Trial of integrated laboratory practice

In most laboratory practices for students in medical schools, a laboratory guidebook is given to the students, in which the procedures are precisely described. The students merely follow the guidebook without thinking deeply, which spoils the students and does not entice them to think creatively. Problem-based learning (PBL) could be one means for the students themselves to actively learn, find problems, and resolve them. Such a learning attitude nurtures medical students with lifelong learning as healthcare professionals. We merged PBL and laboratory practices to promote deep thinking habits and developed an integrated laboratory practice. We gave a case sheet to groups of students from several schools. The students raised hypotheses after vivid discussion, designed experimental protocols, and performed the experiments. If the results did not support or disproved the hypothesis, the students set up another hypothesis followed by experiments, lasting for 4 or 5 consecutive days. These procedures are quite similar to those of professional researchers. The main impact achieved was the fact that the students developed the experimental design by themselves, for the first time in their college lives. All students enjoyed the laboratory practice, which they had never experienced before. This is an antidote to the guidebook-navigated traditional laboratory practice, which disappoints many students. As educators in basic medical sciences stand on the edge in terms of educating the next generation, there is a need to provide a strong foundation for medical students to design and perform scientific experiments. The integrated laboratory practice may provide the solution.     

Back to the future? Active learning of medical physiology in the 1900s

In the early 1900s, teachers of medical physiology faced a problem familiar to those teaching the subject in a contemporary setting: too much information, too little time, too many students in crowded rooms, and exams that discouraged real learning. They wanted students to question authority and demand evidence and thus be better prepared for medicine. Their solution was to bring students into laboratories and minimize didactic learning as they felt strongly that useful information could not be obtained merely from books. Thus, they were strong proponents of what we now call active learning.     

医学生科研创新能力培养“3+X”模式的探索与实践

针对长期以来培养医学生的科研创新能力主要依靠零散的课外科研活动、受众面窄、没有系统性课程教学及其相关制度保障、致使对医学生科研创新能力培养明显乏力低效这一共性瓶颈教学问题,自2002年起,汕头大学医学院生物化学与分子生物学教学团队,在“科教相辅相佐”、“以学生为中心”、“以问题为导向”等先进教育理念指导下,倚重汕头大学医学院“医者之心”系列课程与书院育人文化之特色,发挥汕头大学的生物学、基础医学和临床医学一级学科均拥有本/硕/博/博后完整人才培养体系之优势,联合其他相关专业教学团队,在建立充分体现医学生科研创新能力培养内涵,覆盖医学本科5年全过程的核心课程体系的基础之上,历经20载的不懈努力,补充修善,成功构建了“3+X”模式,着力培养医学生的科研创新能力。所谓“3”意指对医学生的“全人培养”、“全程培养”和“全方位培养”。所谓“X”意指针对“3+X”模式运行效能的若干个验证性维度,主要包括组织医学生参加各种形式的全国大学生创新实验研究大赛、国际大学生学术研讨会,由医学本科生作为第一作者撰写发表学术论文等。培养医学生科研创新能力的成效十分显著,为有效解决上述共性瓶颈教学问题提供了一个有重要借鉴价值的范例。     

Toward meaningful learning in undergraduate medical education using concept maps in a PBL pathophysiology course

Problem-based learning (PBL) is now an established method in undergraduate medical education that aims to develop reasoning skills based on clinical problems. More recently, the use of concept mapping in medical education aims to improve meaningful learning. At the New University of Lisbon, we have been using PBL as a major educational method in a pathophysiology course. In 2003-2004, we started to use Inspiration, a computer-based concept mapping tool, with a single tutorial PBL group. A total of 36 maps were constructed related to short cases, already used in the PBL course, in which a certain number of key nodes were hidden to allow the students to fill in the gaps. The results obtained appear to indicate that the use of concept maps stimulated meaningful learning within a PBL course.     

