Objective To evaluate the feasibility and significance of problem-based learning (PBL) in orthopedic internship. Methods A total of 315 students in grade 2002 were involved in PBL during their internship in the Department of Orthopedics at the First Affiliated Hospital of China Medical University, Shenyang, China. Teaching effectiveness was evaluated with a questionnaire and an ability examination. The results of PBL teaching during different semesters were compared, and the feasibil ity and significance of PBL were analyzed. Results Students who participated in PBL were in a dominant position and were more active in the learning process. The PBL pattern could improve students’ ability to identify, analyze and solve problems, and also contribute to fostering and enhancing their clinical thinking. This could help them solve the problems that emerged from the theory curriculum.Conclusions The PBL pattern used in the orthopedics internship has advantages and practical significance, which are applicable in modern medical teaching practice.
Objectives To train postgraduate medical students the ability of effectively using network resources and independently studying, and to explore new model of clinical liver cancer teaching. Methods The teaching model of problembased learning (PBL) to clinical liver cancer teaching was applied. Results The teaching model of PBL changed graduate student the status of passive acceptance to active participation. The teaching process was full of livingness, and the teaching quality was improved.Conclusion The teaching model of PBL can break through the limitations of passive acceptance of book knowledge in traditional teaching model and improve the ability to handle the comprehensive clinical knowledge of liver cancer, which provides a new model to the teaching of liver cancer to graduate medical students in clinic.
ObjectivesTo systematically review the application of evidence-based medicine (EBM) combined with problem-based learning (PBL) method in clinical teaching.MethodsDatabases including WanFang Data, CNKI, VIP, CBM, PubMed and EMbase were searched to identify eligible randomized controlled trials that compared EBM plus PBL with traditional lecture based learning (LBL) method in clinical teaching from inception to March 28th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. Statistical analysis was performed using Stata 14.0 software.ResultsA total of 33 randomized controlled trials with 2 855 students were included. The results showed that students in EBM combined with PBL group obtained better scores of specialized theory (WMD=6.87, 95%CI 5.08 to 8.66, P<0.001), skills examination (WMD=10.57, 95%CI 8.98 to 12.16, P<0.001) and case analysis (WMD=9.79, 95%CI 4.71 to 14.88, P<0.001), comparing with those in LBL group. Besides, EBM combined with PBL method improved students’ overall ability including independent learning capability, clinical thinking ability, problem-solving capability, literature exploring capacity, communication and presentation skills and team-work ability.ConclusionsApplication of EBM combined with PBL method can improve clinical teaching quality.
The main approaches to medical education reform that have been introduced elsewhere in the world, including the integration of basic and clinical sciences into organ-based model, the establishment of a Center for Faculty Development and problem-based learning (PBL) have been introduced to the College of Medicine, Chung Shan Medical University (CSMU) since the mid 1990s. The process of developing the PBL approach can be divided into the following stages: Observation (1994-2000): In this stage, CSMU observed the practice and effectiveness of PBL programs in other domestic and foreign medical schools. At the same time, we assessed the possibility of introducing PBL to Chung Shan. When the authority decided to introduce PBL, a PBL committee was inaugurated. Preparation (2000-2002): In this stage, tutor training took place, as well as PBL case writing workshops to reach consensus among the faculty. To reduce the total amount of curricula and traditional teaching hours, we combined and simplified related curricula, so that one and half weekdays were reserved for PBL tutorials and students’ self-study. A preliminary course about how to learn well, including the philosophy and methodology of learning as well as evidence-based medicine (EBM), was integrated into premedical curricula. Practice (2002-2004): In light of the number of trained tutors and written cases that have been prepared, and the desire that the PBL would be successful from the start, CSMU chose to introduce PBL to the clinical curricula first in a hybrid curriculum design. This meant that the traditional teaching was retained at the beginning. Evaluation of PBL by the students was done at the end of each semester. Tutor meetings were held twice per semester. Advancement (2004-2006): In this stage, PBL was introduced to the basic medical curricula as well as to the premedical general curricula. Based on our experience and comprehensive evaluation, a PBL guidebook for tutors and students has been published and delivered to both groups. We also developed an on-line evaluation system containing the evaluation forms for students and tutors. Excellence (2006 onwards): In this stage, the PBL website and learning resources will be further developed, and we are designing the system for on-line PBL practice.In conclusion, the introduction to PBL for medical education is reasonable and feasible. It requires b administrative support, a long-standing and high commitment of the PBL committee, consensus among the faculty and an appropriate planning and evaluation mechanism.
Objective To explore the short term and long term effectiveness of the problem-based learning (PBL) in clinical skill training. Methods A total of 162 clinical medicine undergraduates in Grade 2003 (7-years study) and 2004 (5-year study) who were supposed to intern in the internal medicine departments were randomly divided into the PBL group (n=75) and the control group with traditional training (n=87) for having their clinical skills training. Then t test was applied to compare the two groups about the scores of intern rotation examination and graduate OSCE as well. Results About the baseline: the students in the two groups got similar scores in their internal medicine exam before clinical intern rotation (84.04±7.40 vs. 82.63±8.77, P=0.287). About the short term effectiveness: compared to the control group, the students in the PBL group got higher subjective evaluation from their supervised clinicians (P=0.006). In writing examination, the students of those two group got similar scores in knowledge part (54.17±9.26 vs. 51.67±9.56, P=0.92), while the PBL group won in case reasoning question (20.39±5.27 vs. 16.51±4.90, Plt;0.001). About the long term effectiveness: in the graduate OSCE, the two groups got similar scores in skills operation such as punctures and lab results analyses (P=0.567 and P=0.741), while the students in the PBL group had better performance at the case reasoning and standard patients treating (75.59±9.85 vs. 71.11±12.01, P=0.027). Conclusion With the great short term and long term effectiveness, the PBL applied in the clinical skill training improves the students’ ability of both synthesized analyses and the integrated clinical skills such as clinical thinking and interpersonal communication, but doesn’t aim at the basic knowledge and operation skills.
