Strategies for fostering functional literacy in medical students during biochemistry instruction

https://doi.org/10.35912/simph.v1i1.3318
Published: Aug 13, 2025

Abstract:

Purpose: This study aims to enhance functional literacy in medical students by integrating biochemistry teaching with clinical application, thereby fostering professional competence and decision-making readiness.

Research Methodology: A mixed-method approach was implemented with 86 second-year medical students divided into control and experimental groups. The experimental group engaged in case-based learning, simulation tasks, interdisciplinary projects, and formative assessments. Pre- and post-tests, clinical reasoning rubrics, surveys, and instructor observations were used for data collection. Quantitative analysis employed t-tests and ANOVA, while qualitative data underwent thematic content analysis.

Results: The experimental group demonstrated a significant improvement in functional literacy (+26.3%, p < 0.01) compared to the control group (+12.7%, p > 0.05). Higher proportions of experimental group students reached advanced competency levels in applying biochemical knowledge to clinical contexts. Qualitative feedback indicated increased engagement, clarity of purpose, and confidence in clinical reasoning.

Conclusion: Integrating clinical context, active learning strategies, and interdisciplinary collaboration into biochemistry instruction effectively improves functional literacy and bridges the gap between theory and clinical application.

Limitations: The study was limited to one institution and one academic year, which may constrain generalizability.

Contribution: The research offers a cohesive pedagogical framework for embedding functional literacy development into biochemistry courses, demonstrating measurable gains in clinical reasoning and professional readiness.

Keywords:
1. Biochemistry Education
2. Case-Based Learning
3. Clinical Reasoning
4. Functional Literacy
5. Medical Students
Authors:
Amonova Khikoyat Inoyatovna
Associate Professor of the Bukhara State Medical Institute, Uzbekistan
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Inoyatovna, A. K. . (2025). Strategies for fostering functional literacy in medical students during biochemistry instruction . Studies in Medicine and Public Health, 1(1), 31–41. https://doi.org/10.35912/simph.v1i1.3318
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Vol. 1 No. 1 (2025): June
Articles
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    Franco, C., Franco, R. S., Lopes, J. M. C., Severo, M., & Ferreira, M. A. (2018). Clinical communication skills and professionalism education are required from the beginning of medical training - a point of view of family physicians. BMC Med Educ, 18(1), 43. doi:10.1186/s12909-018-1141-2

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    Harden, R. M. (2000). The integration ladder: a tool for curriculum planning and evaluation. Med Educ, 34(7), 551-557. doi:10.1046/j.1365-2923.2000.00697.x

    Hattie, J. (2008). Visible learning: A synthesis of over 800 meta-analyses relating to achievement: routledge.

    Hmelo-Silver, C. E. (2004). Problem-based learning: What and how do students learn? Educational psychology review, 16(3), 235-266. doi:https://doi.org/10.1023/b:edpr.0000034022.16470.f3

    Husna, A. S. a. (2021). Penatalaksanaan Holistik Scabies pada Anak Usia 4 Tahun di Puskesmas Panjang melalui Pendekatan Kedokteran Keluarga. Jurnal Ilmu Medis Indonesia, 1(1), 25-38. doi:10.35912/jimi.v1i1.533

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    Maltagliati, A. J., Paree, J. H., McIntosh, K. L., Moynahan, K. F., & Vanderah, T. W. (2023). Development and evaluation of a pre-clerkship spiral curriculum: data from three medical school classes. Medical Education Online, 28(1), 2167258. doi:https://doi.org/10.1080/10872981.2023.2167258

    Michael, J. (2006). Where's the evidence that active learning works? Adv Physiol Educ, 30(4), 159-167. doi:10.1152/advan.00053.2006

    Nicol, D. J., & Macfarlane?Dick, D. (2006). Formative assessment and self?regulated learning: A model and seven principles of good feedback practice. Studies in higher education, 31(2), 199-218.

    Norman, G. (2005). Research in clinical reasoning: past history and current trends. Medical education, 39(4), 418-427. doi:https://doi.org/10.1111/j.1365-2929.2005.02127.x

    O’Sullivan, S., Campos, L. A., & Baltatu, O. C. (2022). “Involve Me and I Learn”: Active Learning in a Hybrid Medical Biochemistry First Year Course on an American-Style MD Program in the UAE. Medical Science Educator, 32(3), 703-709. doi:https://doi.org/10.1007/s40670-022-01545-6

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    Vygotski?, L. S., & Cole, M. (1978). Mind in society: The development of higher psychological processes. (No Title).