PBL 结合案例教学法在病理生理学教学中的应用

以问题为基础(Problem-based learning,PBL)的教学法和案例教学法都是近年来我国医学教育改革中经常采用的两种新型教学方法。但二者从教学论方面来看,在教学材料的选择上、教学目的上都存在着差别。病理生理学是沟通基础和临床各学科间的桥梁学科,将"以问题为基础"的教学模式与案例教学法有机地结合引入病理生理学教学,符合病理生理学的学科特点,能够有效提高教学质量,在教育观念上更易于被医学生所接受,因而适应对高素质医学人才培养的需要。     

Combination of didactic lecture with problem-based learning sessions in physiology teaching in a developing medical college in Nepal

Physiology teaching as an essential part of medical education faces tremendous criticism regarding curriculum design, methods of implementation, and application of knowledge in clinical practice. In the traditional method of medical education, physiology is taught in the first year and involves little interdisciplinary interaction. The Manipal College of Medical Sciences, Pokhara, Nepal (affiliated with the Kathmandu Univ.) started in 1994 and adopted an integrated curriculum drawn along the lines of the student-centered, problem-based, integrated, community-based, elective-oriented, and systematic (SPICES) medical curriculum. Here, physiology is taught for the first 2 yr of the 4.5-yr Bachelor of Medicine, Bachelor of Surgery course. Methodology adopted is as follows. For a particular topic, objectives are clearly defined and priority content areas are identified. An overview is given in a didactic lecture class to the entire batch of 100 students. Tutorial classes are conducted thereafter with smaller groups of students (25/batch) divided further into five subgroups of five students each. In these sessions, a problem is presented to the students as a focus for learning or as an example of what has just been taught. Each problem was accompanied with relevant questions to streamline the students' thought processes. A tutor is present throughout the session not as an instructor but as a facilitator of the learning process. A questionnaire sought students' opinion on the usefulness of this approach, relevance of the combination of problem-based learning (PBL) sessions and didactic lectures in understanding a particular topic and relating clinical conditions to basic mechanisms, and improvement of performance on the university final examination. The majority of the students opined that the combination of didactic lectures and PBL sessions was definitely beneficial regarding all the above-mentioned aspects of learning. The university results corroborated their opinion. Thus it may be considered that a judicious mixture of didactic lectures and PBL sessions is beneficial as a teaching module of physiology in medical schools.     

Combination of didactic lectures and case-oriented problem-solving tutorials toward better learning: perceptions of students from a conventional medical curriculum

The Department of Physiology of Pramukhswami Medical College at Anand, Gujarat, India, started using problem-based learning in a modified way along with didactic lectures to improve students' understanding and motivate them toward self-directed study. After the didactic lectures were taken for a particular system, clearly defined short clinical problems related to that system were given to the students in the tutorial classes. Each tutor was assigned three to four groups of five to six students each. Problems were accompanied with relevant questions so as to streamline the thought processes of the first-year undergraduates. The tutor then facilitated the study process, and the students discussed among themselves to derive their solutions. At the end of the sessions, feedback was taken from the students through a planned questionnaire on a three-point scale. Of a total of 278 students over a span of 3 yr from 1999 to 2002, 74.4% of students favored a judicious mixture of didactic lectures and case-oriented problem solving in tutorial classes to be an efficient modality in understanding a system under study, and 84% of students stated the mixture of didactic lectures and case-oriented problem solving to be beneficial in relating a clinical condition to the basic mechanism; 82% of students believed that this module helped with better interactions among their batch mates, and 77.2% of students hoped to perform better in the university examination due to this new teaching/learning modality. They also expressed that this gave them ample motivation to do self-directed learning. It may therefore be concluded from the results of the present study that it is possible to have a problem-based learning module in the form of case-oriented problem-solving tutorials coexistent with the traditional didactic lecture module in the first year of medical education under a conventional curriculum.     

提高临床医学生微生物检验 见习教学质量的探索与实践

临床微生物室见习是临床医学专业学生了解微生物检验的重要窗口,提高其见习教学质量,使其认识到微生物检验在感染性疾病诊治中的作用。除了系统介绍临床微生物检验的工作内容及流程外,我们更注重临床医生与微生物检验的密切联系,强调临床医生对微生物检验前质量控制的重要性。案例教学法联合问题导向教学法,将临床感染病例与微生物检验紧密结合。举例讲解临床医生该如何正确解读微生物检验报告结果,从而合理选择抗菌药物进行有效的抗感染治疗。最后提醒临床医学生注意生物安全及医院感染的发生。通过我们的见习教学,临床医学生表示获益颇丰,意识到微生物检验对感染性疾病诊治的重要作用。     

PBL教学在高职院校食品微生物课程中的应用

PBL教学是以问题为载体,以学生为主体,突出能力培养目标的一种全新的教学模式。实践证明高职院校的食品微生物课堂融入PBL教学后,能充分发挥学生的主体性地位和教师的主导性作用,可大大提高学生的学习兴趣,培养学生自主学习和合作学习的能力,提高学生文献检索、分析总结等各项综合素质,取得了良好的教学效果。     

Too much teaching, not enough learning: what is the solution?

