ORIGINAL ARTICLE

Use of Concept Mapping as a Facilitative Tool to Promote

Learning in Pharmacology
Farida Qadir1, Tabassum Zehra1 and Imrana Khan2

ABSTRACT
Objective: To assess whether students find concept mapping a useful learning methodology to conceptualize and
organize topics studied in CNS module of Pharmacology; and to evaluate whether addition of concept mapping
assignment could help to improve examination scores.
Study Design: An analytical study.
Place and Duration of Study: College of Dentistry, Jinnah Medical and Dental College, Karachi, Pakistan, from March to
May 2009.
Methodology: A class of 50 BDS students was recruited for the study. Two randomly selected groups of 12 students each,
prepared concept maps in topics from CNS pharmacology which were displayed and discussed during tutorial sessions.
The other two groups (n=25) following the traditional teaching methodology, served as controls. Scores from best choice
questions and short essay questions were compared between the investigational and control groups using the student's
t-test with significance at p < 0.05. Feedback obtained after completion of the study was evaluated as percent response.
Results: One-best-choice test of the control group showed a mean grade of 57.1 + 16.7 vs. test group mean of 58.8 + 13.
For the short essay questions, control group obtained a mean of 52.3 + 18.8 vs. test group mean grade of 53.8 + 22.5.
Both results were not significantly different (p > 0.05). However, feedback about concept mapping showed that the
technique helped the students to conceptualize difficult topics in CNS pharmacology (86.36%). Concept mapping was
particularly beneficial in preparing for exams as it provided a quick overview of the entire subject (68.68%).
Conclusion: Students found concept mapping as a useful pedagogical tool which could potentially be used to acquire
meaningful learning in Pharmacology as a supplement to traditional teaching techniques. It was not found beneficial in
improving examination grades probably because standard examinations and concept mapping measure different cognitive
domains.

Key words: Concept mapping. Medical education. Critical thinking. Teaching and learning.

INTRODUCTION points, which is well integrated with previous knowledge

Pharmacology is generally perceived by the students
as a subject difficult to conceptualize and retain.
Students, therefore, resort to memorization. Rote
learning is easily forgotten and students are unable to
apply this knowledge to problem-solving situations or to
link this to previous knowledge.1 Cognitive psychology
has shown that the way knowledge is structured in the
memory that determines the ability to retain, recall and
use it to solve problems.2 Concept mapping is a technique
that is well established in helping students build useful
mental frameworks.3,4 According to Michael, meaningful
learning implies “acquiring useful learning which is
stored in a way that can be accessed from various
1 Department of Pharmacology, Liaquat National Medical
College, Karachi.
2 Department of Biochemistry, Jinnah Medical and Dental
College, Karachi.
Correspondence: Dr. Farida Qadir, Department of Pharmacology,
Liaquat National Medical College, Stadium Road, Karachi.
E-mail: faridaqa100@hotmail.com
Received January 19, 2010; accepted June 13, 2011.
and which is accompanied by building mental models
connected with other models for many other phenomena.” 1
A big challenge for medical educators is to search for
pedagogical tools that will promote meaningful learning
and discourage rote learning.5 In pharmacology
meaningful learning implies the ability to understand
the mechanism of action of drugs on the body systems
and to be able to relate these actions to systemic effects
and adverse drug effects, and in turn associate these
effects to clinical uses and contraindications to the use
of these agents. Current teaching strategies appear to
be inadequate in enhancing and improving knowledge
of pharmacology due to which students lack depth
of knowledge and experience difficulties in using
pharmacological concepts in clinical practice settings.6
Concept mapping, initially proposed by Novak, is an
innovative approach that helps the learner to organize
knowledge.7 Concept maps communicate knowledge
graphically instead of relying on lengthy textual
explanations. They have been used in many disciplines
and at all levels of education to provide a very useful
and extremely appealing way of illustrating concepts.8

