An active learning assignment to improve pharmacy students ’ knowledge of herbal medicine

Article history: Received on: 25/12/2014 Revised on: 16/01/2015 Accepted on: 22/02/2015 Available online: 28/03/2015 Medicinal plant courses represent an essential part of the applied sciences component in the curriculum of pharmacy education in Egypt. One of the intended learning outcomes of these courses is to demonstrate knowledge and understanding in the theory and practice of herbal medicine. The aim of the current work was to improve pharmacy students' knowledge and understanding of the herbs used for medicinal purposes. The students, in groups, conducted direct interviews with staff members of the university using a semi-structured questionnaire. The questionnaire included questions about medicinal herbs used by the participants, purpose for use, method of preparation, and sources to obtain. The educational impact of this assignment was evaluated by a questionnaire distributed to the participated students. The majority of students agreed that carrying out the assignment helped them in improving their knowledge and understudying about medicinal herbs. Moreover, their oral communications skills were improved. The described active-learning assignment offered a great opportunity for the students to improve their communication skills and to gain knowledge about the commonly used medicinal herbs in their community.


INTRODUCTION
Egypt has the largest number of pharmacy schools in the Middle East (Soliman et al., 2013).Some of these schools are sponsored by the government while others are privately funded institutions.Undergraduate Pharmacy education in Egypt consists of 5-year program including basic and applied components.It is mainly based on the pharmaceutical sciences; with a little focus on pharmacy practice (El-Awady et al., 2006).Medicinal plant courses represent an essential part of the applied pharmaceutical sciences component of the curriculum.These courses include botany and medicinal plants, pharmacognosy, phytochemistry, herbal medicine, and quality control.Totally, these courses represent 24 credit hours of the 180 credit hours required for pharmacy specialization.The main intended learning .outcomes of these courses are to demonstrate knowledge and understanding in morphological and histological characters of natural drugs, chemistry of natural products, and quality of medicinal plants products.Moreover, student should be able to define theory and practice of herbal medicine.According to the national academic reference standards for pharmacy education in Egypt, pharmacists should possess in-depth knowledge and understanding on complementary therapies, including herbal therapies.
Moreover, they should possess certain skills to communicate orally and in writing with other health care professionals in specialized language and express complex issues in terms that lay people can understand (Al-Azizy, 2007).This requires innovative teaching methods that depend on active learning.Active learning strategies, including team-based learning, will improve students' knowledge and skills and meet curricular standards (Stewart et al., 2011;Allen et al., 2013;Young et al., 2013).The assignment described in this article was carried out by 2 nd year pharmacy students registered in pharmacognosy course.
The overall aim of this course is to provide comprehensive information on natural drugs.The main teaching and learning methods used in this course is lectures, practical sessions, and research assignments.The students are assessed using written semester work, periodical exams, practical exam, midterm exam, and final written and oral exams.There is no course note to this course; otherwise students have to depend on essential and other recommended books available in the library (Wallis , 1985;Evans & Trease, 2009).
The main objective of the described assignment was to improve knowledge and understanding of the students for the commonly used herbs used in their community.In addition, students were given the chance to orally communicate with many people of different ages and background about their studied topics.

MATERIALS AND METHODS
The students worked in 25 groups, each group consisted of 3-4 students.The main task was to conduct direct interviews with academic and non-academic staff members of the university.The interviews were carried out by visiting the participants at their work place.
The interviews included a semi-structured questionnaire prepared by the course instructor.It consisted of questions about whether the participants use medicinal herbs for treatment, and whether they prefer it to conventional medicines.The participants were asked to name the most common herbs they use, against what type of disease, method of preparation, and sources to obtain these herbs.
The plants mentioned by the participants were botanically identified using the available literature available in the library of the department (Boulos, 1991;Bedevian, 1994).

RESULTS AND DISCUSSION
The results of the group of students who conducted the interviews with the largest number of participants ( 164) is described here as an example.Analysis of the questionnaire results showed variation in age of the participants between 20 to 70 years old.Nine participants aged between 20-30, 118 were between 30-40, 30 were between 40-50, 4 were between 50-60, and 3 were between 60-70.Fifty-five participants were from the countryside and 109 living in city.The majority of participants (159) stated that they use medicinal herbs in treatment, whereas only five participants do not use it.Most of the participants (123) preferred using medicinal herbs than conventional medicine for the following reasons: availability, safety, cheaper price, and suitability for the elderly people.Forty-one participants preferred using conventional medicines because of its faster action, effectiveness, standardization, and purity.Some participants claimed they have not enough knowledge about medicinal herbs.
The result of the questionnaire is presented in Table 1.The plants are arranged in alphabetical synopsis.The following information is provided for each plant: binomial nomenclature, family name, disease treated, method of preparation, and times the plant was mentioned by the participants.Forty plant species were mentioned in the questionnaire.
The plants with highest number of uses mentioned were Pimpinella anisum (104), Mentha piperita (103), and Hibiscus sabdariffa (78).This result is in agreement with the data of previously reported ethnobotanical survey conducted in the same governorate (AbouZid & Mohamed, 2011).
The students performed this assignment as part of the semester work of pharmacognosy course taught to second year pharmacy students.
This represents 10% of the weight of the total assessment.In addition, the educational impact of this assignment was evaluated by a questionnaire distributed to the participated students.Sixty percent strongly agree to carry out this activity, and 40% agree.Sixty five percent considered this activity as useful teaching method to be included in the curriculum.Thirty six percent strongly agreed on this point while 8% opposed.Forty four percent of the students agreed that this activity helped them in gaining knowledge and understanding about medicinal herbs, while 36% strongly agreed and 16% opposed.Eighty percent strongly agreed that this activity enhanced their communication skills and 20% agreed.
The students were also allowed to give their opinion about the activity.Most of the students expressed positive opinions and were satisfied.Many students indicated that this activity contributed to gain knowledge about medicinal plants and let them appreciate the importance of this course.Some of them mentioned that they learnt names of new plants and their medicinal uses.Some suggested conducting the questionnaire using the internet to expand the number of participants.
The majority of the students emphasized that their communication skills were greatly enhanced by having chance to talk to many people about their studied subjects.One student complained that the informants were not positively responding to him.

CONCLUSION
In conclusion, this activity offered a great opportunity for students to enhance their communication skills and gain knowledge and understanding about the commonly used medicinal plants in their community.They worked in groups of 3-4 students and used a semi-structured questionnaire prepared by the course instructor.
The main goals were to gain knowledge about medicinal plants in accordance with intended learning outcomes of pharmacognosy course.This was largely achieved among most of the students.Moreover, the students communicated with the public about their studied subjects.

Table . 1
: Plants names, uses, preparation method, and times mentioned by participants in the questionnaire.