The curriculum is packed with so much content that teachers resort to telling students what they know and students simply commit facts to memory. The packed curriculum leaves little time for students to acquire a deep understanding of the subject or to develop life-long skills such as critical thinking, problem solving, and communication. However, learning is not committing a set of facts to memory, but the ability to use resources to find, evaluate, and apply information. This paper addresses these concerns by discussing "how we learn" and reviewing the literature on what works to improve learning. It is clear that active processing of information, not passive reception of information, leads to learning. That is, students must construct their own understanding of concepts, relationships, and procedures. Teachers can encourage this process by carefully considering the type and organization of information as well as instructional strategies. Specifically, teachers should reduce the total amount of factual information students are expected to memorize, reduce our use of the passive lecture format, and devote much more effort to helping students become active, independent learners and problem solvers. Collaborative learning activities, interactive models, educational games, and establishing a culture of inquiry/scholarship are critical for achieving these goals.     

Comparative evaluation of active learning and the traditional lectures in physiology: A case study of 200 level medical laboratory students of Imo State Unversity, Owerri.

Currently, understanding of Physiology and disease patterns is undergoing a fundamental paradigm shift with attendant shift in education of health professionals worldwide towards active learning to encourage exploration of connections and their relationships. We introduced problem-based learning to Physiology teaching of medial laboratory students to confirm worldwide reports that active learning environments offer better learning opportunities over the traditional methods which is the predominant teaching method in Nigerian universities. Our findings indicate that Problem-based learning increases students' attendance/participation in classes and performance in examination. We recommend the integration of active learning into physiology curriculum of Nigerian Universities.     

Teaching medical students basic neurotransmitter pharmacology using primary research resources

Teaching pharmacology to medical students has long been seen as a challenge, and one to which a number of innovative approaches have been taken. In this article, we describe and evaluate the use of primary research articles in teaching second-year medical students both in terms of the information learned and the use of the papers themselves. We designed a seminar where small groups of students worked on different neurotransmitters before contributing information to a plenary session. Student feedback suggested that when the information was largely novel, students learned considerably more. Crucially, this improvement in knowledge was seen even when they had not directly studied a particular transmitter in their work groups, suggesting a shared learning experience. Moreover, the majority of students reported that using primary research papers was easy and useful, with over half stating that they would use them in future study.     

LBL结合PBL在物理诊断教学过程中的初步探索

目的:比较传统教学模式和问题教学法及二者结合教学法的不同优劣势,找出物理诊断学最佳教学方法。传统教学模式采用授课为主的教学法(lecture based learning,LBL),单单强调了教师的重要性,而忽视学生的主观能动性,不利于调动和培养学生自学和灵活运用所学知识的能力。问题教学法(Problem-based learning,PBL),其强调学生自身的主观能动性,弱化了教师在教学中的主体地位,学生有偏离教学主线的风险。因而如果将LBL与PBL有机结合在一起,将可能有利于提高学生的学习效率和学习效果。方法:选取97名全科医学本科学员,在物理诊断课程教学过程中,采用完全随机的方法分为2组,采用LBL教学方法组48人,采用LBL结合PBL教学方法组49人,通过分别对理论、实践分层打分,确定优秀、合格、不合格的比率,采用Mann-Whitney U检验最终评定2组教学方法的授课效果。结果:在理论考试中,2组学员在优秀、合格、不合格的分层评定上均无明显差异(P0.05),而在实践考核中,LBL+PBL组学员成绩在优秀这一分层评定中,优于LBL组,差异具有统计学意义(P0.05)。结论:LBL和PBL教学方法结合应用于物理诊断教学中,符合物理诊断教学的特点,更容易被学生接受,对于知识的识记和应用更有好处,从而更利于培养高素质医学人才,值得在物理诊断教学中进一步推广。     

PBL教学模式在内科临床教学的应用探讨

内科是临床科室的重要组成部分,内科教学是为培养医务工作者的重要步骤,是医学生由学生向医生角色转变的桥梁。传统临床教学以知识灌输为主,学生学习积极性较低,教学质量较低。上世纪60、70年代问题导向(PBL)的教学方法被提出,为教学改革提供了一个全新的思路。本文将PBL教学方法应用于内科临床教学工作中,结合本学科的特点,以学生为中心,以问题为向导,充分发挥学生的学习积极性,提高教学质量,促进学生主动学习能力提高,帮助医学生建立完整的内科诊疗过程思维,进而达到临床内科教学目标。     

Problem-based learning and the medical school: another case of the emperor's new clothes?