476 Journal of the College of Physicians and Surgeons Pakistan 2011, Vol. 21 (8): 476-481
Use of concept mapping as a facilitative tool to promote learning in pharmacology
In constructing a concept map, the key concepts are
enclosed in circles or boxes. Relationship between
concepts are indicated by connecting arrows linking
two concepts. Words on the arrow specify relationship
between the two concepts. Concept maps are
represented in a hierarchical fashion with the more
general concepts at the top of the map and less general
and more specific concepts below. Cross links or arrows
indicate how knowledge in one domain is related to
knowledge in another domain. It is best to construct
concept map with reference to some particular question
we wish to answer (focus question) or a situation we
wish to understand. Specific examples, given at the
bottom, help to clarify meaning of a map. They are not
enclosed in boxes as they indicate specific situations
and not general concepts.
To the best of our knowledge, concept mapping as a
learning methodology has not been investigated in
Pakistan. The purpose of this study was to determine
the usefulness of concept maps in developing
pharmacological concepts and to obtain students feed
back on its value and acceptability and to assess the
usefulness of concept maps in improving test scores.
METHODOLOGY
This analytical study was conducted between March
and May 2009, with 50 undergraduate students,
enrolled in the second year of dentistry. The names of
students, arranged in alphabetical order, was divided
into 4 sections A, B, C, D comprising an average of 12
students each. Through randomization by ballot
method, two groups A and C (n=25), were assigned to
the intervention group, and groups B and D (n=25),
served as controls. The intervention was in the form of a
concept mapping assignment added to the tutorials. The
class was taught the assigned topics by giving classical
style lectures using MS power point presentations. They
were instructed to study the topics covered during the
week for discussion in the tutorial classes the following
week.
For test groups A and C, two introductory sessions were
arranged. First session was a workshop in which they
were explained the purpose and process of concept
mapping and relevance to their education. The method
of creating concept maps was explained by simple
examples. The second session was followed by hands
on experience during which students created concept
maps of a topic from their existing knowledge.
Each student in test groups A and C was asked to
create concept maps on various topics from CNS
pharmacology. During the tutorial class, the students
presented the concept maps, elaborated on the
concepts, clarified misconceptions and shared their
experience with building the concept maps (example of
a concept map given in Figure 1). Emphasis was placed
Journal of the College of Physicians and Surgeons Pakistan 2011, Vol. 21 (8): 476-481
on the mechanism of action of drugs and how drugs
alter normal physiological processes leading to
their systemic effects. The actions of drugs were related
to their uses and adverse effects which in turn
were correlated with contraindications to their use.
Pharmacokinetic and pharmacodynamic aspects of drug
interactions were also emphasized. Links to related
topics in physiology, anatomy or biochemistry were also
elaborated upon wherever relevant. The tutor guided the
students to correct their cognitive difficulties in
organizing and clarifying the concepts and in removing
misconceptions.
Control groups B and D attended the same lecture
and had the same number of tutorials comprising of
discussion sessions during which an equally qualified
tutor asked questions to clarify doubts.
At the end of the unit, module tests based on the best
choice questions (BCQs) and short essay questions
(SEQs) were taken to assess the theoretical knowledge
of all the students. The intervention group was asked
to fill in a questionnaire in which they recorded their
impression about the concept mapping assignments.
For the quantitative data, statistical analysis was done
using on-line Graphpad p-value calculator. Mean and
standard deviation was calculated for the test scores.
Student's t-test was used for determining the difference
between the test scores. P-value < 0.05 was taken as
significant.
Proportions were computed for qualitative variables
like student's degree of satisfaction with the concept
mapping, usefulness of the mapping in understanding
difficult concepts, benefit of extra time spent with the
new method etc.
RESULTS
Results were analyzed using Student’s t-test. For best
choice questions (BCQ), a mean of grade of 57.1 + 16.7
was obtained by the control group and 58.8 + 13 by
the test group (p=0.72) which was not statistically
significant. In short essay questions (SEQ) test, the
average grade for the control group was 52.3 + 18.8 and
for the test group it was 53.8 + 22.5 which was not found
significant (p=0.84).
To evaluate students’ perception regarding concept
mapping, a questionnaire was filled by students at
the end of the project (Table I). This showed that 86.36%
of the students found concept mapping very useful in
understanding the topic and 54.54% in retaining
the knowledge acquired; 68.18% thought that the
major benefit of the concept map was that it helped
in quick revision before a test and 50% could clear
misconceptions during discussion of the maps.
However, 45.45% of students spent more than 2 hours
and 40.9% spent more than 1 hour in making a map.
477
Farida Qadir, Tabassum Zehra and Imrana Khan

Figure 1: Part of concept map of sedative hypnotic drugs.