ObjectivesTo systematically review the efficacy of problem-based learning (PBL) model in clinical oncology teaching.MethodsPubMed, EMbase, CNKI, WanFang Data, CBM databases were electronically searched to collect randomized controlled trials (RCTs) of PBL model used in clinical oncology teaching in China from January, 2000 to March, 2019. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 and Stata 12.0 software.ResultsA total of 29 RCTs involving 2 238 subjects were included. The results of meta-analysis showed that: PBL model in clinical oncology teaching was superior to traditional lecture-based learning (LBL) model on the total score (MD=6.50, 95%CI 4.44 to 8.55, P<0.000 01), theoretical knowledge score (MD=4.58, 95%CI 3.38 to 5.78, P<0.000 01), case analysis score (MD=4.26, 95%CI 3.38 to 5.78, P<0.000 01), skill operation score (MD=6.10, 95%CI 4.77 to 7.43, P<0.000 01), overall course satisfaction (RR=1.74, 95%CI 1.34 to 2.27, P<0.000 01), increased learning interest (RR=1.52, 95%CI 1.28 to 1.81, P<0.000 1), improved teamwork cooperation (RR=1.67, 95%CI 1.39 to 2.01, P=0.002), and improved self-study ability (RR=1.51, 95%CI 1.20 to 1.90, P<0.000 1), the differences were statistically significant.ConclusionsCurrent evidence shows that the PBL model can improve clinical teaching effect of oncology and learning satisfaction. Due to limited quality and quantity of the included studies accumulated, more high quality studies are required to verify above conclusion.
ObjectivesTo compare the role of problem-based learning (PBL) combined with team-based learning (TBL) methods with traditional lecture-based learning in the clinical probation teaching of bone tumor and explore which teaching method is more suitable for clinical probation teaching of bone tumor.MethodsThe 60 students of the 2013 grade five-year program medical students in West China Clinical College of Sichuan University who were undergoing clinical probation teaching in the orthopedic bone tumor subspecialty of West China Hospital of Sichuan University in April 2017 were randomly divided into 2 groups. The trial group adopted PBL combined with TBL teaching method, the control group adopted traditional teaching method. The general situation of the two groups of students were compared. After the end of the probation, the two groups of students’ knowledge mastery, comprehensive ability and satisfaction were compared.ResultsThere was no significant difference in the gender composition and the assessment scores of the last semester diagnostics course of the two groups of students (P>0.05). After the probation, in terms of knowledge mastery, the trial group’s theoretical test scores (89.13±3.47 vs. 87.03±2.99; t=2.511, P=0.015), teacher evaluation (88.33±4.48 vs. 85.90±3.96; t=2.231, P=0.030) and student evaluation (89.83±2.97 vs. 87.47±2.91; t=3.117, P=0.003) were better than those of the control group. In terms of comprehensive ability, the trial group’s ability in reasoning and induction, information management, goal completion, and communication (17.90±1.09, 18.00±0.91, 18.00±1.02, 17.90±1.13) were better than those of the control group (17.20±1.13, 17.13±1.20, 17.10±1.24, 16.83±1.29), the differences were statistically significant (P<0.05). There was no statistically significant difference in satisfaction between the two groups of students (P>0.05).ConclusionsPBL combined with TBL methods can improve the effect of clinical probation of bone tumors, deepen mastery of professional knowledge, improve comprehensive ability, and improve teaching quality.
Objective To evaluate the effect and significance of PBL in clinical skills experiment teaching center (CSETC). Methods A total of 60 undergraduates in major of clinical medicine were divided into two groups according to their student ID. The control group (n=30) was set in an ordinary small classroom, while the experimental group (n=30) was in CSETC for fully using the teaching resources there. Both groups were taught with PBL method by same teachers, and the integrated final examination and questionnaire were adopted to evaluate the teaching effect. SPSS was used for statistical analysis. Results All 8 participated teachers believed that carrying out PBL in CSETC could promote teachers’ professional development, alleviate the shortage of teachers and classroom, increase the utilization ratio of CSETC, and improve the teaching quality. The results of survey on students showed that, compared with the control group, information management ability and clinical skills of students were improved obviously (Plt;0.01). Although there was no difference in total score of final exam, the experimental group was markedly higher than the control group in the score of clinical skill subject (Plt;0.01). Conclusion Carrying out PBL in CSETC can improve teaching quality, and clinical skills and information management ability of students. It is helpful to alleviate the shortage of teachers and classroom, and promote the teaching standards of CSETC.
Objective To diversify the methods of human physiology teaching for medical students at Chang Gung University College of Medicine. Methods We divided the grades of semester evaluation for physiology into two parts: 70% for lecture-examinations, 30% for non-examination-associated learning model including oral presentation of a scientific paper (conference), problem-based learning (PBL) performance, and quizzes. Results By a questionnaire survey at the end of the semester, we found that students were willing to spend time preparing non-examination-associated learning model; and from their own evaluations, the effectiveness of non-examination-associated learning was comparable to lecture-examination methods. Conclusion We conclude that from this analysis of students’ learning attitude and actual time (in hours per week) spent in each learning models, non-examination-associated learning model is well accepted and appeares to be as effective as traditional examination-forced study.
The evaluation of student performance is an important but difficult part of the implementation of problem-based learning (PBL). This article introduces the background to the reform of evaluation in PBL, analyzes the principles of such evaluation, and gives a critical review of the methods applied in the reform of student evaluation in PBL, so as to help medical schools adopt practical and efficient evaluation methods.