CONTENTS

Page

1. Subject Review Process 2

2. Brief History of the University, Faculty and the Department 3

3. Aims and Learning Outcomes 3

4. Findings of the Review Team 14

4.1. Curriculum Design, Content and Review 14
4.2. Teaching, Learning and Assessment Methods 15
4.3. Quality of Students including Student Progress and Achievements 16
4.4. Extent and Use of Student Feedback, Qualitative and Quantitative 17
4.5. Postgraduate Studies 17
4.6. Peer Observation 18
4.7. Skills Development 18
4.8. Academic Guidance and Counseling 19

5. Conclusions 19

6. Recommendations 22

7. Annexes 24
1. SUBJECT REVIEW PROCESS
The Quality Assurance and Accreditation (QAA) framework currently implemented in the
University system in Sri Lanka, envisages reviewing all subjects/programmes and institutions
in the national Universities of Sri Lanka. In keeping with this objective, the Quality
Assurance and Accreditation (QAA) Council of the University Grants Commission, Sri
Lanka appointed a team of senior academics from the Universities of Kelaniya, Ruhuna and
Sri Jayawardenepura to undertake a subject review in Parasitology at the Faculty of
Medicine, University of Peradeniya.
The Review Team comprised of:
Prof. Nilanthi de Silva (Review Chair)
Prof. Nelun de Silva
Prof. Sriyani Ekanayake
The subject review was undertaken to evaluate the quality of the Parasitology teaching
programme at the Faculty of Medicine University of Peradeniya. The review visit was carried
out by the above team from 12 – 14 March 2007 (see Annex 1 for programme). The process
used was acquisition of additional information through discussion of issues, and gathering of
and analysis of evidence. These findings were then compared with the Self Evaluation Report
(SER) presented by the Department of Parasitology (DP).
The aim was to use all evidence to make a judgment as required by the Quality Assurance
Programme on the quality of the eight review aspects listed below, as given in the Quality
Assurance Handbook, for Sri Lankan Universities, published by the CVCD and UGC in July
2002:
1. Curriculum Design, Content and Review
2. Teaching, Learning and Assessment Methods
3. Quality of Students, including Student Progress and Achievements
4. Extent and Use of Student Feedback (Qualitative and Quantitative)
5. Postgraduate Studies
6. Peer Observation
7. Skills Development
8. Academic Guidance and Counseling
The Faculty is in the process of changing its MBBS curriculum at present. Students in the
first and second years of study are following the new curriculum, while the more senior
batches are following the old curriculum. The teaching programme for the last batch of
students on the old curriculum has been completed, and students are awaiting their end-of-
course examination. Currently, there are 2 batches of students on the new curriculum, and
both 1st and 2nd year students receive inputs from the DP. Thus the review process covered
both programmes.
The review processes adopted by the Review Team were:
• meetings with the Vice-Chancellor; Dean; Head of DP; academic and non academic
staff in the DP; Senior Student Counselors in the Faculty; and undergraduate and
postgraduate students (see Annex 2 for complete list of persons met during the visit).

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 • observation of teaching/learning sessions – 2 lectures for 2nd year students on the
new curriculum and one laboratory demonstration of learning material on infective
agents for self study by students
• inspection of academic facilities: lecture halls, tutorial rooms, laboratory and learning
support facilities (library and e-library).
• perusal of documents (curriculum documents, timetables, handouts, examination
papers, samples of answer scripts, records etc.).

2. BRIEF HISTORY OF THE UNIVERSITY, FACULTY AND THE DEPARTMENT

University of Peradeniya commenced with the inception of the University of Ceylon, on 1st
July 1942 and shifted to Peradeniya on 6th October 1952. It is now one of the largest
universities in the country, with over 10,000 internal students registered for its academic
programmes in seven faculties and two postgraduate institutes.
The Peradeniya Medical School was established in 1961 and the first batch of 103 students
was admitted in January 1962. The Peradeniya Medical School and Dental School were
converted to an independent Medical and Dental Faculty in 1967. The School of Veterinary
Science became a part of the Faculty in 1970. In 1980, Veterinary Medicine and Animal
Science were separated to form a new Faculty of Veterinary Medicine and Animal Science.
The Dental School became a separate Faculty in 1986. The Teaching Hospital, Peradeniya,
the most significant addition to the Faculty of Medicine in recent years, was opened in June
1980. Currently, the Faculty has 15 Departments of study, including the DP, and 2 Units.
The DP was one of the initial departments that comprised the Faculty at its inception in 1963.
The DP contributes to the MBBS degree programme. The Parasitology teaching programme
for students on the old curriculum is in the 3rd year of the MBBS programme. The last batch
of students on the old curriculum (2003/04 intake, 194 students) have currently finished their
teaching programme and are on study leave prior to end-of-course examinations in April
2007. For students on the new curriculum, departmental teaching activities will extend
throughout the first four years of study. Currently, there are 184 students in the 2nd semester
of the 2nd year (2004/05 intake, new curriculum) and 200 1st year students (200 students,
2005/06 intake).
The DP has cadre provision for one Chair and 4 other academic posts; these are occupied by
1 Senior Professor, 2 Merit Professors, and 2 Senior Lecturers. One of the Senior Lecturers is
due to go on post-doctoral training overseas this year, while all 3 senior staff members are
due to retire by the end of next year. Steps have been taken to advertise two positions in
anticipation of these changes.
Support staff in the DP includes a Chief Technical Officer, 4 Technical Officers (including
one computer technician), 1 clerk and 2 laboratory attendants. All non-academic staff
positions are filled at present.

3. AIMS AND LEARNING OUTCOMES

Old Curriculum
The stated learning objectives for the Parasitology programme for students on the old MBBS
curriculum, as given in the SER, are listed below.

