When drugs speak: an exploratory convergent mixed-methods study of a first-person creative narrative activity for anti-seizure medication pharmacology in undergraduate medical education

Background Anti-seizure medications (ASMs) are difficult to teach. Their mechanisms overlap, their indications cross over, and their adverse effect profiles are long enough that students often default to rote memorisation. Conventional revision -re-reading notes, highlighting, rehearsing lists -keeps facts available for recall but does little to embed them in a usable framework, and it rarely engages retrieval practice or elaborative encoding in any deliberate way. To our knowledge, no prior study has evaluated structured first-person creative writing as a pharmacology learning activity within a formal mixed-methods design. We therefore designed and evaluated When Drugs Speak , a 30-minute, zero-cost classroom activity in which students write from the point of view of an ASM. Methods We recruited second-year MBBS students at the Department of Pharmacology, JIPMER Karaikal, India. Of 60 students enrolled, 56 took part (93.3%) in a 30-minute session combining brief self-directed revision with free-format first-person creative writing about a chosen ASM. The design was an exploratory convergent parallel mixed-methods study, following Creswell and Plano Clark. Immediately after the activity, students completed a six-item binary (yes/no) feedback form capturing their perceptions of the session. Separately, two investigators carried out an inductive thematic analysis of all 56 handwritten narratives using Braun and Clarke's six-phase approach, supported by a cohort-level rubric covering six pharmacological domains. The two strands were analysed on their own terms and then brought together through a Joint Display. Ethical approval was obtained from the Institutional Ethics Committee for Observational Studies, JIPMER, Puducherry (JIP/IEC-OS/2024/628, dated 08 May 2025), and the study follows the COREQ and GRAMMS reporting guidelines for its qualitative and mixed-methods components respectively. Results All 56 participants returned complete feedback forms and narratives. Endorsement on the perception survey was consistently high: 96.4% said they preferred the activity to conventional revision, 96.4% felt it improved their retention, 92.9% reported increased interest in pharmacology, 96.4% found it broke the monotony of revision, 85.7% felt their conceptual understanding had improved, and 92.9% wanted it included periodically in the curriculum. The thematic analysis produced five themes - the drug became a character, mechanism moved from textbook to story, adverse effects became memorable warnings, the narratives encouraged clinical reasoning, and the act of writing itself gave students a sense of ownership over the material. When the two strands were placed side by side in a Joint Display, the qualitative themes mostly expanded on what the survey numbers showed rather than simply confirming them - together they point to retrieval practice, elaborative encoding, and narrative schema-building as plausible mechanisms behind the perceived benefit, none of which passive revision typically engages. Conclusions A structured first-person narrative writing activity appears feasible, costs nothing to run, and was well received by students, who reported high engagement and perceived learning benefit. The mixed-methods integration points to specific mechanisms - emotionally anchored adverse-effect recall, mechanism-driven comprehension, and spontaneous clinical reasoning - that may underlie these perceptions, though pharmacokinetic content came through less consistently and would benefit from additional reinforcement. Larger, multi-site studies with objective outcome measures and longer follow-up are needed before efficacy claims can be made.