Effect of teaching methodology and assessment on learning outcomes in a block-based undergraduate medical curriculum

Abstract

Background: Globally, medical education has been shifting from traditional discipline-based models toward studentcentered, outcome-based, and integrated curricula. The Mongolian National University of Medical Sciences (MNUMS) has implemented a six-block integrated curriculum; however, evidence on how teaching methodology and assessment practices influence student learning outcomes within this framework remains limited. Aim: To determine the effect of teaching methodology and assessment practices on student learning outcomes in a blockbased undergraduate medical curriculum. Materials and Methods: A retrospective study was conducted from January 2023 to January 2026 among 1,130 undergraduate medical students (years 3–6) at the School of Medicine, MNUMS. A stratified random sampling method was applied, representing 66.8% of the target population. Data were collected using a structured 185-item questionnaire based on a 5-point Likert scale. Statistical analyses included descriptive statistics, independent t-tests, one-way ANOVA with Tukey post-hoc tests, and multiple linear regression using SPSS version 26.0. Internal consistency was high (Cronbach’s α=0.90–0.98). Results: The overall mean evaluation score was 4.00±0.73. A decreasing trend in scores was observed with advancing academic years, with final-year students reporting the lowest scores (M≈3.92). Significant inter-year differences were found in Blocks 3 and 4 (p<0.05), suggesting a potential gap during the theory-to-clinical transition. Blocks 5 and 6 showed consistently high and stable scores (M≈4.10–4.15). Teaching methodology and assessment practices were strong predictors of learning outcomes (β=0.289–0.610), with regression models explaining 67–77% of the variance (R²=0.668– 0.774). Elevated VIF values indicated multicollinearity among predictors. Conclusion: Teaching methodology and assessment practices were found to be decisive determinants of learning outcomes within the integrated block curriculum (R²=0.668–0.774). Although overall student evaluations exceeded the mean threshold, a systematic decline observed across advancing academic years reflects the phenomenon of retrospective critical evaluation, while inter-year discrepancies in Blocks 3 and 4 indicate insufÏcient curricular coherence during the theory-to-clinical transition. Therefore, it is imperative to further develop the curriculum in a competency-based framework, and to reform both teaching methodology and assessment practices in alignment with clinical competence requirements.