Concept mapping : student perceptions of using a teaching tool in a Pharmacy course

Concept mapping consist of diagrams that represent the relationships between concepts and words that describe them. The present study aimed to examination of student perceptions of using concept mapping in a pharmacy course. A group of undergraduate students from the sixth semester were the participants. Students received the concept mapping before and after the theoretical class, also could make their own map. In general manner, 97% of the students made use of concept mapping, 90% consider that their use may be useful for learning pharmacology. 50% of participants considered the help provided by concept mapping for their learning as satisfactory, 25% as very satisfactory and 25% as regular. Still, 63% of students intend to continue use of conceptual maps and 34% think about continuing to use concept mapping. Therefore, the study demonstrated that use of concept mapping as a teaching tool for pharmacology class, managed to arouse students interest in contents.


Introduction
The pharmacology education is a discipline that generates reflections on teaching and learning methodologies for decades (Engels, 2018). This occurs, because teaching in health sciences encompasses a number of basic disciplines. However, in recent years, there has been an increase in the amount of information in pharmacology education, rendering an already demanding subject even more challenging (Baños, Reverte & Bosch, 2002;Baumann-Birkbeck et al., 2015). In this sense, new teaching strategies have evolved from a teachercentered process to a learner-centered process in an effort to enhance students in the pursuit of knowledge (Baumann-Birkbeck et al., 2015). Still, the teaching-learning process should strengthen the advances toward the implementation of promoting a less-strict hierarchical culture between students and their educators which is crucial to consolidation critical thinking (Basheti et al., 2015). In order for this methodological approach to take place egalitarian, learning perceptions and needs must be considered (Basheti et al., 2015). Like this, education in pharmacology poses a major challenge to teacher, even more than model used is usually the traditional teaching (Machado & Mello-Carpes, 2018).
Pharmacology is a key curriculum among a number of preclinical courses in different undergraduate and graduate of health sciences area. However, their learning is extremely important for pharmacy students (Zhou et al., 2016). In this sense, experimental pharmacology is essential for understanding drug action in the treatment of disease. Also, to pharmaceutical industry for drug discovery and development. Besides that, clinical Development, v. 9, n. 9, e467997696, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.7696 4 pharmacology is essential for prescribing practice in hospital and underpins pharmacy practice and therapeutics (Lloyd et al., 2013). The teaching and learning of pharmacology conventionally occur after the other core courses of health sciences, such as anatomy, pathology, biochemistry, chemistry and physiology (Liu et al., 2019). Likewise, clinical applications basic skills in performing pharmacology experiments, and professional knowledge of the laws and regulations of drug administration (Zhang et al., 2015).
Pharmacology education needs integrated effort of multiple techniques to reach a total understanding of the action of drugs. The increasing number of drugs, changes in knowledge on general principles of mechanisms of drug action and more detailed information (particularly on the subcellular and genomic levels) regarding properties of drugs require consequently innovative approaches to undergraduate pharmacology education (Liu et al.,

2019).
For students of pharmacy course, the pharmacology education differs from that of health science students, because not only they need to understand mechanisms of drug action but also must memorize numerous detailed facts regarding drug classes, individual compounds and their practical uses. Like this, traditional pharmacology teaching-learning has been criticized for neither preparing students for practice nor teaching the safe and rational use of medicines (Shah et al., 2016). Therefore, health sciences courses have a major challenge in teaching students for pharmacology.
In view of above, constructivist theory is an alternative teaching methodology to objectivist theory. In objectivist theory, experiences do not have any role in understanding and knowledge exists independently of instruction (Herrington & Herrington, 2005). In objectivism, the perception of knowledge influences the view on instruction. However, in constructivist the knowledge cannot simply transfer from one person to another because it is not a pure copy of external world (Phillips, 2000). Like this, students may express what they have learned in different ways, even if they have shared the same learning process (Tse-Kian, 2003).
In this context, the concept of learning within framework of constructivist theory (Urquhart et al., 2013), where student is an active and non-passive figure in knowledge construction. Ends up contemplating the significant learning theory proposed by Ausubel (1963), which has specific conditions such as existence of prior knowledge along with predisposition to learning. Still, according to Ausubel (1963), when considering the conditions outlined above, prior knowledge is more relevant to meaningful learning. In this sense, it is precisely the prior knowledge that concept mapping seek to rescue. Concept Research, Society and Development, v. 9, n. 9, e467997696, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.7696 mapping was developed by Novak in 1972 to promote critical thinking (Gul & Boman, 2006).
Still, is a tool that can capture a pictorial record of learning process, similar to mind mapping (Buzan & Buzan, 2010). Concept mapping is concerned with the ways in which people organize and reorder new knowledge based on their past learning and understanding (Von Glasersfeld, 1984).
The methodology tool has been utilized in a range of educational disciplines (Bressington et al., 2013), as a strategy to promote learners' development of an in-depth understanding (Baugh & Mellott, 1998). Concept mapping and subsequent reflection on the series of maps are thought to help students reconsider information (Bressington et al., 2013).
In sense, to promote critical analysis and deeper learning (Wheeler & Collins, 2003). The cyclical process applied in concept mapping generate reflection on their help's students engage in further meaning-making by presenting an opportunity to picture the way they have worked through trying to understand a complex subject (Gul & Bowman 2006;Bressington et al., 2013).
Therefore, concept mapping consists of diagrams that represent the relationships between concepts and words that describe them. Are generally elaborated in hierarchical form and may present arrows between concepts, since they seek to relate the concepts presented (Semsar et al., 2019). The implementation of concept mapping includes: assimilating new concepts in circles or boxes; creating hierarchical arrangements between concepts and subconcepts; and identifying relationships between concepts and sub-concepts that can be connected with lines or linking words (Rochmawati & Weichula, 2010). Still, concept mapping end up generating a meaningful learning that differs from mechanical, where one has a short period of memory, which ends up causing a low retention of learning and knowledge.
In addition, concept mapping corroborates with theories that seek to optimize teaching and learning, including clinical practice. Such as theory described by Russell and Burch (1992), the three principles (replacement, reduction and rejection). The applied concept aims to decrease the use of animals through substitution by other techniques for teaching in pharmacology, physiology and other basic disciplines (Altermann et al., 2016). It is proven that concept mapping has contributed to the enhancement of undergraduate clinical judgment skills (Gerdeman et al., 2013). In view of above, the present study aimed to examination of student perceptions of using concept mapping in pharmacy course a South American country.