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  2. Azer, S. A. (2005). The qualities of a good teacher: how can they be acquired and sustained? Journal of the Royal Society of Medicine, 98(2), 67-69. doi:https://doi.org/10.1177/014107680509800211
  3. Barry Issenberg, S., Mcgaghie, W. C., Petrusa, E. R., Lee Gordon, D., & Scalese, R. J. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Medical teacher, 27(1), 10-28.
  4. Brauer, D. G., & Ferguson, K. J. (2015). The integrated curriculum in medical education: AMEE Guide No. 96. Medical teacher, 37(4), 312-322. doi:https://doi.org/10.3109/0142159x.2014.970998
  5. Bruen, C., Illing, J., Daly, R., Meagher, F., Delany, C., Offiah, G., . . . Kelly, H. (2025). Medical student experiences of Case-Based Learning (CBL) at a multicultural medical school. BMC Medical Education, 25(1), 152. doi:10.1186/s12909-024-06585-7
  6. Bruner, J. S. (1997). The culture of education The culture of education: Harvard university press.
  7. Damp, J. B., Dewey, C. M., Wells, Q., Horn, L., Kroop, S. F., & Mendes, L. (2016). Faculty development on clinical teaching skills: an effective model for the busy clinician. Journal of medical education and curricular development, 3, JMECD. S40798. doi:https://doi.org/10.4137/JMECD.S40798
  8. Dickinson, B. L., Gibson, K., VanDerKolk, K., Greene, J., Rosu, C. A., Navedo, D. D., . . . Graves, L. E. (2020). “It is this very knowledge that makes us doctors”: an applied thematic analysis of how medical students perceive the relevance of biomedical science knowledge to clinical medicine. BMC Medical Education, 20(1), 356. doi:10.1186/s12909-020-02251-w
  9. Donkin, R., Yule, H., & Fyfe, T. (2023). Online case-based learning in medical education: a scoping review. BMC Medical Education, 23(1), 564. doi:10.1186/s12909-023-04520-w
  10. Eissa, S., Sallam, R. M., Moustafa, A. S., & Hammouda, A. M. A. (2020). Large-scale application of case-based learning for teaching medical biochemistry: a challenging experience with positive impacts. Innovation and Education, 2(1), 1. doi:10.1186/s42862-020-0006-9
  11. Elmoazen, R., Saqr, M., Khalil, M., & Wasson, B. (2023). Learning analytics in virtual laboratories: a systematic literature review of empirical research. Smart Learning Environments, 10(1), 23. doi:10.1186/s40561-023-00244-y
  12. Ervina, L., Berawi, K., Busman, H., Irawan, B., Azizah, N., & Yolanda, J. E. (2025). Laboratory and Clinical Manifestation Correlation of Neonatal Sepsis in Abdul Moeloek Hospital. Jurnal Ilmu Medis Indonesia, 4(2), 145-115. doi:10.35912/jimi.v4i2.4250
  13. Evans, D. L., Bailey, S. G., Thumser, A. E., Trinder, S. L., Winstone, N. E., & Bailey, I. G. (2020). The Biochemical Literacy Framework: Inviting pedagogical innovation in higher education. FEBS Open bio, 10(9), 1720-1736. doi:https://doi.org/10.1002/2211-5463.12938
  14. Faezi, S. T., Moradi, K., Amin, A. G. R., Akhlaghi, M., & Keshmiri, F. (2018). The effects of team-based learning on learning outcomes in a course of rheumatology. Journal of advances in medical education & professionalism, 6(1), 22. doi:https://doi.org/10.1891/9780826161215.0010
  15. Franco, C., Franco, R. S., Lopes, J. M. C., Severo, M., & Ferreira, M. A. (2018). Clinical communication skills and professionalism education are required from the beginning of medical training - a point of view of family physicians. BMC Med Educ, 18(1), 43. doi:10.1186/s12909-018-1141-2
  16. Fraser, S., Wright, A. D., van Donkelaar, P., & Smirl, J. D. (2019). Cross-sectional comparison of spiral versus block integrated curriculums in preparing medical students to diagnose and manage concussions. BMC Medical Education, 19(1), 17. doi:10.1186/s12909-018-1439-0
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  19. Hattie, J. (2008). Visible learning: A synthesis of over 800 meta-analyses relating to achievement: routledge.
