ORIGINAL ARTICLE

Using Mind Maps to Improve Medical Student Performance

in a Pharmacology Course at Kunming Medical University
Guo Ying1, Xie Jianping3, Luo Haiyun1, Li Xia1, Yang Jianyu1, Xuan Qun1 and Yu Jianyun2

ABSTRACT
Objective: To determine whether students using mind maps would improve their performance in a final examination at
the end of lecture-based pharmacology course.
Study Design: A quasi-experimental study.
Place and Duration of Study: Kunming Medical University, from September 2014 to January 2015.
Methodology: One hundred and twenty-two (122) third year undergraduate medical students, starting a 48-hour lecture-
based pharmacology course, volunteered to use mind maps as one of their study strategies (intervention group), while the
remaining 100 students in the class continued to use their usual study strategies (control group) over the duration of the
course. The performance of both groups in the final course examination was compared. Students in the intervention group also
completed a questionnaire on the usefulness of mind maps during the course and in preparation for the final examination.
Results: The students' performance of intervention group was superior to performance of the control group in all parts of
a multi-modal final examination. For the multiple choice questions and comprehensive scores, average marks of 45.97
±7.22 and 68.07 ±12.77, respectively were acquired by the control group, and 51.77 ±4.95 (p<0.01) and 80.05 ±7.54
(p<0.01), respectively by the intervention group. The median IQR scores for "filling in the blanks" questions, short answers
questions and case analyses, were 6.00 (6.00), 8.00 (3.50), 8.75 (5.88), respectively for the control group, and were all
significantly higher at 8.00 (4.00) (p=0.024), 10.00 (2.00) (p<0.001), and 11.00 (3.25) (p=0.002), respectively for the
intervention group. Questionnaire responses showed that 95.45% thought that mind maps helped them to prepare more
efficiently for the final exam; 90.91% believed that mind maps helped them to better understand all of pharmacology.
Ninety-one percent also thought that mind maps would help them to better understand other disciplines, and 86.36%
students would like the lecturers to utilize mind mapping as an alternative to conventional teaching formats, such as the
use of Power Point.
Conclusion: The addition of mind maps to students' study of pharmacology at Kunming Medical University improved their
performance in all aspects of a multi-modal final examination.

Key Words: Pharmacology. Mind maps. Multi-modal final examination.

INTRODUCTION contrast with rote learning, mind maps help students

Pharmacology is the study of the interaction between the
human body and pharmaceutical agents. A key concern
for many students studying pharmacology is how to
accurately understand and retain relevant concepts.1 In
view of the rapid developments in pharmacology, it is
increasingly important to guide clinical medical students
in their learning and understanding of pharmacological
principles to ensure rational drug use in their future
practice.
Mind mapping describes creative, effective and active
methods of making notes, which includes the use of
interesting and helpful colorful diagrams or scripts.2 In
1 School of Basic Medical Sciences / Quality Monitoring and
Assessment Center2, Kunming Medical University, Kunming,
Yunnan, China.
3 Library, Yunnan Minzu University, Kunming, Yunnan, China.
Correspondence: Xuan Qun, Associate Professor of School of
Basic Medical Sciences, Kunming Medical University, Kunming,
Yunnan, China.
E-mail: 982643134@qq.com
Received: November 15, 2016; Accepted: July 19, 2017.
more easily connect new knowledge to foregone
knowledge, so that it is not forgotten with ease by
students.3 Mind mapping is considered as supportive
means for enhancing learning, memory, motivation and
creativity of students.4 It is in greater accordance with
the natural way of processing information in our brain.5
A concept map is a diagram that depicts relationships
between concepts. Mind maps and concept maps help
students to take greater responsibility for their own
education by helping them to create more structured
learning experiences.6 At the same time, concept
mapping can enhance the students' learning capacity
and learning outcome.7 Constructivism also becomes a
basic of two learning strategies, which can be applied to
pharmacology education. One strategy is concept
mapping and another is mind mapping.8
In this study, a hybrid of concept and mind maps as
colorful diagrams were used to show relationships
between key concepts. In keeping the constructivist
theory of learning, the use of concept maps and mind
maps help learners drink in new knowledge within their
existant information which results in meaningful
learning. This study was conducted as an attempt to