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Subject Matter
1. Protozoology: Malaria; amoebiasis; giardiasis; balantidiosis; trichomoniasis; leishmaniasis;
trypanosomiasis; toxoplasmoais: Sarcocystis infection; intestinal
coccidioses; pathogenic free-living amoebae.
2. Helminthology: Intestinal nematode infections; lymphatic filariasis; onchocerciasis;
loaiasis; Dirofilria infection; tape worm infestations; fluke infestations;
trichinosis; guinea worm infestation; larva migrans.
3. Entomology: Mosquitoes; sand fly; house fly; tsetse fly; fleas; bugs; lice; ticks and mites.
4. Miscellaneous: Snakes; zoonoses; insecticides and vector control.

Learning Aids: Three terms work consisting of 28 lectures (45 minutes each); Tutorials:
approximately 20 hours; Practicals: 60 hours of practica1s (students in two
groups)

Objectives
At the end of the course, student should be able to

1. Protozoology
1.1. Malaria
• name the human malarial parasites and indicate the two species found in Sri Lanka.
• describe the life cycle with stages find events in chronological order.
• identify these stages on a slide.
• stain a thin blood film with Leishman stain and identify the erythrocytic stages of P.
falciparum, P. vivax and P. malariae.
• describe the pathological and clinical consequences of the erythrocytic cycle.
• describe briefly the immune responses to the malarial parasite.
• indicate the stages in the life cycle where preventive measures are applicable and
briefly describe these measures.
• describe the geographical distribution of malaria in Sri Lanka.
• name the vector(s) in Sri Lanka.
• describe the seasonal incidence of the disease.
• name the drugs used and their sites of action.

1.2. Amoebiasis, giardiasis and balantidiosis

• list the common intestinal protozoa found in man and indicate the pathogenic parasities
• describe the two morphological forms of Entamoeba histolytical, Giardia lamblia and
Balantidium coli met with clinically.
• recognize these forms on a slide.
• name the sites in the human body where these parasites can be found.
• describe the clinical consequences of the presence of these parasites at these sites.
• describe the mode of infection
• describe collection of a specimen of stools for examination in amoebiasis.
• describe the preventive measure applicable to each parasite.

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1.3. Trichomoniasis
• identify Trchomonas vaginalis on a saline smear and on a fixed, stained smear.
• name the sites in the human body where the parasite is found
• describe the pathogenic effects of this parasite.
• describe the mode of infection

1.4. Trypanosomiasis and leishmaniasis

• name the parasites and the diseases caused by each
• name the vectors of trypanosomiasis and leismaniasis
• describe the geographical distribution of each disease
• identify the organisms on a slide

1.5. Toxoplasmosis
• name the parasite that causes toxoplasmosis
• identify the parasite in a smear
• describe the life cycle of Toxoplasma gondii
• describe the mode of transmission
• describe the laboratory diagnosis
• outline the preventive measures applicable to this disease

1.6. Sarcocystis infection

• identify Sarcocystis in a smear or tissue section
• recognize a Meischner's tube
• identify the habitat of this parasite
• name the pathological lesion caused by this parasite

1.7. Intestinal coccidioses

• name the parasites that cause intestinal coccidioses in man
• describe their mode of transmission
• describe their laboratory diagnosis
• identify the parasites in laboratory specimens

1.8. Pathogenic free-living amoebae

• name (to genus level) the free-living amoebae that are pathogenic to man.
• outline the clinical consequences of infection with these amoebae.
• outline their mode of transmission.
• describe their laboratory diagnosis.

2. Helminthology
2.1. Intestinal nematode infections (Ascaris lumbricoides, hookworms, Strongyloides
stercoralis, Trichuris trichiura, Enterobiuss vermicularis)
• name the pathogenic intestinal nematodes found in man.
• name the common habitat of each.
• describe the mode of infection in each parasite.
• outline the stages in the life cycle of each.

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 • describe the clinical consequences of these stages in man.
• identify the adult worms.
• make faecal smears in iodine and saline to demonstrate helminth ova (and protozoal
cysts).
• identify the ova on a slide.
• describe the methods of diagnosis.
• describe the preventive measures applicable to each parasite.

2.2. Lymphatic filariasis

• name the filarial worms that infect man in Sri Lanka.
• name the vectors in each case.
• describe the distribution of filariasis in Sri Lanka.
• outline the stages in the life cycle.
• describe the clinical consequences of the stages in man.
• make a thick blood film and stain with Delafield haematoxylin stain to demonstrate
microfilaria.
• identify the microfilaria of Wuchereria and Brugia on a blood film.
• indicate the site in the life cycle where preventive measures are applicable and briefly
describe these.
• describe the control programme carried out in Sri Lanka.
• describe the aetiology of tropical eosinophilia syndrome.
• list the clinical features of the condition.

2.3. Onchocerciasis and loaiasis

• name the parasites that cause these diseases.
• outline the clinical consequences of infection with these filarial worms.
• name (to genus level) the vectors of these parasites.
• describe the geographical distribution of these diseases.

2.4. Animal filarial infections

• name the animal filarial worm that can cause disease in man in Sri Lanka.
• outline the clinical consequences of infection with this parasite.

2.5. Tape worm infestations

• identify the scolices of Taenia saginata. T. solium. Hvmenolepis nana, H.. diminuta.
Diphyllobothrium latum.
• recognize and differentiate the gravid segments of T. saginata and T. solium.
• identify the adults of Taenia species, Echinococcus granulosus., H. nana and H.
diminuta.
• identify the larval stages of Taenia species and E. granulosus.
• identify the ova of Taenia species, H. nana, H. diminuta.
• name the definitive hosts in T. saginata. T. solium. E. granulosus, H. nana H. diminuta
and D. latum.
• outline the life cycle in each case, indicating where preventive measures are applicable.
• describe cysticercosis in man.
• outline the geographical distribution of human hydatidosis.

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 • describe the sylvatic cycle of E. granulosus in Sri Lanka.

2.6. Fluke infestations

• name the flukes pathogenic to man.
• identify adult specimens of these flukes.
• outline the life cycle of each fluke.
• outline the preventive measures applicable in each.
• identify the ova of Clonorchis sinensis and the schistosomes of man
• describe the sylvatic cycle of Paragonimus westermani in Sri Lanka.

2.7. Guinea worm

• identify the adult worm.
• identify the intermediate host.
• outline the life cycle.
• describe the pathological lesion produced by this parasite.
• outline the preventive measures.