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  21. Husna, A. S. a. (2021). Penatalaksanaan Holistik Scabies pada Anak Usia 4 Tahun di Puskesmas Panjang melalui Pendekatan Kedokteran Keluarga. Jurnal Ilmu Medis Indonesia, 1(1), 25-38. doi:10.35912/jimi.v1i1.533
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  23. Langi, S., & Winarti, E. (2024). Pengaruh Kualitas Pelayanan terhadap Kepuasan Pasien. Jurnal Ilmu Medis Indonesia, 3(1), 31-39. doi:10.35912/jimi.v3i1.2870
  24. Lujan, H. L., & DiCarlo, S. E. (2025). The Paradox of Knowledge: Why Medical Students Know More But Understand Less. Medical Science Educator, 1-6. doi:https://doi.org/10.1007/s40670-025-02379-8
  25. Maltagliati, A. J., Paree, J. H., McIntosh, K. L., Moynahan, K. F., & Vanderah, T. W. (2023). Development and evaluation of a pre-clerkship spiral curriculum: data from three medical school classes. Medical Education Online, 28(1), 2167258. doi:https://doi.org/10.1080/10872981.2023.2167258
  26. Michael, J. (2006). Where's the evidence that active learning works? Adv Physiol Educ, 30(4), 159-167. doi:10.1152/advan.00053.2006
  27. Nicol, D. J., & Macfarlane?Dick, D. (2006). Formative assessment and self?regulated learning: A model and seven principles of good feedback practice. Studies in higher education, 31(2), 199-218.
  28. Norman, G. (2005). Research in clinical reasoning: past history and current trends. Medical education, 39(4), 418-427. doi:https://doi.org/10.1111/j.1365-2929.2005.02127.x
  29. O’Sullivan, S., Campos, L. A., & Baltatu, O. C. (2022). “Involve Me and I Learn”: Active Learning in a Hybrid Medical Biochemistry First Year Course on an American-Style MD Program in the UAE. Medical Science Educator, 32(3), 703-709. doi:https://doi.org/10.1007/s40670-022-01545-6
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  31. Peña, S., Martinez-Santander, C., Cantos-Reyes, V., & Rojas, M. F. (2025). Active methodologies and didactic techniques in medical education: A systematic review. Educación Médica, 26(4), 101040. doi:https://doi.org/10.1016/j.edumed.2025.101040
  32. Schmidt, M., Pinney, B., Canby, C., Vargus, A., & Pille, M. (2024). An early-curricular team learning activity to foster integration of biochemical concepts and clinical sciences in undergraduate medical education. Biochem Mol Biol Educ, 52(3), 340-347. doi:10.1002/bmb.21821
  33. Schön, D. A. (2017). The reflective practitioner: How professionals think in action: Routledge.
  34. Spicer, D. B., Thompson, K. H., Tong, M. S., Cowan, T. M., Fulton, T. B., & Lindsley, J. E. (2019). Medical biochemistry without rote memorization: multi-institution implementation and student perceptions of a nationally standardized metabolic map for learning and assessment. Medical Science Educator, 29(1), 87-92. doi:http://dx.doi.org/10.1007/s40670-018-00631-y
  35. Summaries, C. E. (2018). PISA 2018 Results: I.
  36. Sun, L., Liu, D., Lian, J., & Yang, M. (2023). Application of flipped classroom combined with virtual simulation platform in clinical biochemistry practical course. BMC Medical Education, 23(1), 771. doi:10.1186/s12909-023-04735-x
  37. Sutrisno, S., & Tamim, H. (2022). Hubungan Tingkat Pendidikan dan Pengetahuan Ibu Tentang Gizi dengan Status Gizi pada Balita di Posyandu Abung Timur Wilayah Kerja Puskesmas Bumi Agung Kabupaten Lampung Utara Tahun 2020. Jurnal Ilmu Medis Indonesia, 2(2), 77-83. doi:10.35912/jimi.v2i2.1513
  38. Ten Cate, O., & Scheele, F. (2007). Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Academic medicine, 82(6), 542-547. doi:https://doi.org/10.1097/acm.0b013e31805559c7
  39. Vygotski?, L. S., & Cole, M. (1978). Mind in society: The development of higher psychological processes. (No Title).