404 Journal of the College of Physicians and Surgeons Pakistan 2017, Vol. 27 (7): 404-408
Using mind maps to improve medical student performance in a pharmacology course
assess the usefulness of mind maps in pharmacology
education and its effect on student performance in the
final examination of a 48-hour course in pharmacology.
METHODOLOGY
This quasi-experimental study was implemented
between September 2014 and January 2015 when 122
third year undergraduate medical students of the
Kunming Medical University completed a 48-hour long,
lecture-based pharmacology course.
At the start of the course, mind maps and their use were
explained to all students in the class, who were then
invited to participate or not to participate in the mind
maps intervention. Students volunteered to incorporate
mind maps into their regular study strategies
(intervention group), while the remaining 100 students in
the class did not, and continued their usual study habits
(control group). To assess the comparability of students
in the intervention and control groups, their medical
school entry scores (pre-test scores) were compared.
Each student in the intervention group was taught how
to develop mind maps. Tutors initially provided a simple
mind map which contained the fundamental framework
and access to the free software (Freemind V0.9.0 or
Xmind 6). They were uploaded to an online chat group
for these students, which formed the main channel of
communication between the tutors and those students.
Thereafter, students in the intervention group were
required to download the unfinished mind maps
throughout the course to complete and submit as
required assignments. Tutors provided feedback to the
students on the mind maps that they had submitted.
Usual class assignments were also given to the control
group, but they were not instructed on the use of mind
maps and did not have access to the online chat group.
All students in the class completed a multi-modal course
final exam and the results of the students in the
intervention group were compared with those of the rest
of the class. The course final examination consisted of a
range of different types of questions that assessed both
factual recall (e.g. "filling in the blanks" type questions,
10%), understanding (e.g. short answer,15% and
multiple choice questions, 60%) and application of
knowledge (e.g. case analyses, 15%). Comprehensive
scores consisted of the total final examination scores
(60%) and the quiz scores (40%).
After exam, a questionnaire was applied to estimate the
method of additional mind mapping after class, which
was ranged into eight broad headings: better
understanding of specific topics, revision for the exam,
enhancement of structured learning knowledge, better
understanding all of pharmacology, adding new
knowledge onto existing knowledge, preparation for
exams in other disciplines, learning of other disciplines
and serving as a substitution of slides.
Journal of the College of Physicians and Surgeons Pakistan 2017, Vol. 27 (7): 404-408
For the data analyses, statistical analyses were
performed using SPSS 19.0 software. Means and
standard deviations were counted for pre-test scores,
comprehensive scores and multiple choices, which were
contrasted using independent sample t-test. Students'
median scores for the other questions modalities ("filling
in the blanks" questions, short answers and case
analyses) were compared using the Mann-Whitney
U-test, and median with interquartile (IQR) range was
calculated for them. Significance was determined at a
p-value = or < 0.05.
RESULTS
Comparison of students' performance in our medical
school entrance (pre-test) examination, which tested
knowledge of Chinese, English, mathematics, physics,
chemistry and biology, showed that there was no
difference in the academic performance, in that test
among those in the intervention group (mean score,
528.50 ±19.46, n=22) and control group (mean of grade
of 530.60 ±14.40, n=100) (Figure 1). This suggested to
us that there was no academic bias in those
volunteering to participate in the intervention group.
There were five main areas in the course in which
students either developed mind maps (intervention
group) or completed traditional course work questions
(control group). These areas included general
pharmacology, peripheral nervous system pharmacology,
central nervous system pharmacology, cardiovascular
pharmacology and chemotherapy. Figure 2 showed an
initial mind map on general principles of antimicrobial
chemotherapy prepared by the pharmacology lecturer
and Figure 3 showed how effectively this was further
developed by students in the intervention group.
The mean scores in the comprehensive scores and in
the multiple choice question section were 68.07 ±12.77
and 45.97 ±7.22, respectively in the control group; and
80.05 ±7.54 (p<0.01) and 51.77 ±4.95 (p<0.01),
respectively in the intervention group. The superior
performance of the students in the intervention group
Figure 1: Pre-test scores compared with control group and intervention
group.
405
Guo Ying, Xie Jianping, Luo Haiyun, Li Xia, Yang Jianyu, Xuan Qun and Yu Jianyun

Figure 2: Simple mind maps made by the tutors.

Figure 3: Finished mind maps made by the students.

Table I: Comparison of the final exam scores of pharmacology

medians (IQR) were as follows: 8.00 (4.00), 10.00 (2.00),
between intervention group and control group. 11.00 (3.25) for the intervention group, and 6.00 (6.00),
Control group Intervention group p-value#* 8.00 (3.50), 8.75 (5.88) for the control group. These
N=100 N=22 differences were significant at p values of 0.024, 0.000,
Multiple choices, 45.97 (7.22) 51.77 (4.95)* <0.01 0.002, respectively (Table I).
mean (SD)
Filling in the blanks, 6.00 (6.00) 8.00 (4.00)# 0.024
At the end of the semester, to assess students'
median (IQR) perception in regard to mind maps, a questionnaire was
Short answers, 8.00 (3.50) 10.00 (2.00)* 0.000 completed by students in the intervention group. This
median (IQR)
showed that 100% students discovered mind maps were
Case analysis, 8.75 (5.88) 11.00 (3.25)* 0.002
median (IQR) quite useful in better understanding specific topics;
Comprehensive score, 68.07 (12.77) 80.05 (7.54)* <0.01 95.45% thought revision for the exam was advanced by
mean (SD)
mind maps; 100% agreed structured learning of new
knowledge was improved; 90.91% believed mind maps
#p<0.05, * p <0.01 compared with control group.

