International Journal of Anatomy and Research

eISSN 2321-4287 · pISSN 2321-8967

Volume 14 · Issue 2 · Pages 9559–9567 · June 2026

Research Article

Comparing the Effectiveness of Heutagogy-Driven Micro-module Creation with (Versus) Traditional Teaching-Learning Methods in Early Medical Education: A Mixed-Method Protocol

Ravindra Kumar B1*, Snehal S. Samal², Vaibhav P. Anjankar³

¹School of Higher Education and Research (SHER), Datta Meghe Institute of Higher Education and Research (DMIHER), Sawangi (Meghe), Wardha, Maharashtra, India; and Parul Institute of Medical Sciences & Research, Faculty of Medicine, Parul University, Vadodara, Gujarat, India.
²Department of Neuro-Physiotherapy, Ravi Nair Physiotherapy College & School of Higher Education and Research (SHER), Datta Meghe Institute of Higher Education and Research (DMIHER), Sawangi (Meghe), Wardha, Maharashtra, India.
³Department of Anatomy, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (DMIHER) & Director, School of Higher Education and Research (SHER), Sawangi (Meghe), Wardha, Maharashtra, India.

Corresponding author: Dr. Ravindra Kumar B, Masters in Health Professions Education (MHPE) Scholar, School of Higher Education and Research (SHER), Datta Meghe Institute of Higher Education and Research (DMIHER), Sawangi (Meghe), Wardha, Maharashtra, India. ORCID: 0000-0003-0569-1472, E-Mail: dr.ravindrakumar@gmail.com

Author ORCIDs: Snehal S. Samal: 0000-0003-0105-2411; Vaibhav P. Anjankar: 0000-0002-3033-2239

Received: 30 March 2026 · Revision received: 18 April 2026 · Accepted: 20 May 2026 · Published: 05 June 2026

DOI: 10.16965/ijar.2026.150

ABSTRACT

Background

Phase 1 MBBS medical education in India is traditionally content-heavy and teacher-centred, frequently causing student dissatisfaction and cognitive overload. While the National Medical Commission (NMC) mandates active, student-centred strategies, empirical evidence regarding heutagogy—self-determined learning—remains sparse within the Indian context. Grounded in Self-Determination Theory (SDT), this study introduces student-designed micro-modules to foster critical metacognitive reflection, peer learning, and active learner capability.

Objective

To implement and compare the effectiveness of heutagogy-driven micro-module creation against traditional didactic teaching-learning methods on the self-directed learning readiness and psychological need satisfaction of first-year medical students.

Methods

This 8-week mixed-methods quasi-experimental study will be conducted at the Parul Institute of Medical Sciences, Vadodara, India. A sample of 150 first-year MBBS students will be divided into intervention (n = 75) and control (n = 75) groups using purposive stratification. The intervention group will collaboratively design 10-15 minute anatomy micro-modules, while the control group undergoes standard didactic lectures. Quantitative data includes pre- and post-intervention scores from the refined 30-item Self-Directed Learning Readiness Scale (SDLRS) and Autonomy, Competence, Relatedness (ACR) questionnaires. Qualitative insight will be gathered through thematic analysis of student reflection logs and focus group discussions.

Results

The detailed results will be published in subsequent reports.

Conclusions

Shifting the pedagogical paradigm toward heutagogy via microlearning mini-projects holds significant promise for cultivating lifelong learning capabilities. This approach successfully balances instructional innovation with formal curriculum requirements, directly supporting the operationalization of India's competency-based medical education framework.

Keywords: Heutagogy; Microlearning; Medical Education; Self-Determined Learning; Self-Directed Learning Readiness.

INTRODUCTION

For decades, undergraduate medical education in India, particularly the foundational Phase 1 MBBS curriculum, has remained highly teacher-centric and heavy on core content. Students stepping into medical colleges are suddenly introduced to a vast sea of anatomical and physiological concepts. This volume often forces them into passive rote memorization rather than building conceptual clarity. To address this issue, the National Medical Commission (NMC) rolled out the Competency-Based Medical Education (CBME) framework. This major policy shift explicitly mandates a transition toward student-centred pedagogies, cutting down traditional lecture hours to make room for active learning strategies like Early Clinical Exposure and integrated instructional modules [1].

However, despite these clear policy goals, a practical implementation gap persists in daily classroom dynamics. First-year medical undergraduates still experience minimal autonomy over how they learn or what creative resources they can build. The challenge before educators today is to find active learning tools that balance strict regulatory alignment with meaningful learner independence.

