failed to improve their ability
the week after the midterm examination. After the mid- to solve problems, while the experimental class students
term examination, students evaluated the teaching believed the new teaching method could improve their
method and made recommendations. problem-solving ability. The results of the survey showed
Demographic data was analyzed to identify general that STQD had more advantages in developing students’
characteristics of the student participants. All statistical multiple skills than the traditional method. There was a
analyses were performed using IBM SPSS 19.0 Statistics significant difference (p,.01) when comparing satisfac-
(Armonk, NY). For continuous variables with distributions tion between the two cohorts, indicating students in the
that approximated normality, t-test was used for compari- experimental class were more satisfied with basic science
sons between the two groups. When normality assumptions learning.
were not satisfied, the nonparametric Mann-Whitney U test All participants who responded to the items in the
was used. All data were expressed as mean and standard open-ended questionnaire in the experimental class
deviation of each parameter. agreed that STQD was effective in improving their learn-
ing and provided responses describing how STQD im-
RESULTS proved their learning.
The response rates in non-STQD-related question- Table 3 provides examples of student responses on
naire survey were 97% (116/120 the experimental class each of the themes in STQD-related questionnaire. The
students) and 96% (129/134 the traditional class stu- students indicated that the web-based self-study and ex-
dents). The response rate in STQD-related questionnaire tracurricular group discussion in the STQD helped to
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Table 2. Results of Non-Novel Teaching Method-related Questionnaires from the Experimental Class and the Traditional Class
Novel Teaching Method
class N=116 Traditional class N=129
Items M (SD) M (SD) p value
This teaching method improved the academic value of this 3.75 (0.52) 3.10 (0.76) ,.01
course
This teaching method improved my knowledge 3.91 (0.98) 3.75 (0.84) .16
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I’m interested in this subject 4.46 (1.10) 4.21 (1.15) .07

I’m willing to study in this way 4.87 (1.01) 3.45 (0.88) ,.01
I’m more responsibility for my learning 3.76 (0.65) 2.63 (0.92) ,.01
I spent more time preparing for lessons 4.86 (0.52) 3.08 (1.21) ,.01
This teaching method improved my self-directed learning 4.84 (0.82) 3.95 (0.92) ,.01
initiative
This teaching method improved my problem- solving skills 3.92 (0.54) 2.58 (0.72) ,.01
I’m more aware about multiple solutions 3.74 (0.62) 3.52 (0.53) ,.05
This teaching method let me relate theory to practice 4.74 (0.92) 4.11 (0.79) ,.01
This teaching method improved my research skills 4.01 (0.89) 3.91 (0.91) .37
I’m actively involved in learning process 4.79 (0.51) 3.84 (0.42) ,.01
This teaching method improved my communication skills 4.65 (0.45) 4.01 (0.72) ,.01
This teaching method improved my judgment skills 3.92 (1.21) 3.83 (0.97) .51
This teaching method improved my efficiency of learning 4.82 (0.31) 3.75 (0.65) ,.01
This teaching method improved my reasoning ability 3.67 (0.82) 3.32 (0.79) ,.05
I have more interest and enthusiasm to study 4.77 (0.37) 3.20 (0.91) ,.01
This teaching method stimulated my critical thinking 4.09 (0.47) 3.64 (0.72) ,.01
This teaching method increased my retention rate 4.05 (0.81) 3.63 (0.77) ,.01
This teaching method developed my investigative skills 4.67 (0.43) 3.10 (0.95) ,.01
This teaching method developed my learning ability 4.75 (0.31) 3.02 (0.81) ,.01
This teaching method improved my learning 4.52 (0.43) 3.36 (0.62) ,.01
I’m satisfied 4.65 (0.45) 3.63 (0.63) ,.01

understand concepts with a mean score of 4.05 (SD 0.91). own learning and could significantly improve knowledge
Eighty-eight percent of the students strongly agreed that retention.
the self-study session of STQD was beneficial. Further- As shown in Table 3, the test session could help
more, 95% of the students strongly agreed that the self- students to prepare for in-class discussion with a mean
study session of STQD was better than traditional method. score of 4.02 (SD 0.62). A qualitative analysis of student
The results of the open-ended questionnaire showed stu- responses to open-ended items on the questionnaire found
dents found the self-study session of STQD to be effective that the test session made them more motivated to take
in improving retention of basic science information the initiative to learn and could help them with self-
(Table 4). This new model enabled students to do their assessment. The experimental class students pointed out