2.8. Trichinosis
• recognize the larval stage of Trichinella spiralis.
• outline the life cycle.
• describe briefly the clinical manifestations.
• outline the preventive measures.

2.9. Cutaneous and visceral larva migrans

• identify the nematodes and the stages in the life cycle that cause these diseases in man.
• describe the pathological lesions in these two conditions.
• describe the clinical consequences of infection

3. Entomology
3.1. Mosquitoes I
• list the diseases in Sri Lanka where mosquitoes act as a vector and name the vector(s)
in each case.
• identify an adult male and a female mosquito.
• recognize the mouthparts of a mosquito.
• outline the life cycle of a mosquito.
• differentiate between an adult anopheline and a culicine mosquito.
• recognize a mosquito larva if shown specimens.
• differentiate between an anopheline and a culicine larva.

3.2. Mosquitoes II
• identify the adults of the following mosquitoes: Anouheles. Culex fatigans, Mansonia
uniformis, M. annulifera, Ades aegypti, Aedes albopictos.
• describe the habits and breeding places of the above mosquitoes.
• identify the eggs of these Anopheles, Culex, Mansonia, Aedes mosquitoes
• identify the larvae of these mosquitoes.

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 • describe the control measures applicable to each of these mosquitoes.

3.3. Fleas
• identify the adults of Pulex irritans. Xenopsylla astia. X. Cheopis. Ctenoqephalides sp.
(cat and dog fleas) and Nosopsylia sp. (rat flea).
• outline the life cycle of a flea.
• describe the medical importance of fleas, indicating the species responsible in each
case.
• name the vectors that transmit bubonic plague to man.
• describe the mechanism of transmission of plague by the flea.
• list the reasons for X. cheopis being a more efficient vector than X. astia.
• describe the epidemiology of plague.
• describe the control measures applicable to plague.

3.4. Ticks
• recognize a tick when shown a specimen.
• list the important differences between hard ticks and soft ticks.
• identify a hard tick and a soft tick.
• distinguish between Argas persicus and Ornithodoros if given specimens.
• outline the life cycle of a soft tick and that of a soft tick.
• name the diseases transmitted to man by these ticks and indicate the species in each
case.
• describe the modes of transmission in each of these diseases.

3.5. Mites and scabies

• name the causative organism of scrub typhus and scabies.
• describe the geographical distribution of scrub typhus.
• name the endemic areas in Sri Lanka.
• identify an adult ma1e and female of Sarcoptes scabiei and the adult of a trombiculid
mite.
• identify the larva of a trombiculid mite.
• describe the habitat of the scabies mite in man.
• describe the clinical consequences of its presence in man.
• describe the treatment and control of scabies.
• outline the control measures in scrub typhus.

3.6. Dipteran flies of medical importance and myiasis.

• name the diseases transmitted by the sand fly and the tsetse fly.
• describe the mechanisms by which the house fly transmits disease.
• identify adult specimens of sandfly, tsetse fly, house fly, Sarcophaga and Chrysomyia.
• identify the wing of a house fly and a tsetse fly.
• identify maggots of a dipteran fly.
• describe the life cycle of the house fly.
• describe the methods of control of house flies.
• define myiasis and describe it, giving examples.

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3.7. Lice
• identify the adults of Pediculus humanus and. Pthirus pubis.
• describe the medical importance of the head louse.
• name the diseases transmitted by the body louse.
• describe the mechanism of transmission in each disease.
• outline the life cycle of a louse
• name the habitat in the human body of each species.
• identify the egg of a louse.
• describe the treatment and control of pediculosis and infection with pthirus pubis.

3.8. Bugs
• identify an adult bed bug and a reduviid bug.
• name the habitat of bed bugs and the medically important reduviid bugs.
• name the disease transmitted by reduviid bugs.
• describe the mode of transmission.
• describe the medical importance of bed bugs.
• outline the life cycle of a bed bug.
• describe the control of bed bugs.

4. Miscellaneous
4.1. Snakes
• name the poisonous snakes found in Sri Lanka.
• name the important non-poisonous snakes found in Sri Lanka.
• recognize each if given a specimen.
• list the districts in which the poisonous snakes are commonly found in Sri Lanka.
• name the type of venom toxicity in each case.
• describe the clinical manifestations resulting from the bites of these poisonous snakes.
• outline the management and treatment in these cases.

4.2. Zoonoses
• define a zoonosis
• describe the different types of zoonosis
• name the important zoonotic diseases in the world
• name and describe the parasitic zoonoses in Sri Lanka

4.3. Vector control and insecticides

• list the different methods available for the control of medically important arthropods.
• list the different groups of insecticides.
• describe the insecticidal action of each group.
• name the insecticides in common use belonging to each group.
• list the advantages and disadvantages of each of these
• describe the different methods of insecticide formulation.
• describe the different methods of insecticide application.

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New Curriculum
The learning objectives related to Parasitology, for 1st and 2nd year students on the new
MBBS curriculum are listed in below. These were obtained from the documents presented by
the department staff during the review visit.

Year 1: Infection, Immunity and Barrier Tissues

At the end of the module, student should be able to
Concepts: Introduction to Microbiology: An Overview
Objectives: 1. understand the interactions of microorganisms with human beings
2. state why medical undergraduates need to know about microorganisms
3. understand what medical microbiologist does
Concepts: Proving Causations of Infection - Causality - Koch's Postulates and Its Limitations
Objectives: 1. state Koch's postulates and their limitations
2. discuss how causal associations can be proved in infective diseases
Concepts: Microbial Classification and Visualization
Objectives: 1. describe the basis of microbial/parasitic classification (viruses, bacteria, prions,
atypical agents, fungi, parasites)
2. state the means by which microorganisms/parasites can be visualized
Concepts: Host parasite Relationships
Objectives: 1. describe the different ways in which microorganisms relate to the human host
2. define the terms infection, disease
Concepts: Microbial Growth, Dissemination and Survival Within and Outside the Human
Host
Objectives: 1. describe the dynamics of growth in different types of micro-organisms (e.g.:
Virus, Bacteria, and Parasites)
2. list the different ways in which microorganisms survive for long periods
within and outside the human host
Concepts: Macro-Parasitic Growth, Dissamination and Survival Within and Outside the
Human Host
Objectives: describe how microorganisms dissaminate within and outside the human host
Concepts: Methods of Preventing Infections
Objectives: describe the modes of transmission of the organisms /agents listed in 2005-
1/SBM-7/03-1
Concepts: Diagnostic Procedures in Infective Diseases
Objectives: 1. outline the process by which an aetiological diagnosis can be made
2. describe the relavance by making an aetiological diagnosis
3. state the limitations of the diagnostic procedure