Theoretical Framework: Heutagogy and Self-Determination Theory

This study proposes a deliberate shift beyond basic pedagogy and self-directed andragogy toward heutagogy (self-determined learning). While andragogy lets learners work independently within teacher-defined boundaries, heutagogy empowers them to navigate their own learning tracks, design resources, and engage in 'double-loop learning'. This is a reflective process where students question their own underlying assumptions and adapt their learning styles accordingly [2,3].

As established by Blaschke and Hase, heutagogy focuses on building lifelong capability rather than simple content competency. This intervention is theoretically anchored in Self-Determination Theory (SDT) by Deci and Ryan, which posits that a learner's intrinsic motivation and academic achievement thrive when three basic psychological needs are met: Autonomy (having a genuine voice and choice in the learning process), Competence (engaging with optimal challenges that build professional confidence), and Relatedness (experiencing connection and belonging with peers and mentors) [3,5]. Prior empirical assessments, such as those by Feri and colleagues (2016) [4], demonstrate that autonomous motivation directly predicts academic success in medical students. Furthermore, recent global synthesis by Panta and colleagues (2025) [2] underscores that while heutagogy fosters agency, its effectiveness remains context-dependent, highlighting a clear need for structured institutional trials.

The Rationale for Student-Designed Microlearning

To introduce heutagogy smoothly without inducing cognitive fatigue, this study utilizes microlearning—the practice of breaking down complex, extensive topics into compact, bite-sized units. Instead of merely consuming pre-fabricated digital media, the intervention requires students to become creators. When first-year MBBS students collaboratively design 10-to-15-minute anatomy micro-modules, they step into higher-order cognitive domains within Bloom's Revised Taxonomy. They are required to filter core clinical facts, organize complex information logically, select appropriate media, and anticipate peer learning gaps. This exercise moves the student from a passive spectator to an active instructional designer. Concurrently, the faculty member shifts from a traditional lecturer to a supportive, non-controlling coach.

The Concept of Heutagogy, the PAH Continuum, and Double-Loop Learning

The conceptual framework is rooted in the Pedagogy-Andragogy-Heutagogy (PAH) continuum. While Pedagogy is teacher-directed and Andragogy is self-directed within boundaries, Heutagogy shifts the focus entirely to learner-determined capability development [2,5,6]. A key mechanism is Double-Loop Learning: unlike Single-Loop Learning (which focuses on detecting an error and fixing it, e.g., memorizing anatomical branches to pass a viva), Double-Loop Learning requires learners to look inward and question their underlying assumptions, learning methodologies, and mental models [7].

METHODOLOGY

This protocol outlines a mixed-methods educational intervention designed to examine the operational feasibility and pedagogical impact of shifting from teacher-led instruction to self-determined learning (heutagogy) in early medical education. The study addresses the heavy cognitive load inherent to Phase 1 of the MBBS curriculum in India by introducing student-led digital micro-modules. Framed within Self-Determination Theory (SDT), the protocol evaluates whether active resource design cultivates intrinsic motivation, learner autonomy, and long-term lifelong learning readiness, aligned with the NMC's CBME framework and STROBE guidelines.

Study Design and Sample Size

This study employs a mixed-methods quasi-experimental design featuring a non-equivalent control group setup with an embedded qualitative inquiry using an explanatory sequential strategy. A total sample size of N = 150 first-year undergraduate medical students from the Parul Institute of Medical Sciences, Vadodara, India will be recruited through purposive sampling and stratified across academic performance quartiles based on entry-level parameters: Intervention Group (n = 75) engaging in collaborative micro-module design and Control Group (n = 75) undergoing standard didactic teaching.

Inclusion and Exclusion Criteria

Inclusion criteria comprise: 1) Students officially enrolled in Phase 1 MBBS during 2025-2026; 2) Students maintaining >=80% attendance across scheduled study sessions; 3) Voluntary willingness to complete all psychometric scales, topic exams, and reflection logs; 4) Written informed consent (and parental consent for participants <18 years). Exclusion criteria include formally documented learning disabilities (unless institutional accommodations allow equitable participation), withdrawal of consent, and consecutive absences exceeding 2 weeks during the 8-week block.

Data Collection Scales and Instruments

Refined 30-Item Self-Directed Learning Readiness Scale (SDLRS): Breaks down readiness into five core subdomains (6 items per domain) scored on a 5-point Likert scale (total score: 30-150, Cronbach's alpha >= 0.75) [13,14].

Autonomy, Competence, and Relatedness (ACR) Questionnaire: A 12-item adapted scale (4 items per SDT domain) on a 6-point Likert scale (Cronbach's alpha = 0.73-0.86).

Micro-Module Quality Assessment Rubric: Analytical metric for blinded faculty evaluation across accuracy/depth, pedagogical clarity, interactivity, and creativity (0-25 points each, total 100 points, verified via ICC).