478 Journal of the College of Physicians and Surgeons Pakistan 2011, Vol. 21 (8): 476-481
Use of concept mapping as a facilitative tool to promote learning in pharmacology

Table I: Students’ opinion about concept mapping (CM).

Open ended questions:
Questions Number of Percentage
students What in your opinion are the main disadvantages of making
1. How much did CM help you in understanding concept maps?
the topic?
1. Very time consuming.
A. Not at all 0 0%
18 students (81.81%).
B. Somewhat 3 13.63%
C. Very useful 19 86.36%
2. Sometimes difficult and confusing to make.
2. Did CM help you in retaining information?
5 students (23.80%)
A. Not at all 0 0% 3. Precise, have to refer to text for details.
B. Somewhat 10 45.45% 4 students (18.18%)
C. Very useful 12 54.54% 4. Not helpful in attempting tests.
3. How much information did you retain during 5 students (23.80%)
the test?
What in your opinion are the main advantages of making
A. < 25% 0 0%
concept maps?
B. 25-50% 6 27.27%
C. 50-75% 12 54.54% 1. Helpful in revision before tests.
D > 75% 4 18.18% 15 students (68.18%)
4. Did CM help you in correlating this knowledge 2. Helpful in understanding the subject.
to your past knowledge? 14 students (63.63%)
A. Not at all 3 13.63%
3. Classroom discussion helped to clear concepts and
B. Somewhat 16 72.72%
remove misconception.
C. Very useful 3 13.63%
11 students (50%)
5. How much time did you spend in making CMs?
A. < 1hour 3 13.63%
4. Useful for a quick overview of the subject.
7 students (31.81%)
B. 1-2 hours 9 40.9%
C. > 2 hours 10 45.45%
Nevertheless 68.18% felt that the extra time spent
6. Did this extra time spent benefit you in under-
standing the subject? benefited them in understanding the subject. Majority
A. Not at all 0 0% (76.19%) said they preferred concept mapping over
B. Somewhat 7 31.81% the traditional tutorial format and 68.18% favoured
C. Very useful 15 68.18% use of concept mapping in other subjects as well. On
7. Did the extra time spent benefit you in the other hand, 72.72% had difficulty in correlating
attempting the test? pharmacological concepts with the knowledge acquired
A. Not at all 0 0% in previous years in other basic sciences.
B. Somewhat 11 50%
C. Very useful 11 50% DISCUSSION
8. Did you use the concept maps to prepare for
the test? The pharmacology curriculum is loaded with information
A. Not at all 1 4.54% which the teachers expect the students should know.
B. Somewhat 11 50% This makes the student simply memorize the facts
C. Very useful 10 45.45% without acquiring a deep understanding of the subject.
9. Did CM help you in attempting the BCQ test? A review of a concept map made by a student on
A. Not at all 1 4.54% pharmacology of sedative hypnotics like benzodia-
B. Somewhat 14 63.63% zepines and barbiturates (Figure 1), shows that students
C. Very useful 7 31.81% after thoroughly reading through the topic analyzed
10. Did CM help you in attempting SEQ test? the content to identify key concepts and structured the
A. Not at all 2 9.09% information such that a glance shows the key concepts
B. Somewhat 12 54.54% and their relationships thereby allowing a holistic
C. Very useful 8 36.36% understanding of the topic. This is reflected in the
11. Would you like to use the concept maps in students’ response where majority found that concept
other topics/subjects?
maps effectively summarize the subject and is very
A. Not at all 3 13.63%
useful in revision before exams when not enough time is
B. Probably 4 18.18%
available to go through lengthy texts. Summarizing is
C. Very much 15 68.18%
important because it aids memory, makes review more
12. Do you prefer concept mapping over the
traditional tutorial format? efficient and encourages high level critical thinking.
A. Not at all 0 0% Concept maps encourage creativity as each map is
B. Probably 5 23.80% unique and reflects the thinking process of the builder.
C. Very much 16 76.19% Different colours used to group sections of the map