Year 2 Foundation Module 2: Scientific Basis of Ill Health

At the end of the module, student should be able to
Concepts: Infections
Objectives: Recall
1. the terms infection, infestation, disease, incubation period, host, pathogen,
virulence, zoonoses

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 2. the spectrum of ionfective agents and their major morphological and
biological characteristics that determine visualization/identification in the
laboratory
3. the different modes of transmission of these agents to humans including
source(s), entry into and exit from the human body.
4. the principles of the different mechanisms by which infective agents cause
disease.
5. the principles underlying prevention of infection and ill health due to these
agents
Concepts: Animal Bites and Stings
Objectives: 1. state the common animal bites in Sri Lanka
2. state the primary and secondary effects of animal bites
3. name the organisms that cause secondary infections of the animal bites
4. state the common marine animal and arthropod stings
5. list the effects of stings
Concepts: Poisonous Snakes and Envenomation
Objectives: 1. state how snakes are classified into poisonous and non-poisonous
2. name the poisonous snakes found in Sri Lanka
3. name common (important) non-poisonous snakes in Sri Lanka
4. recognize these (2&3) if shown a specimen/an image (see demonstration on
snakes
5. state the major effects of snake venom in the different groups of poisonous
snakes in Sri Lanka
6. state the principles underlying the treatment and management of snake bites.
7. state how snake bites can be prevented
8. recognize medically important snakes of Sri Lanka if shown specimens or
images
Concepts: Biological Properties (Structure and Function) of Different Groups of Micro and
Macro Organisms
Objectives: appreciate how biological properties of the different groups of micro/macro
parasites determine the causation, diagnosis, management, prevention and
control of major infective disease in humans
Concepts: Protozoa Introduction
Objectives: list the different characteristics of the different groups of Protozoa
Concepts: Sporozoa- Plasmodium
Objectives: 1. list the human malarial parasites indicating the species found in Sri Lanka
2. describe the life cycle with stages and events
3. name the vector(s) in Sri Lanka
4. identify stages that cause pathogenic effects
5. outline laboratory methods of visualization/identification of organism
6. identify points in the life cycle (lc) where preventive measures are applicable
Concepts: Protozoa (flagellates) - Leishmania
Objectives: 1. outline their life cycle indicating stages that cause pathogenic effects
2. outline laboratory methods of visualization/identification of organism
3. identify points in the life cycle where preventive measures are applicable
Concepts: Protozoa- Amoebae
Objectives: name amaoebae that parasitize humans

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Concepts: Toxoplasma & Cryptosporidium
Objectives: 1. identify those tht cause human disease
2. state sources of infection, entry and exit of agent in each
3. outline their LC indicating stages that cause pathogenic effects
4. outline laboratory methods of visualization/identification of organism
Concepts: Protozoa- Ciliates
Objectives: name the ciliate that cause human disease
Concepts: Balantidium Coli
Objectives: 1. state sources of infection, entry and exit of agent in each
2. outline their LC indicating stages that cause pathogenic effects
3. outline laboratory methods of visualization / identification of organism
4. identify points in the lc where preventive measures are applicable

Year 2: Infection Immunity & Barrier Tissues

At the end of the module, student should be able to
Concepts: Helminths-Intestinal Nematodes; Ascaris, Necator, Trichuris, Enterobius
vermicularis, Strongyloides stercoralis
Objectives: 1. list the different groups of parasitic helminths
2. list the major characteristics of parasitic nematodes
3. list the common intestinal nematodes in humans
4. outline the LCs with stages and events
5. write a comparative account of the different LCs.
6. state the stages that cause pathogenic effects and identify those stages of
diagnostic importance
7. outline laboratory methods of visualization/identification
8. identify points in the LC where preventive measures are applicable
Concepts: Tissue Nematodes-Filarial Parasites
Objectives: 1. name the major tissue nematodes of humans indicating their location in the
human body
2. list the major characteristics of the filarial parasites of humans indicating those
found in SL
3. name the vectors of those parasites found in Sri Lanka.
4. outline the LC of W. bancrofti with stages and events
5. describe the phenomenon ‘periodicity of microfilaria’
6. state the stages that cause pathogenic effects and identify those stages of
diagnostic importance
7. outline laboratory methods of visualization/identification
8. identify points in the LC where preventive measures are applicable
Concepts: Cestodes -Taenia solium, T. saginata, Hymenolepis diminuta, H.nana,
Echinococcus granulosus
Objectives: 1. list the major characteristics of the different groups of parasitic cestodes of
humans indicating those found in Sri Lanka
2. outline the LCs with stages and events
3. state the stages that cause pathogenic effects and identify those stages of
diagnostic importance
4. outline laboratory methods of visualization/identification of organism
5. identify points in the LC where preventive measures are applicable