Topic-Specific Academic Assessment Exam: Validated multiple-choice questions (MCQs) and short-answer questions measuring knowledge retention on anatomical subjects.

Chronological Protocol Procedures (8 Weeks)

Week 1: Baseline demographic forms, SDLRS, and ACR scales administered to both cohorts.

Week 2: Control group initiates standard lectures; intervention cohort receives structured orientation on heutagogy, double-loop learning, and micro-modules, forming self-selected teams of 4-5.

Weeks 3-6 (Active Creation Phase): Intervention teams select an anatomy topic (e.g., brachial plexus, coronary circulation), conduct literature searches, map Bloom's objectives, select digital media, and draft a 10-15 minute module with weekly peer-feedback loops and non-controlling faculty coaching. Controls receive parallel standard lectures (2h) and practical lab demonstrations (2h).

Week 7: Intervention teams deliver completed micro-modules to peers and facilitators during interactive feedback sessions.

Week 8: Post-intervention data collection (identical topic exam, SDLRS, ACR scales, final reflection logs) followed by semi-structured Focus Group Discussions (FGDs).

Data Analysis Plan and Focus Group Discussions

Quantitative analysis will be performed using paired t-tests (or Wilcoxon signed-rank tests), independent t-tests, and ANCOVA (baseline scores as covariates) with effect sizes reported as Cohen's d (alpha = 0.05). Qualitative data from weekly reflection logs and 5 FGD sessions (3 intervention FGDs with n=15 total; 2 control FGDs with n=10 total) will be transcribed verbatim, catalogued in TAGUETTE, and evaluated via Braun and Clarke's 6-phase thematic analysis framework (Cohen's kappa >= 0.75).

RESULTS (EXPECTED OUTCOMES)

As this is a study protocol, detailed empirical findings will be published in subsequent reports. Expected deliverables include: 1) Quantified learner metrics demonstrating statistically significant gains in SDLRS, psychological need satisfaction (ACR), and academic performance; 2) Practical scalability guidelines and mitigation strategies for overcoming systemic friction points; 3) Standalone validated evaluation rubrics for student-created micro-modules; and 4) Institutional curricular mapping frameworks for Phase 1 MBBS CBME integration.

DISCUSSION

Shifting along the PAH continuum in Indian medical education addresses the chronic problem of passive rote learning under heavy cognitive load. Transitioning toward heutagogical interventions aligns with undergraduate student preferences mapped by Bansal et al. (2020) [7] and supports NMC CBME mandates [1,9].

Operationalizing Self-Determination Theory (SDT) within anatomy education is critical: autonomy is granted through media and workflow choices, competence is built by synthesizing complex anatomical data into bite-sized units, and relatedness is fostered through collaborative peer design. Feri et al. (2016) demonstrated that autonomous motivation directly predicts academic achievement (beta = 15.2, p = 0.004) and relatedness strongly predicts clinical decision-making performance [4]. Babenko and Lee (2022) also highlighted that nurturing psychological well-being and autonomous drive is essential to prevent medical student burnout [9].

Microlearning acts as an effective cognitive scaffolding tool by respecting working memory limits [6,11]. Authoring micro-units engages students in Bloom's highest tier (creation). Double-loop reflection logs capture metacognitive shifts, closing the readiness gap where 32.9% to 64% of first-year medical students typically score below average on self-directed readiness [13,14].

Identified systemic barriers—such as educator resistance, student unpreparedness for self-direction, and curricular rigidity [2]—are actively mitigated through structured scaffolding, non-controlling coaching, and validated local assessment tools [8]. Methodological strengths include the explanatory sequential mixed-methods design, while limitations include the quasi-experimental non-randomized allocation, single-site cohort (N = 150), and potential Hawthorne effect.

CONCLUSION

Shifting the pedagogical paradigm toward heutagogy via microlearning mini-projects holds significant promise for cultivating lifelong learning capabilities. This approach successfully balances instructional innovation with formal curriculum requirements, directly supporting the operationalization of India's competency-based medical education framework.

ABBREVIATIONS

ACR

Autonomy, Competence, and Relatedness

ANCOVA

Analysis of Covariance

CBME

Competency-Based Medical Education

FGD

Focus Group Discussion

ICC

Intra-class Correlation Coefficient

MBBS

Bachelor of Medicine, Bachelor of Surgery

MCQ

Multiple Choice Question

NMC

National Medical Commission

PAH

Pedagogy-Andragogy-Heutagogy

SDLRS

Self-Directed Learning Readiness Scale

SDT

Self-Determination Theory

STROBE

Strengthening the Reporting of Observational Studies in Epidemiology

DECLARATIONS

Conflict of interest: None.

REFERENCES

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