Transition to active learning in rural Nepal: an adaptable and scalable curriculum development model

Area of Science:

• Medical Education
• Continuing Medical Education
• Global Health

Background:

• Traditional medical education often relies on passive learning methods.
• Active learning strategies have been documented but inconsistently implemented in medical education.
• A multidisciplinary continuing medical education curriculum was developed to shift towards active learning in a rural Nepali hospital.

Purpose of the Study:

• To describe and analyze the implementation of an active learning-based medical education curriculum in a rural Nepali district hospital.
• To assess the impact of the new curriculum on learner engagement and knowledge acquisition.
• To evaluate the transferability of the educational model to other resource-limited settings.

Main Methods:

• A mixed-methods needs assessment guided curriculum development.
• Physicians served as both learners and teachers, utilizing lecture templates for clarity and engagement.
• Learner talk-time was audited as a measure of active learning, alongside daily lecture evaluations and pre/post knowledge assessments.

Main Results:

• Learner talk-time increased significantly from 14% to 30-31% during the study period.
• Participant satisfaction with the curriculum was high, with improved knowledge assessment scores (50% to 64%).
• The curriculum was successfully replicated at an additional clinical site, demonstrating organizational change.

Conclusions:

• Active learning can be effectively facilitated through structured educational strategies in rural healthcare settings.
• Lecture audits are valuable for internal program improvement and monitoring active learning.
• Key transferable components include learner-as-teacher models, standardized lecture templates, and immediate feedback mechanisms.