Table 3. Results of the Novel Teaching Method-related Questionnaires from the Experimental Class (N5116)
Evaluation Categories M (SD)
Web-based self-study improved learning efficiency 4.46 (1.10)
Graphics and animations in self-study session stimulated interest 4.21 (0.98)
Group discussion at the self-study stage helped to understand concepts 4.05 (0.91)
The self-study session of the novel teaching method was beneficial 4.73 (0.64)
The self-study session of the novel teaching method was better than traditional method 4.92 (0.59)
The test session helped to prepare for in-class discussion 4.02 (0.62)
The questions and discussions session promote the communication between students and teachers 4.85 (0.41)
The discussion stimulated active learning 4.54 (0.70)
The point-awarding system made me more enthusiastic to learn 4.62 (0.51)
Feedback improved my learning 4.51 (0.66)

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Table 4. Experimental Class Students’ Responses to Open-ended Questions (N5116)

Themes Example of student’s response
Self-study session “I like this session. The graphics and animations in the self-study session stimulated my
interest and enhanced my learning process. It was time efficient and effective in improving
my knowledge retention.”
Test session “The Test session made me more motivated to take the initiative to learn and could help me self-
assessment. Although the test session made me a little nervous, it really promoted my study.”
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Question and Discussion “I learned more in the course of the discussion. The mode of classroom discussion and group
session competition stimulated my enthusiasm for active learning.”
Feedback session “The feedback from the test session was very helpful to improve my learning.”
Point-awarding system “The point-awarding system made my study more passionate and I would study harder in order to
get points. Although sometimes I was a little disappointed when I did not get points, I would
study harder to get more points next time. In a word, this point-awarding system promoted my
learning.”
The novel teaching “I really like this way of teaching. It is very interesting. The knowledge expansion and our
method collaborative spirit could be developed in this way.”