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Concepts: Trematodes Intestinal, Tissue and Blood Trematodes
Objectives: 1. list the major characteristics of the trematodes of medical importance
indicating those found in Sri Lanka
2. outline the LC of a trematode and that of a blood fluke with stages and events
3. state the stages that cause pathogenic effects and identify those stages of
diagnostic importance of the major trematodes of humans
4. outline laboratory methods of visualization/identification of organism
5. identify points in the LC where preventive measures are applicable
Concepts: Arthropods - Mosquitoes
Objectives: 1. list the major characteristics of the different groups of arthropods of medical
importance
2. list the major characteristics of the different groups of mosquitoes
3. list the major mosquito bone diseases Globally
4. list the mosquitoes of medical importance in Sri Lanka indicating the diseases
they transmit
5. outline the LC of a mosquito with stages and events
6. recognize LC stages in those of major medical importance in Sri Lanka
7. describe the breeding habits of the medically important mosquito species in
Sri Lanka
8. outline the strategies used for control of these mosquito species in Sri Lanka
Concepts: Flies
Objectives: 1. list the dipteran flies of major medical importance globally and those found in
Sri Lanka
2. describe the medical importance of dipteran flies as vectors of diseases and in
myiasis
3. outline the LC of a house fly with stages and events
4. describe the breeding habitats of flies of medical importance in Sri Lanka
5. identify preventive and control methods used against these insects
Concepts: Fleas, Lice and Bugs
Objectives: 1. list the medical importance of fleas, lice and bugs and name those of medical
importance of Sri Lanka
2. name the fleas transmitting plague
3. describe the mechanisms of transmission of plague by fleas
4. identify preventive and control methods that are used against these insects
Concepts: Ticks & Mites
Objectives: 1. list the major characteristics of ticks & mites
2. state the medical importance of ticks and mites
3. list the major diseases transmitted by ticks and mites globally and identify
those relevant to Sri Lanka
4. identify preventive and control methods that are used against these arthropods

Foundation 3 Module: Basic laboratory Skills in Parasitology

At the end of the module, student should be able to,
Concepts: Basic Laboratory Bench Skills in Infective Disease Diagnosis
Objectives: 1. effectively use a compound light microscope to visualize infective agents and
diseased tissue under different magnifications (X100,X400,X1000)
2. make wet faecal smears in iodine and saline and identify parasitic stages

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 3. identify malaria parasites in a stained thin blood film

4. FINDINGS OF THE REVIEW TEAM

4.1 Curriculum Design, Content and Review

Old Curriculum
Under the old curriculum, 3rd year students followed a traditional course in medical
parasitology: students learned about parasites that affect humans and arthropod vectors from
a disease perspective. Detailed learning objectives that specify the required knowledge and
practical skills have been identified and repeatedly revised at periodic intervals since the
1980s. These learning objectives were included in the handouts that are given to students.
New Curriculum
The document titled ‘Curriculum Revision 2006 of the Faculty of Medicine, University of
Peradeniya’ states that “… Beyond 2004 denotes the revised curriculum of the faculty that
incorporates changes suggested by the World Federation of Medical Education (WFME)
2003: conforming to the needs and demands of the modern world… As opposed to traditional
methods of teaching, the new curriculum focuses mainly on early clinical relevance, self-
directed learning, professional development and community oriented learning”.
The new curriculum is conducted on a semester system, with credit rated modules, and
assessment based on Grade Point Averages.
The streams that constitute the MBBS programme during the first eight semesters are:

SBM – Scientific Basis of Medicine – providing the knowledge base to perform the
CLM skills

CLM – Clinical Laboratory Management – imparting clinical, laboratory and patient
management skills

CLR – Communication, Learning and Research – Improving communication skills,
English proficiency, web based learning and Research skills

DIS – Doctor in Society – Empowering doctors role in society in relation to
population issues and judicial medicine issues.

HCT – Hospital Community based Training.

YES – Year –end Extra Semester Programme
The teaching activities involving the DP are in two streams: SBM and CLM. The detailed
learning objectives for both streams are given in a document that is made available to all
students through the Faculty website. In the first two years, much of the Parasitology input
occurs through the SBM stream; in the 3rd and 4th years, the teaching will be through the
CLM stream.
In the new curriculum, the discipline of medical parasitology has been merged with that of
microbiology into a composite infective diseases programme with inputs commencing in the
1st year, and going on until the 4th year, instead of being limited to the 3rd year, as in the past.
The overall aim is to introduce concepts, definitions and principles underlying infective
disease in the 1st year; to introduce systematics of infective agents in the 2nd year; and specific
diagnostic laboratory skills in the 3rd year. The study of infective disease is incorporated into
the different system-based modules, while major multi-system disease and special topics

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relating to infective disease, diagnosis, prevention and control are to be taken up as special
learning topics.
This approach has many positive aspects: it enables the holistic study of infective agents,
their morphological and biological properties, interactions with the host, disease outcomes
and prevention and control from a comparative perspective. The approach overcomes the
traditional, artificial division of infective agents (based on their size) into microbiology and
parasitology. The practice of introducing basic concepts in the 1st year, and then re-visiting
the disease agents and diseases at increasing levels of complexity over a 4-year period is
likely to encourage deeper learning among students.
However, because learning activities that were previously concentrated into one year are now
spread out over 4 years, great care needs to be taken in ensuring that staff and students are
clear about what is expected of students at each level of learning. Also, because the
systematics of infective agents are taken up separately from the disease conditions they cause,
staff need to take care in ensuring that students appreciate the clinical relevance of what they
learn in the 1st and 2nd years.
The judgment of the Review Team on this aspect is GOOD.

4.2. Teaching, Learning and Assessment Methods

Old curriculum
The teaching/learning programme consisted of 28 lectures of 45 minutes each, 3 - 5 tutorials
and 12 - 15 hours of practicals per student, over the course of 3 terms. The lectures are
delivered as PowerPoint presentations using other visual aids. Handouts are given to students
to supplement the lectures and practical skills. E-Learning facility and videotapes are
available for the students. Tutorials are conducted by dividing the batch into 6 groups.
Questions or special topics are given prior to the tutorial class and the academic staff
members discuss the answers with the students. Laboratory classes and demonstrations
provide the students an opportunity to acquire practical skills. Assessment methods consist of
continuous assessments held at the end of first and second terms and an end of year
examination. One-hour theory paper consisting of 2 essay questions is given for the first
continuous assessment and a spot test (20-25 spots) for the second continuous assessment.
The end of the course evaluation comprises a 2-hour theory paper with 4 essay questions, a
spot test of 20 spots, a 40-minute practical exam and a viva-voce examination (10 minutes
per student).

