The student-led seminar is an approach where postgraduate students take an active role in designing, organizing, and leading seminars or group discussions. Each student is responsible for selecting a topic, conducting relevant research, and preparing a presentation or discussion materials. During the seminar, students present their findings and facilitate discussions among their peers. ⁵ This method encourages student autonomy, research skills, and critical thinking. It also provides an opportunity for postgraduate students to develop presentation and communication skills while exploring topics of interest in depth.

End posting examination was conducted for the postgraduates to evaluate the effectiveness of the student centric methods. Feedback was obtained from the postgraduates on the student centric methods.

In a study by Suter B et al., first year medical students were educated on the process of connecting pertinent biochemical mechanisms, histological observations, and anatomical characteristics with clinical indications and manifestations. This enabled them to effectively diagnose conditions and propose appropriate courses of treatment for cervical adenocarcinoma. 8 In a study by Flowers M et al., students completed the Self-Assessment of Clinical Reflection and Reasoning, Physical Therapy Self-Efficacy Scale, and Health Science Reasoning Test during the first and last weeks of the semester which demonstrated significant increase in self-perceived clinical reasoning and self-efficacy among those who received high dose experiential learning compared to low dose experiential learning. 9

In our study the Pathology residents conveyed that experiential learning by analyzing laboratory data of the cases; fostered critical thinking and problem-solving abilities as they analyzed complex data, consider differential diagnoses, and make informed decisions.

Experiential learning empowers pathology residents to develop diagnostic skills by directly observing and analyzing histopathological changes fostering the ability to differentiate these conditions and recognize characteristic features, and enhancing their capacity to correlate histopathological findings with clinical presentations.

By flipping the traditional learning model, in which students passively receive information during lectures and then complete assignments at resident hostel, pathology residents can actively engage with the material, collaborate with peers, and apply their knowledge in a practical context.

In a study by Maness HTD et al., the department of pathology at the University of Florida developed and implemented a training program to address the needs of current students, faculty, and staff in the upcoming field of pathology informatics. The program consisted of three one-credit courses designed with a flipped classroom approach. To evaluate the program's effectiveness, a unique survey instrument was used to assess each course, and follow-up interviews were conducted with six participants six months after completing the program. The courses successfully achieved their objectives, although there is room for improvement. Key factors that positively influenced the program included collaborative learning and the inclusion of real-world practice problems. The program also resulted in improved communication with informatics colleagues and enhanced job task efficiency and effectiveness. ¹⁰

Similarly, in our study the flipped classroom approach for studying organ function tests offered pathology residents several benefits. It promoted active learning through pre-class activities and individual pacing, allowing residents to engage deeply with the material. In-class time was dedicated to interactive discussions, collaborative activities, and practical exercises that enhance critical thinking and real-world application. Residents received immediate feedback, benefitted from multidisciplinary perspectives, and had continued access to learning resources in the Department and Central library. The flipped classroom approach maximized residents' understanding, retention, and practical skills related to organ function tests.

In a study by Vij V et al., an active-learning strategy called Student-Led Seminar Series (SLSS) was implemented as a substitute for passive learning in traditional tutorial classes in the subject of physiology. Over a 4-month period, the effectiveness of the SLSS program was evaluated and statistically significant improvement in student satisfaction and self-perceived increase in knowledge, skills and attitude was reported. ¹¹

In our study, Pathology residents benefited from student-led seminars focused on urinalysis and instrumentation of colorimeters, spectrophotometers, and high-performance liquid chromatography (HPLC). Firstly, taking the lead in preparing and delivering seminars enhanced their understanding of the subject matter as they delved into the details, critically analyzed concepts to synthesize knowledge. Secondly, these seminars fostered peer learning and collaboration, allowing residents to share expertise, exchange ideas, and broaden their understanding through discussions and interactions with their peers. Additionally, leading seminars helped residents develop communication and presentation skills, which are vital for effective communication in their future pathology practice. Practical application of knowledge was also emphasized through hands-on examination in the central diagnostic laboratory, enabling residents to confidently and accurately interpret the investigations. Lastly, the "learning by teaching" effect ensures long-term retention of knowledge as residents reinforce their understanding, organize information, and enhance their retention through actively teaching others during the seminars.

The constructivist learning model known as the "5 E" model, which consists of the stages Engage, Explore, Explain, Elaborate, and Evaluate, aligns well with the principles of constructivism and provides a framework for effective learning experiences. ⁶

Jensen JL et al conducted a study using a quasi-experimental design to compare the effectiveness of an active non-flipped classroom and an active flipped classroom, both employing the 5-E learning cycle. The aim was to isolate the role of the instructor as the main variable while controlling for other potentially influential factors. The results indicated that both conditions yielded similar outcomes in terms of low-level and deep conceptual learning. Furthermore, attitudinal data showed that students expressed equal satisfaction with the course in both settings. Interestingly, both groups ranked their contact time with the instructor as more influential to their learning than the activities they performed at home. ¹²

In our study each stage of the 5 E model was adapted to enhance the pathology postgraduates learning experiences:

In India, Postgraduate medical education programs have embraced a competency-based curriculum that outlines required skills, with competency-based assessments involving active self-assessment, peer assessment, and feedback processes, aligning with defined competencies and enabling learners to showcase their skills in real clinical contexts. ^{13, 14}

Postgraduate students can benefit from mentorship and coaching, where experienced faculty or clinicians can guide and support their learning journey. ¹⁵ Mentors or coaches can provide feedback, career guidance, and support for professional development. ¹⁶

Learners can be encouraged to reflect on their learning experiences and provide feedback on the curriculum, teaching methods, and assessments. This feedback can help educators to refine the curriculum, teaching strategies, and assessments to better meet the needs of learners. ¹⁷ Student-centered learning (SCL) prioritizes the role of the student in shaping educational policies, practices, and decision-making. SCL recognizes the importance of involving students in meaningful ways, empowering them to take ownership of their learning journey and fostering a collaborative and engaging educational environment. ¹⁸

A small sample size may result in limited variation in responses, limiting the depth and breadth of the data collected. In qualitative research, data saturation, the point at which no new information or themes emerge from the data, may be more challenging to achieve with a small sample size. The limited number of participants may not provide enough diverse perspectives and experiences to reach data saturation. However, the homogeneity of the study group and focused research objectives facilitate the extrapolation of findings to other studies.

This study was conducted based on the principles of the Declaration of Helsinki. Before the study, the approval of the Institutional Ethics Committee of Sri Devaraj Urs Medical College (No.DMC/KLR/IEC/440/2021-22) was obtained.

All the authors participated in the process of the initial writing of the manuscript, its revision, presentation of the idea and initial design, and collection and analysis of data. Moreover, all authors accept the responsibility for the accuracy and correctness of the contents of the present manuscript and approve the final version of the manuscript.

This article was the result of a qualitative study approved by Sri Devaraj Urs Medical College constituent college of Sri Devaraj Urs Academy of Higher Education and Research. The authors would like to express their appreciation and gratitude to the Department of Pathology and all the Pathology Junior Residents who participated in this study.