that the feedback from the test session was helpful in was difficult for the group to complete the discussion, and
improving their learning. Although a few students wrote most of the group members would learn from themselves;
that the test session made them nervous, they agreed that it while the discussion became too intense when all group
promoted their study. members were extroverted.25 It was also a problem when
Students agreed that the question and discussion ses- all students tended to study with high achieving students
sion could promote communication between students and in one group.26,27 To better learn from each other, discuss
teachers with mean score of 4.85 (SD 0.41). Survey re- within and between groups, and compete, the grouping
sults showed that when students were answering ques- method was carefully designed as described in the method
tions on behalf of the group, they were inclined to section.
perform better so that they would learn harder. When The self-study session of STQD positively affected
students prepared classroom questions and answers, they student motivation and supported the development of
consciously read more learning materials and had a self-regulatory skills. There was no time control in the
deeper understanding the lesson. In the open-ended ques- self-study process, so students could study and discuss
tionnaire, some students wrote that the active learning, at their own pace, which may have a positive effect on
knowledge expansion, distinctive mind and collaborative students who were tasked with learning core materials
spirit could be developed in this way. Based on feedback ahead of classes.28 Students would take the initiative to
about STQD, it improved student learning with a mean spend more time on issues that they felt were difficult and
score of 4.51 (SD 0.66). less time on simple issues. Web-based self-study helped
Analysis of the final examination indicated a sig- to engage the learners in active processing of instructional
nificant difference (p,.05) in students’ performance materials to increase interest in learning.29 Previous stud-
between STQD class (mean 85, SD 15, n5120) and tra- ies demonstrated that visuals had positive effects on fa-
ditional class (mean 74, SD 18, n5134) in a four-year cilitating student achievement.30-32 Students could select
study. the pace and type of interactivity based on their current
knowledge. Educational animations supported concep-
DISCUSSION tualization and contextualization of instructional ma-
STQD used multiple existing teaching methodolo- terials, and promoted internal reflection for deeper
gies for independent and active learning to develop learn- understanding.33
ing skills and improve outcomes in pharmacy education. Formative assessment in STQD represents an edu-
The main reason for the positive outcomes was an effec- cational intervention that is consistent with the current
tive combination of self-study, test, discussion, feedback, emphasis on using assessment to improve student per-
point-awarding system. formance in pharmacy education.34,35 The formative
Grouping was an important step in STQD, whose assessment of STQD has four main stages: learning ac-
method was carefully designed. In the early days of this tivities, assessment, feedback, and improvement. The test
study, students were grouped randomly or voluntarily. session as a part of formative assessment in STQD had
When all the students in one group were introverted, it indirect and direct benefits to student learning, which
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improved student knowledge retention after self-study This study outlined several effective design strate-
and helped them self-assess and find deficiencies to im- gies that should be considered when developing STQD.
prove their learning strategies.36-38 Believing in student The essential elements of the STQD include effective
ability to learn, emphasizing progress toward learning self-study, test, feedback, question and discussion. Using
goals rather than score, and assessing the development STQD to encourage self-directed learning is consistent
of learning ability were all manners in which motivation with the goal of developing the skills for lifelong learning
was enhanced through an effective use of formative as- in pharmacy education. Although STQD is successful in
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sessment in STQD.39 basic course, it applies only to small classes of fewer than
Inductive teaching in STQD could be character- 30 students. This study focused on this method only in the
ized as a constructivist method in which students con- basic science curriculum in pharmacy education. Future
struct their own knowledge rather than the teacher research should focus on the application of STQD in other
imparting it to them.40,41 In class, the discussion pro- subjects.
vided opportunities for knowledge elaboration.42 When
students were able to answer their classmates’ ques- CONCLUSION
tions from their self-study, they gained a higher sense Assessment data support that STQD is an effective
of achievement and increased their motivation to student-centered teaching method, in which students for-
learn.26,43,44 The use of a point-awarding system played mulate questions of their own, solve problems, discuss,
a vital role in the success of the teaching strategy be- explain, debate during class. The use of STQD in an in-
cause students were encouraged to learn, and improve tegrated basic science curriculum has the potential to de-
their performance because they were competing with velop students’ learning skills and improve their learning
their peers. Because the teacher randomly chose a stu- of basic sciences in pharmacy education. The utilization
dent to answer on behalf of the group, students studied of STQD in pharmacy education has the potential for in-
harder. Aside from group competition, there was also dividualized teaching. When implementing STQD, it is
individual competition. Because each student could necessary to understand each student as much as possible
gain an individual point, student scores were also dif- to make a reasonable grouping. Controlling the rhythm of
ferent from each other within the group. In STQD, it is classroom discussion is crucial in STQD. The self-learn-
essential to create effective classroom discussions, al- ing materials and feedback provided to the students will
low students to become instructional resources for each increase teachers’ workload. Future research should focus
other, and stimulate students to become owners of their on the application of STQD in other subjects of pharmacy
own learning. Because of classroom discussions and the education.
point-awarding system, students took the initiative to
spend more time preparing for lessons outside the class- ACKNOWLEDGMENTS
room. This work was supported by Heilongjiang Province
In lecture-based class, deductive teaching is the Education Science "13th Five-Year" Youth Fund Project
teaching method is used. The instructor conducts lessons Planning (No. GJD1316033), Heilongjiang Province
by introducing and explaining concepts or skills to the Higher Education Society "13th Five-Year" Higher Edu-
students, then students practice the skills they were cation Research Project Fund (No. 16Q265), and Hei-
taught. This is a teacher-centered model of teaching that longjiang University of Chinese Medicine Education
is rule driven. Some of the positives of this method in- Research Fund (No. XJJ2015014).
clude: it is easy to get the main points of the lesson and it
is suitable for teaching a large class.45, However, the
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