New curriculum
The contents and subject matter of the new curriculum are the same as the old curriculum but
have been merged with Microbiology into an infective disease programme. The inputs
commence from the first year and spreads over the first 4 years. Learning objectives are
module-based. In the first year, concepts, definitions and principles underlying infective
diseases are introduced. In the second year systematics of infective diseases are introduced.
Systematics of infective agents and diseases are to be taught in the third year with emphasis
on specific diagnostic laboratory skills. Evaluation includes formative assessment for each
module and summative assessment at end of each year. Each assessment consists of theory
questions (SAQs and MCQs of both True/False and Best Answer types) and OSPE where
relevant.
In both old and new curricula, the teaching learning activities are most appropriate for the
specified learning outcomes. It was clear that the staff take a lot of trouble in preparing

15
teaching materials of all sorts: lectures, handouts, bench aids, instructional videos, and CDs
for self-study and self-assessment by students. It is to the great credit of the DP that despite
perennial financial constraints within the university system, they have managed to obtain a
variety of different types of equipment for teaching in the student laboratory (which is shared
with the Microbiology Dept), and maintained them in working condition.
However, the Review Team noted with concern that the 60 microscopes used by students are
all more than 10 years old now; and that all departmental staff (academic and non-academic)
have to share just 3 computers and one laser printer. The Team also noted that the department
has access to only one tutorial room, which is shared with the Departments of Community
Medicine and Microbiology.
The range of assessment tools also matches the expected learning outcomes, in both old and
new curricula. However, students following the new curriculum seem to be burdened with a
large number of end-of-semester assessments (run over 7 – 8 days), and it is possible that
when all students in the faculty are on the new curriculum, staff will find it difficult to cope
with such a large volume of assessment. Furthermore, some important exam regulations have
not yet been finalized. The second year students expressed some concern that although they
are aware that they have to face a bar at the end of the current semester, they have not yet
been informed of the exact manner in which this bar will be implemented. However, the
Review Team is cognizant of the fact that these issues are not the direct responsibility of the
DP, but of the Faculty as a whole.
The Review Team rates this aspect of the DP as SATISFACTORY.

4.3. Quality of Students, including Student Progress and Achievements

Old curriculum
Under the old curriculum, the continuous assessments carried 15% of the marks; the essay
paper 45% of the marks; the practical examination 30% of the marks and the viva voce
examination 10% of the marks. Students were required to obtain an overall average of 50% or
more in order to pass Parasitology, and 70% or more to be awarded a Distinction. The
progress of students for the past few years in Parasitology is shown in Table 1.
As Table 1 shows, the proportion of students referred in Parasitology is relatively low: 15%
or less. Between 3 – 15% of students have been awarded Distinctions each year. Analysis of
the marks obtained in the individual components of the examination indicated that while the
average mark for the end-of-course theory paper was 47 – 49%, the average mark for the spot
test was much higher (64 – 74%). This reflects the fact that most students who failed did so
because of low marks in the theory paper. The SER attributes this relatively poor
performance in answering essay questions to poor command of the English language and
inadequate essay writing skills.
Table 1: Performance of Students in Parasitology Examinations
Year Total marks Total marks Referrals (total Distinctions
≥60% 50 – 59% marks <50%)
2003 53.2% 31.3% 8.5% 5.2%
2004 47.8% 31.6% 5.6% 15.1%
2005 32.5% 50.1% 13.9% 3.5%

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New curriculum
Only one batch of students has undergone Parasitology-related assessments under the new
curriculum. These are incorporated in the relevant end-of-semester examinations. An analysis
of marks obtained by 2nd year students in the Semester 1 assessment of the Foundation 2
module indicated that students achieved a mean score of 64.4% in the 8 assessment items
relating to Parasitology.
The Review Team is of the opinion that the Quality of Students, including Student
Progress and Achievements is GOOD.
4.4. Extent and Use of Student Feedback (Qualitative and Quantitative)
The documentation provided to the reviewers, the presentation of the Head of the DP,
discussions held with students and staff, indicated that there is a comprehensive mechanism
in place in the DP to obtain quantitative feedback from students on a regular basis in the
undergraduate as well as the postgraduate degree programmes. The documents scrutinized
contained well-structured questionnaires for all aspects of teaching and learning and analysis
of feedback obtained as charts. Quantitative feedback has been used by the majority of the
academic staff to obtain feedback from students from the 1990’s. Feedback has been obtained
on individual teachers during lectures and on practicals and demonstrations conducted in the
department.
The undergraduate student ratings for lectures and tutorials have been very good on aspects
such as capturing their attention, creating an interest in the subject and creating a friendly
environment, clarity and confidence. Good ratings were given for the teachers in the DP for
being accessible and punctual, student friendly, thoroughness in the subject matter and
treating students fairly. However the scores were marginally satisfactory in terms of
encouraging active learning during lectures. Though there was no documentation of the
outcomes of these evaluations, there was evidence of progressive improvements taking place
in the teaching learning activities through subsequent student evaluations.
The postgraduate teaching learning programmes too have been evaluated regularly from 1996
to 2006 and very good ratings have been given by the postgraduates for organization of the
training programme, academic and technical staff assistance during practical sessions.
However the Review Team noted that the DP has not used qualitative feedback from the
students in terms of formal staff, student department meetings and liaison committees. The
Team wishes to recommend initiation of qualitative feedback and establish a formal
mechanism to facilitate bilateral communication.
The Review Team judges this aspect as GOOD.