Journal of the College of Physicians and Surgeons Pakistan 2011, Vol. 21 (8): 476-481 479
Farida Qadir, Tabassum Zehra and Imrana Khan
make it visually appealing. Information is structured in a
manner which allows the students to see how complex
ideas fit together - how the mechanism of action relates
to the systemic effects which in turn relates to adverse
effects and indications for use of sedative hypnotics.
Concept maps also provide an opportunity for holistic
understanding of a subject as it discern overlaps and
commonalities allowing cross-disciplinary linking, for
example between physiology of action potential and
mechanism of action of sedatives as shown in
Figure 1. Also links were discerned to other topics in
pharmacology - pharmacokinetics, pharmacodynamics,
drugs of abuse, antiepileptic and general anaesthetic
agents, this encourages highly divergent lateral thinking.
To our knowledge, use of concept maps as a
pedagogical tool in Pharmacology has so far not been
reported. However, in other medical disciplines, like
physiology, microbiology internal medicine, and medical
research,11-14 concept mapping has been used
effectively. It has been shown that concept maps can
promote meaningful learning in medical education.15,16
Several health-related fields like veterinary medicine,9
and nursing,10 have also found concept mapping to be a
successful learning strategy.
This study found no significant difference in scores of
one best choice and essay type tests between the
intervention and control groups. However, average
grades were generally higher for intervention than
control group. This result is consistent with findings of
various other studies which have found no correlation
between conventional measures of learning like grades
of standardized tests and concept mapping assessment
scores.17,18 This could be due to the fact that the
assessments do not test concepts rather they rely on
memorization of trivial facts not covered in the concept
maps. Students learning physiology by concept
mapping have performed significantly better at problem-
solving exams, but the difference was not significant in
multiple-choice exams.19 However, concept mapping
was found to benefit students in the lower percentiles in
acquiring significantly higher grades in MCQ tests, this
difference was not observed in high-achievers.19
Moreover, comparative study of classical teaching
method with concept mapping technique has shown to
produce a significant improvement in OSCE scores in a
plastic surgery course.20
The questionnaire designed to evaluate perception of
the students at the end of the project showed that
students found constructing concept maps to be helpful
in understanding CNS pharmacology. A majority of the
students agreed that concept maps assisted and
enhanced thinking and learning of Pharmacology,
however, they found the process time intensive. It was
found that the response was less favourable when
asked about establishing interrelationships between
other basic sciences. This might reflect difficulty faced
480 Journal of the College of Physicians and Surgeons Pakistan 2011, Vol. 21 (8): 476-481
by the students in moving from simpler and basic
subjects to subjects involving greater conceptualization
and application.
It would probably be more useful to expose students to
a wide range of maps at the beginning of the project in
order to better familiarize the students to the techniques
of concept mapping. Also much time could be saved by
using computer-based concept mapping software like
Inspiration or CMap. The most encouraging aspect of
this study was that most students stated that they would
like to use concept maps as a learning tool for future
studies in Pharmacology and other subjects.
We suggest that concept mapping as a pedagogical tool
could be applied to the entire subject of Pharmacology.
It could also be included in text books of Pharmacology
as an explicit overview at the end of each chapter.
CONCLUSION
Students found that concept maps enhanced their
capacity to develop clear concepts in Pharmacology and
in getting a comprehensive and accurate overview of the
entire topic. This helped in quick revision before exams.
This learning methodology did not help to improve
scores of one best-choice and essay-type tests likely to
be due to differences in cognitive domains involved.
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