Layout of concept mapping
For layout of maps, they all contained first a rectangle with a blue border and a green background where the drugs action site was mentioned. Located in upper part of map, after that information was inserted a rectangle with orange border and transparent background, in which was the name of pharmacological class.
Almost in a central position on map was the representation of drugs action (agonistic or antagonistic), in a black-bordered rectangle with a blue background. After that, there was a yellow ellipse for name of the drug along with its administration routes, followed by a rectangle of green border, inferior to ellipse and connected to it by a continuous line indicating the relation, where it was described its use and/or function.
Finally, a rectangle with a red border and transparent background, still lower and also connected by line, where the main adverse effects were located (schematic representation of concept mapping is located in Figure 2).

Second stage
Students answered a questionnaire composed of twenty questions: 14 objective, 2 discursive and 4 practices, but which admitted discursive responses as complementary to chosen alternative. The questionnaire was divided into two parts, the first one referring to concept mapping provided by teacher and tutor. The second part referring to concept mapping elaborated by students, as well a comparison between the availability and construction of concept mapping. This stage was carried out at the end of activity, after pharmacology semester evaluation. Development, v. 9, n. 9, e467997696, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.7696

Data Analysis
Statistical analysis was performed based on answers given by students to questionnaire of stage 2 (descriptive statistics). The results are presented as a percentage. Microsoft® Office Excel 365® is software used by statistical analysis.

Results
All students agreed to participate in proposed activity. The following contents were approached by concept mapping: drugs that interfere in blood tissue (S1), drugs for endocrine system (S2) and antibiotics (S3).

Questionnaire responses
Taking into account the responses obtained from questionnaire at end of activity with 22 students. 97% of students made use of concept mapping, 90% consider that their use may be useful for learning pharmacology and 10% believe that its use can not be useful. 50% of participants considered the aid provided by concept mapping for their learning as satisfactory, 25% as very satisfactory and 25% as regular.
Regarding timing of the delivery of maps, 56% of participants assessed that receiving after the content is delivered, is more productive than previous delivery. In contrast to delivery of map, ready or elaboration of map itself, only 22% considered adapting better elaboration of concept mapping itself. More than 88% of participants considered concept mapping provided by teacher and tutor satisfactory or very satisfactory. As 80% of class considered the aid provided by use of concept mapping as satisfactory or very satisfactory.
Still, 63% of students intend to continue use of concept mapping and 34% think about continuing to use concept mapping (Results showed in Table 1). Table 1. Results of questionnaire applied to students.

Questions
Responses of students (percentage)

Use of conceptual maps provided 97%
Students who consider the use of conceptual maps useful for learning pharmacology 90% Students that considered the aid provided by conceptual maps for their learning as very satisfactory 25% Students that considered the aid provided by conceptual maps for their learning as satisfactory 50% Students that considered the aid provided by conceptual maps for their learning as regular 25% Students that preferred to receive conceptual maps after the content is delivered 56% Students who preferred to draw their own conceptual maps 22% Students that considered conceptual maps provided by teacher and tutor satisfactory or very satisfactory 88% Students that considered the aid provided by use of conceptual maps as satisfactory or very satisfactory 80% Students that intend to continue use of conceptual maps 63% Students that think about continuing to use conceptual maps 34% Source: Authors.
Through the discursive questions present in questionnaire, some participants pointed out the maps provided as "of great utility", helping to differentiate and elucidate each class of drugs better, improving the understanding of the discipline.

Discussion and Conclusion
In present study, we presented concept mapping a teaching tool for students in discipline of pharmacology. According to MacDonald and Saarti (2006), learning a topic full of facts like pharmacology should be less of a chore and more of a pleasurable experience. In this sense, significant learning seems to expose itself as a good method for this purpose (Carrlopez et al., 2014).
In first stage, occurred the delivery of concept mapping produced by teacher and tutor.
Making it possible to compare students preference for reception of maps before or after pharmacology class and in which of these methodologies the student better adapted. In the study conducted by Carr-Lopez et al. (2014), also realized in students of pharmacy course but in fifth semester, was adopted the same methodology for delivery of concept mapping to students. In relation to concept mapping, it was also possible to evaluate the impact of tool available to students on layout, configuration, design and theoretical quality. We highlight that the studies by Carr-Lopez et al. (2014) and Laight (2006) emphasize the importance of student feedback regarding the qualitative assessment of teaching tool.
For S3, concept mapping were developed by students themselves after instructions given by teacher and tutor. Thus, at this stage the students were already able to use a new teaching tool, which induces a constructivist learning process, going according to Urquhart Similarly, in study of Miesner et al. (2012), was reported the impact of methodological tools on the increase in pursuit of knowledge in pharmacy students.
In last stage, a questionnaire was applied to evaluate the impact of methodological tool on students. Through open questions, students were able to present their opinion regarding concept mapping available in pharmacology discipline. Still, students were questioned regarding the elaboration of concept mapping and about comparison of receiving and elaborating the maps. Given the above, the students reported a fragility of methodological