4.5. Postgraduate Studies

Postgraduate studies in the DP are carried out through the appropriate Boards of Study of the
Postgraduate Institute of Medicine (PGIM), University of Colombo, Postgraduate Institute of
Science (PGIS) and Postgraduate Institute of Agriculture (PGIA) University of Peradeniya.
Their most significant contribution to postgraduate studies is the training of postgraduate
students in MD Parasitology, Diploma in Medical Microbiology in collaboration with the
PGIM, University of Colombo. In addition the DP offers its major contribution in terms of a
two-week course for the M.Sc. course in Medical Microbiology, a new course conducted by
the PGIS, University of Peradeniya.
The documentation provided to the reviewers indicated that there has been a continuous
stream of postgraduate students working in the DP from 2000. They included students who

17
followed MD Parasitology programme, Diploma in Medical Microbiology, Post MD
Parasitology training programme, MPhil and PhD. research programs. From 2000 to 2006
there has been two PhD and four MPhil research students who have successfully completed
their degrees. There has been an input into the MSc course in Integrated Water Resources
Management of the PGIA in 2003/04. The DP has also made contributions to the Practical
and Tropical Pediatrics component of James Cooke School of Public Health and Tropical
Medicine, Australia.
The Review Team is satisfied that the DP possesses a sufficient infrastructure, facilities and
equipment to conduct postgraduate research and provide a dedicated supervisory service to
all postgraduate students.
It is the view of the Review Team that the status of Postgraduate Studies of the DP can be
judged as GOOD.

4.6. Peer Observation

Procedures for observing teaching by peers have not been established in the DP from its
inception. However there seems to be an informal tradition of peer observation of lectures in
the department. Junior lecturers regularly sit in at senior lecturers’ and professorial lectures of
the department. The Head of the DP reviews junior lecturers’ lecture content prior to the
lecture. Constructive criticism is encouraged from junior as well as senior colleagues.
Recently the teachers in the department realized the need for such appraisals to enhance the
teaching quality and have initiated such practices in the teaching learning activities of the
new curriculum with structured questionnaires developed by the Department of
Microbiology.
After introduction of the new curriculum, a formal process of peer review has been set up
within the Medical Faculty. The original SER did not contain any information regarding this
aspect of the review. The documents provided subsequently included information regarding
peer review of 3 lectures by a non-departmental staff member. The reviews were performed
using a structured assessment form with an overall judgment regarding the teaching session.
The reviewer was from the department of Microbiology and his comments suggest that the
quality of lectures was excellent and that peer review is a useful experience for improving
teaching the content areas that are shared by these two departments. The DP should attempt
to continue this process, extend it to other teaching/learning methods and obtain the views of
colleagues from other departments regarding the quality of teaching offered by its staff
members.
The Review Team was provided with the completed peer evaluation forms with comments.
The Review Team was impressed by the cooperation of the academic staff in the
implementation of an effective peer observation process for the future.

The Review Team judges this aspect as SATISFACTORY.

4.7. Skills Development

Opportunities are provided for undergraduate students to develop personal and subject
specific skills under both the old and the new curricula. In the undergraduate programme the
subject specific skills (practical skills) are incorporated into the academic programme.

18
Old curriculum
In the old curriculum the course provides practical training throughout the parasitology
programme conducted during the third year of the curriculum. These include skills in
examining stained blood film, preparation and examinations of faecal smears, use of
microscope and identifying protozoan/helminths infecting humans and vectors of medical
importance. Students who fail the end of course examinations are given the opportunity to
relearn skills by way of revision practical sessions. There is evidence that communication
skills are strengthened in the old curriculum. In tutorial classes the students are given topics
and questions and are given an opportunity to discuss and present.

New curriculum
In the new curriculum, basic laboratory bench skills in infective disease diagnosis are to be
taught in Year 3. These skills are to be taught in the foundation and the infection and
immunity modules in the CLM stream. Four hours/student are allocated for training students
to attain these skills. In addition laboratory facilities with technical assistance will be made
available during time allocated for independent learning throughout the semester for practice
of specific skills. The evaluation will be done at the end of the semester and will be on an
OSPE format. In the new curriculum communication, learning and research skills and web
based learning skills are included in a separate stream referred to as the CLR stream.
It is the view of the Review Team that the Skills Development in the DP can be judged as
GOOD.

4.8. Academic Guidance and Counseling

In the old curriculum the students whose performance is poor in their end of term tests and
those failing the end of course examinations are called up for discussion and given a feed
back regarding their performance. Theory papers are handed over to the students for their
scrutiny. Students who are weak in their English and language writing skills are referred to
the ELTU directly or through student advisors. In the new curriculum the students can seek
advise from the Academic Committee for academic guidance.

The Review Team judges this aspect as GOOD.

5. CONCLUSIONS
1. Curriculum Design, Content and Review
Strengths/Good Practices
1. The overall MBBS curriculum has been changed to focus on early clinical relevance,
self-directed learning, professional development and community-oriented learning.
2. Monitoring and revision of the Parasitology curriculum has taken place on a regular
basis in the past; the parasitology input in the new curriculum appears to be well
thought out, and as such it is likely to work well.
3. The new curriculum design enables the holistic study of infective agents, their
morphological and biological properties, interactions with the host, disease outcomes
and prevention and control from a comparative perspective.

19
 4. The practice of introducing basic concepts in the 1st year, and then re-visiting the
disease agents and diseases at increasing levels of complexity over a 4-year period is
likely to encourage deeper learning among students.
Weaknesses
None of note with current level of implementation of new curriculum

2. Teaching, Learning and Assessment Methods

Strengths/Good Practices
1. Copies of lectures presentations are made available at the e-library for students to
refer.
2. Handouts supplementing lectures are regularly updated
3. A MCQ Bank with both multiple true/false and best answer type questions has been
initiated for the new curriculum
4. Students are given an opportunity to observe written comments made by academic
staff in their answer scripts and spots discussed following completion of tests, so that
students can learn from their mistakes
Weaknesses
1. Lack of space to conduct tutorials
2. Lack of resources – inadequate computers and printers to prepare teaching material
3. Too many exams are conducted at the end of the semester under the new curriculum
4. Students following the new curriculum were uncertain of the nature of the bar at the
end of the second year.
5. About 7 modules are scheduled for each semester, and as a result there is no
flexibility in re-arranging lectures if they are missed due to strikes etc.

