Objective To systematically review the teaching effects of problem-based learning (PBL) combined with lecture-based learning (LBL) versus lecture-based learning (LBL) teaching models on students in surgical clinical education in China. Methods Such databases as The Cochrane Library, PubMed, CNKI, WanFang Data and VIP were electronically searched for randomized controlled trials (RCTs) on PBL+LBL versus LBL applied in surgery education in China from inception to February 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results Fourteen RCTs including 1 386 students were included. The results of meta-analysis showed, compared with LBL, PBL+LBL were superior in basic knowledge of surgery (MD=3.33, 95%CI 2.07 to 4.60, P<0.000 01), case analysis (MD=5.90, 95%CI 2.61 to 9.19,P=0.000 4), clinical skills (MD=3.38, 95%CI 0.57 to 6.19, P=0.02), comprehensive performance (MD=7.15, 95%CI 3.87 to 10.43, P<0.000 1) and teaching satisfaction (OR=3.05, 95%CI 1.90 to 4.9,P<0.000 01) with significant difference. There was no differences in inquiry/physical examination/medical record between the two groups (MD=0.82, 95%CI 0 to 1.64,P=0.05). Conclusions PBL+LBL teaching method is superior to LBL in surgical clinical education in China. Large-scale and high quality randomized controlled trials are needed to confirm the above conclusions.
Objective?To assess the effect of problem-based learning (PBL) to improve clinical practice skills for clinical students after graduation. Methods?Computer retrieval was conducted to search for controlled studies comparing PBL with non-PBL. The quality of the included studies was critically evaluated and data were analyzed. Results?A total of 16 articles were included. The results showed that in integrated capabilities, PBL teaching was superior to traditional teaching methods. Whether in self-evaluation or objective evaluation, in terms of legal and ethical aspects of health care, research and presentation skills and ability to solve problem, PBL teaching was superior to non-PBL-learning methods. But in other aspects, it was yet controversial whether PBL-learning was better than non-PBL-learning. Conclusion?Problem-based learning could improve clinical practice skills for clinical students after graduation. However, most trials included are of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.
ObjectiveTo explore the effectiveness of problem-based learning (PBL) during the internship process for undergraduates in general medical colleges and universities. MethodsFrom September 2011 to September 2012, PBL mode teaching was carried for the five-year undergraduates, in which students were encouraged to explore, innovate, and put forward questions by themselves, and teachers were responsible for guiding. Based on entrance theoretical examination results and the comprehensive evaluation results, the grade 2008 undergraduate interns who received "3+2" two-phase teaching were divided into experimental group and control group with 50 students in each. Students in the experimental group were given the PBL teaching method, while the control group continued to receive traditional teaching mode. Finally, we adopted questionnaire survey, theory exam, and skill evaluation to compare the two groups of students. ResultsFor the questionnaire survey, students in the experimental group got significantly higher marks in such items as "mutual assessment between teachers and students" and "skill operation knowledge mastery" than the control group (P<0.05), but in items like "medical ethics" and "social cultivation", the differences were not significant (P>0.05). For the theory exam results, the average score for students in the experimental group (84.98±9.78) was not significantly different from that in the control group (81.86±10.04) (P>0.05). For the skill operation, the average score for the experimental group was 8.87±0.89, which was significantly higher than that for the control group (6.80±1.46) (P<0.05). ConclusionPBL mode is worth popularizing for its function of improving students' practical operation ability and thinking ability. However, the improvement of theoretical knowledge learning needs to be further solved.
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.
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.
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.
ObjectiveTo compare the effect of problem-based learning (PBL) and traditional teaching method (lecture-based learning) on clinical practical teaching of orthopedic surgery. MethodsBetween May 2012 and December 2013, 55 orthopedic interns were chosen to be divided into two groups: PBL group (n=29) and traditional lecture group (control group, n=26). Case report and examination on a completion of orthopedic surgery were used to assess the teaching outcomes. ResultsPerformance differences in content of presentation and capability of answers to questions were significant between PBL group and the traditional group in the report test (P<0.05). The test scores of case analysis examination in PBL group were significantly higher than those in the traditional lecture group (P<0.05). There was no significant difference between the two groups in other types of questions (P>0.05). ConclusionThe participants in PBL group have performed significantly better in culturing clinical thinking and comprehensive analysis, competence and in no circumstance did they perform worse than traditional lecture method.
Outcome-based education (OBE) emphasizes student learning outcomes as the core, utilizing a backward design approach to construct the curriculum. In teaching practice based on OBE, teachers need to develop a blueprint in advance that is closely aligned with the content of the teaching, aiming to promote deep learning and ensure that students can fully demonstrate their learning outcomes. Electroencephalogram (EEG) is a widely used technology in the field of neuroscience, and the special EEG changes convey a variety of information, which is crucial to the study of diseases. However, due to its specialization and learning difficulty, EEG teaching has been facing many challenges. Under the guidance of OBE concept, traditional knowledge lecture and problem-based learning (PBL) are organically integrated, combined with case analysis and flipped classroom teaching mode, which are applied in EEG teaching practice, in order to obtain more ideal teaching effect.
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.
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.