Both teaching and learning medical education content are challenging. A common standard is needed within the medical education system to aid in the improvement of both processes [7, 8]. Checklists are widely used and have shown to be effective in various fields. One study has shown that having a checklist to assess students’ performance in a group proved to be a reliable and valid tool, in the setting of a small group of PharmD students for their curriculum session . Another study has shown that using a checklist might improve the quality of care for pregnant women with opioid use disorders . However, the evidence for the necessity of having a checklist within the classroom, and students’ perception towards it, are undocumented.
Our cross-sectional, quantitative, survey-based study was conducted at Nagasaki University, Japan in 2021. With this study, we aim to fill the gap of knowledge, i.e., investigate students’ perception toward using checklists in class and the necessity of having a checklist to aid learning. We recruited 31 students, twenty-two of them were included in the analysis (three students refused to participate afterward and two were excluded because of missing data). Most of the participants were older than 25 years old (90%, n = 20), sixteen of them were Master's students, and no Ph.D. students were included. More than half of the students declared that they know the checklist will be used in the course which we investigated. Most students do not use checklists in their courses so often, as only two of them (9%) usually used them. Twelve students confirmed that no other courses or lessons in TMGH use checklists. No students found the usage of checklists not easy or not practical to apply. Many students thought the length of the checklist was suitable and not too short, although three students (14%) found it lengthy.
Health education relies largely upon passing knowledge from the instructor to the student. To properly train future healthcare workers and researchers, we must broaden our understanding of how to teach, notably, by including intentional instructional design in the way curriculum is carried out, as a component of clinical education . Undoubtedly, checklists are among one of the best methods for instructional design studies and their protocols. As for demonstrating the necessity of a checklist, our study has shown five major fields students found improvement in as a direct result of its implementation. These areas were: understanding the lesson and curriculum knowledge, writing the protocol systematically and organizationally, studying for the final exam, and keeping focused and preventing unnecessary detours in the course information. Our results were like a study of De La Garza et al., which revealed that checklists also help increase students’ knowledge acquisition with E-learning . More than one-third of our participants responded that the checklist helped them to not only save time remembering details but also facilitate communication between colleagues (n = 8, accounted for 36%). A total of seven students (32%) were able to concentrate better in class. Only one student found the checklist did not provide any significant advantages, which accounted for 5%. No students found the checklist was bad or awful. Most of them described the checklist as beyond good (n = 19; 86%) and they would recommend using a checklist for teaching other college students (n = 16; 73%).
Some limitations of checklists were also investigated. One common disadvantage was that the checklist was so lengthy that it confused students (n = 5; 23%). To a lesser extent, three students (14%) found the checklist was not thorough because of some missing information, and 3 others complained that the checklist has eliminated their need to ask for instructors’ help. In an educational environment, communication between students and teachers/instructors is a crucial part of learning but is often limited. Checklists can further degrade this relationship. We suggest that students use checklists as an organizational tool and a reference source and not for sole dependence of information to resolve this issue. That is because more than the half of students (n = 13, 59%) were satisfied with the checklist and didn’t find any disadvantages. In addition, we have not examined the effect of a checklist on the educational attainment of undergraduate students. Conducting further studies with a bigger sample that includes other medical or research courses is essential to explore the true impact of using educational checklists.
Despite the limitations, our pilot study revealed students have a positive perception of using checklists in class. In the range of our knowledge, our study was the first study in the field of using checklists in education, especially within an educational research setting. The results also suggested that using checklists can ameliorate overall education quality, help to keep students focused and improve their knowledge acquisition, and reduce time-consuming tasks, all the while facilitating communication. It is worth mentioning, a practitioner’s education should be multifaceted and not dependent upon one strategy, such as checklists alone. Furthermore, checklists should be used wisely and alongside other education strategies. For example, a checklist could be used as a supplement for the Rigorous section of the “10R’s of Clinician Education”, to attain maximum effect . This study paves the way for further studies with better designs to investigate the pros and cons of using checklists within a classroom setting. In laying this foundation, we hope to ultimately contribute to the improvement in the quality of the medical education system.