3. Quality of Students, including Student Progress and Achievements

Strengths/Good Practices
1. The proportion of students referred in Parasitology under the old curriculum is
relatively low and has remained so over the last three batches of students.
2. Average student performance in the Parasitology component of the Foundation 2
module assessment was good.
Weaknesses
None of note

4. Extent and Use of Student Feedback

Strengths/Good Practices
Use of comprehensive, well-structured questionnaires to obtain student feed back on teacher
evaluation on a regular basis

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Weaknesses
Absence of a formal Student-Staff Liaison Committee and qualitative feedback

5. Postgraduate Studies
Strengths/Good Practices
Involvement of the staff in postgraduate training programmes of the PGIM, University of
Colombo, PGIS and PGIA, University of Peradeniya
Weaknesses
None

6. Peer Observation
Strengths/Good Practices
Commencement of peer observation of lectures conducted by all the teachers in the
Parasitology Department, by someone outside the department
Weaknesses
Lack of evidence of peer observation practices as part of the routine practices of the structure
of the department

7. Skills Development
Strengths/Good Practices
1. Equipment for learning practical skills is available in the Department and include
microscopes, a visual presenter, TV monitor, Microscope with video and camera
attachment
2. Video programmes and CD for demonstration of laboratory skills have been prepared
and are available to the students
Weaknesses
1. Microscope numbers are inadequate for the large number of students; only 60
microscopes are in satisfactory condition; and the newest among them are over 10
years old
2. Funds are not available for maintenance of equipment and for purchase of spare parts.

8. Academic Guidance and Counseling

Strengths/Good practices
The Departmental staff offer specific academic guidance to weak students who have
difficulty in passing examinations
Weaknesses
None

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Based on the observations made during the visit by the review team and discussed above, the
eight aspects were judged as follows:

Aspect Reviewed Judgment Given

Curriculum Design, Content and Review Good
Teaching, Learning and Assessment Methods Satisfactory
Quality of Students, including Student Progress and Achievements Good
Extent and Use of Student Feedback Good
Postgraduate Studies Good
Peer Observation Satisfactory
Skills Development Good
Academic Guidance and Counseling Good

The overall judgment is suspended

6. RECOMMENDATIONS

1. It is recommended that all staff members of the DP agree about the different levels of
knowledge and skills required of students at different stages of learning under the new
curriculum; and that this is clearly conveyed to students.
2. The departmental staff and the Curriculum Coordinating Committee (CCC) may
consider obtaining qualitative feedback on the teaching programme from students, in
addition to the quantitative feedback that is already obtained. If the CCC retains
responsibility for obtaining all student feedback, specific feedback could be sought on
departmental level inputs in order to facilitate any remedial measures that may be
required.
3. The DP may consider extending the recently introduced practice of intra-departmental
peer observation and feedback to include all staff members, junior and senior.
4. It is recommended that the Faculty take cognizance of the fact that departments such
as Parasitology, which are responsible for conducting laboratory based teaching
activities, require extra financial support for purchase and maintenance of laboratory
equipment (such as microscopes) as well as items such as computers and printers
which are essential for development of subject-specific and generic skills.
5. Departmental recommendations regarding purchase of such items of equipment that
they deem most appropriate for their needs should be given serious consideration.
6. Timetabling of the teaching learning activities in the new curriculum need to be
incorporated some leeway to cope with unexpected problems such as non-academic
staff strikes, etc.
7. It is recommended that the Faculty ensure that students are made aware of regulations
pertaining to bar examinations well in advance of the implementation of such bars.

22
8. The Faculty may wish to consider reducing the number of end-of-semester
examinations in the new curriculum since they are very stressful for students and will
place a heavy workload on staff when all batches of students have switched over to
the new curriculum.

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7. ANNEXES
ANNEX 1. PROGRAMME FOR THE REVIEW VISIT
Day 1: Monday, 12.03.2007
8.15 – 8.45 am Meeting of QAAC Representative with Review Team
8.45 – 9.15 am Observe teaching: Lecture on Intestinal Nematodes for Y2 students
by Prof Sarath Edirisinghe
9.15 – 9.30 am Discuss Review visit programme with Head of Dept
9.30 – 10.15 am Meeting with Vice-Chancellor and Dean / Medicine
10.15 – 10.30 am Tea
10.30 – 12.00 pm Presentation on Self-Evaluation Report by Head of Dept
12.00 – 12.30 pm Observation of facilities: dept labs, e-library and main library
12.30 – 1.30 pm Lunch
1.30 – 2.30 pm Perusal of documents
2.30 – 3.30 pm Meeting with non-academic staff
3.30 – 4.30 pm Meeting with academic staff
4.30 – 5.00 pm Meeting with 3rd year students (old curriculum)

Day 2: Tuesday, 13.03.2007

8.00 – 9.00 am Observe teaching: Lecture on Cestodes for Y2 students by Dr
Devika Iddawela
9.00 – 10.15 am Perusal of documents
10.15 – 10.30 am Tea
10.30 – 12.30 am Perusal of documents
12.30 – 1.30 pm Lunch
1.30 – 2.00 pm Observe teaching: Material on infective agents for student
generated learning activity
2.00 – 3.00 pm Meeting with 2nd year students (new curriculum)
3.00 – 4.00 pm Meeting of reviewers

Day 3: Wednesday, 14.03.2006

9.00 – 10.00 am Meeting with student counselors
10.00 – 10.15 am Tea
10.15 – 11.00 am Wrap-up meeting with Departmental staff
11.00 – 11.30 am Meeting of reviewers and report writing
11.45 – 12.30 pm Wrap-up meeting with Chairman, IQAU

24
ANNEX 2. LIST OF PERSONS MET BY THE REVIEW TEAM

1. Vice-Chancellor, University of Peradeniya

2. Dean, Faculty of Medicine, University of Peradeniya

3. Members of the academic staff in Department of Parasitology

Senior Professor and Head of Department

Professors - 2
Senior Lecturers – 3
Technical Officers – 5

4. Non-academic staff members in Dept of Parasitology

Chief Technical Officer
Technical officers - 4
Clerk – 1
Laboratory Attendants – 2

5. Groups of undergraduate students from 2nd and 3rd years of study and two
postgraduate students

6. Student Counselors: Deputy Proctor and 2 of the Senior Student Counselors in the
Faculty of Medicine

7. Chairman, Internal Quality Assurance Unit, University of Peradeniya and Medical

Faculty Representative in IQAU

25