For almost four decades, problem-based learning (PBL) has been the stated cornerstone of learning in many medical schools. Proponents of PBL cite the open nature of the learning experience where students are free to study in depth, unencumbered by the burdens of broad courses based on the memorization of facts; detractors, on the other hand, cite the lack of breadth and factual knowledge required for professional qualification. Both points of view have merit. Professional schools have a different set of needs and requirements, and it is these that drive the curriculum and learning philosophies. The constraints of the professional school are so different from those of the purely academic environment that PBL, while admirably suited to the latter, is just problem solving in the former.     

PBL教学法在医学寄生虫学教学中的几点体会

目前全国高等医学院校医学寄生虫学学时大大减少,有的院校列为考查课,有的列为选修课。在此情况下,医学寄生虫学实验所占学时更是少之又少,如何利用好有限课时,使学生最大限度地吸收、掌握教学内容,已成为摆在高校师生面前的一道难题。传统的教学方法以讲授为主,容易忽视学生学习的主动性和积极性。而应用了PBL(problem based learning)教学法,其基本要点是以学生为中心、基于问题、综合地、相互合作和交互式地学习,有助于培养和提高学生在自学、实验技术、团队合作、分析问题和解决问题等方面的能力,激发学生学习的积极性和主动性。     

PBL教学模式在八年制《医学导论》教学中的应用

《医学导论》课对于八年制临床医学专业学员的学习非常重要,将PBL教学模式应用到《医学导论》教学中,从课程设计、问题筛选、团队精神培养等环节进行实施,有利于培养学员自主学习和解决实际问题的能力,圆满完成了《医学导论》的教学任务。     

Design and performance frameworks for constructing problem-solving simulations

Rapid advancements in hardware, software, and connectivity are helping to shorten the times needed to develop computer simulations for science education. These advancements, however, have not been accompanied by corresponding theories of how best to design and use these technologies for teaching, learning, and testing. Such design frameworks ideally would be guided less by the strengths/limitations of the presentation media and more by cognitive analyses detailing the goals of the tasks, the needs and abilities of students, and the resulting decision outcomes needed by different audiences. This article describes a problem-solving environment and associated theoretical framework for investigating how students select and use strategies as they solve complex science problems. A framework is first described for designing on-line problem spaces that highlights issues of content, scale, cognitive complexity, and constraints. While this framework was originally designed for medical education, it has proven robust and has been successfully applied to learning environments from elementary school through medical school. Next, a similar framework is detailed for collecting student performance and progress data that can provide evidence of students' strategic thinking and that could potentially be used to accelerate student progress. Finally, experimental validation data are presented that link strategy selection and use with other metrics of scientific reasoning and student achievement.     

What can experience add to early medical education? Consensus survey

Objective To provide a rationale for integrating experience into early medical education (“early experience”).Design Small group discussions to obtain stakeholders'' views. Grounded theory analysis with respondent, internal, and external validation.Setting Problem based, undergraduate medical curriculum that is not vertically integrated.Participants A purposive sample of 64 students, staff, and curriculum leaders from three university medical schools in the United Kingdom.Results Without early experience, the curriculum was socially isolating and divorced from clinical practice. The abruptness of students'' transition to the clinical environment in year 3 generated positive and negative emotions. The rationale for early experience would be to ease the transition; orientate the curriculum towards the social context of practice; make students more confident to approach patients; motivate them; increase their awareness of themselves and others; strengthen, deepen, and contextualise their theoretical knowledge; teach intellectual skills; strengthen learning of behavioural and social sciences; and teach them about the role of health professionals.Conclusion A rationale for early experience would be to strengthen and deepen cognitively, broaden affectively, contextualise, and integrate medical education. This is partly a process of professional socialisation that should start earlier to avoid an abrupt transition. “Experience” can be defined as “authentic human contact in a social or clinical context that enhances learning of health, illness or disease, and the role of the health professional.”