was also seen in the sections with "filling in the blanks" could assist them to better comprehend all of
questions, short answers and case analysis. The pharmacology; 95.45% reported that mind maps were

406 Journal of the College of Physicians and Surgeons Pakistan 2017, Vol. 27 (7): 404-408
Using mind maps to improve medical student performance in a pharmacology course
favorable for building relationship between new
knowledge and preexisting one in pharmacology; and
95.45% looked mind mapping on a good way to prepare
for examinations in other disciplines. For 90.91% of
students, the biggest benefit of mind mapping was that it
could be used to understand other disciplines more
easily. Further, 86.36% students were willing to use mind
mapping as an alternative to conventional teaching
formats, such as the use of Power Point presentations.
DISCUSSION
At present, lectures remain the mainstay of pharmacology
education. This has resulted from a combination of the
lack of tutors and limited teaching hours. The result is
that the majority of students remain passive recipients of
information. This study shows that the final exam
performance could be substantially improved through
students' use of mind maps. Further, lecturers can guide
students in their early use of the mind maps by preparing
incomplete maps, which students complete. But, as
students become more proficient, then they can be left
to generate their own mind maps.
Mind mapping provides facile access to methodizing
complicated knowledge points,9 simplifying emphasis
and difficulty,10 arousing learning interest,11 and giving
play to conscious activity. Further, deeper students
understanding is ensured by lecturers’ modification and
feedback on their mind maps, at the end of each major
pharmacological theme, thus guaranteeing accuracy in
their understanding of new knowledge. Mind maps also
help teacher to design their teaching assignments more
clearly, than with more traditional formats such as the
use of Power Point software.
Although some students in the intervention group would
like lecturers to utilize mind mapping as an alternative to
Power Point, the latter still has an essential role in
teaching, not only for its ease of use, but also because it
provides a knowledge hierarchy.
The majority of students report that mind mapping help
them in several important domains, better comprehension
of the topic, reviewing workpiece ratio, methodizing
thought, comprehending pharmacology, associating the
new knowledge with the preexisting one, preparing for
the exam, and even help them with divergent thinking,12,13
while they master the key points of knowledge and refine
the specific contents. Furthermore, they believe mind
maps can increase their study efficiency and relieve
learning burden,14,15 which derive from the diagrammatic
drawing of ideas on mind maps being superior and
easier to read.16
Mind maps are not only helpful in learning pharmacology
but can also be used to other curricula and problems.17,18
Pharmacology and relevant curricula can be combined
into one mind map, which will also help integration of
Journal of the College of Physicians and Surgeons Pakistan 2017, Vol. 27 (7): 404-408
ideas across disciplines.19 There are a lot of similarities
between mind maps and complex problems, in which
difficulty will be reduced if it is settled length by length.
Additionally, mind mapping can inspire the employ of
critical thinking skills to resolve intractable problems.20
How to assess the depth and the extent of mind
mapping usage? In four steps, the first is to gain skill in
making mind maps. Next is understanding how to use
mind maps to include a wider range of pharmacological
principles into the map and so drive learning to a further
level. Thirdly, pharmacology and correlative curricula are
integrated into one mind map to better understand their
relationship.21 Finally, mind maps can become a regular
part of students' learning tools as in the mean time they
gain profit from it.22
Problems which the authors encountered in the period of
this study included a shortage of participating faculty and
insufficient time for the collection of more date points.
Next time, more tutors will be invited and more teaching
hours will be spent. An impeccable research will inspect
a large, randomly selected sample of students who have
more time.
CONCLUSION
Students, who were taught how to use mind maps and
continued to use them throughout a pharmacology
course, performed significantly better in their final
examination than a control group of students who did not
use mind maps. Simultaneously, this learning technology
also increased their ability to organize clear notions in
pharmacology, which assist in rapid revision before the
exams.
Acknowledgement: This research was supported by
the key educational characteristic subjects of Kunming
Medical University in 2014: Concept maps and mind
maps integration of six medical subjects (2014JY-Z-1),
and academic education research station in Yunnan
province: comprehensive quality management and
research station of medical courses.
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