Introduction of Problem-Based Preclerkship Clinical Training in Internal Medicine / 医学教育

To increase the safety and effectiveness of clinical clerkships, we have developed a 4-week preclinical training program, “Problem-Based Clinical Training, ” based on the concept of problem-based learning with the aim of encouraging life-long self-directed learning. The first week is a preparation period for clinical practice in which students are trained in problem-solving skills, basic-practice skills, and clinical reasoning. The second and third weeks are a practical training period in which students learn how be in charge of a patient's care. The fourth week was a problem-solving period without practical training in which students learned to solve problems. The students were encouraged to record daily “problem notes” describing problems and “problem solving notes” summarizing problems solved. To emphasize lessons learned, the students also presented and discussed problems. Evidence-based medicine was used as a tool for problem solving. Furthermore, medical record training based on the problem-oriented system using evaluations by other students encouraged self-development to improve clinical practice and the medical record. This curriculum should be effective for mastering the skills of self-directed learning and for motivating for advancement due to consideration of contributable proposals for the patients.

Development of a Problem-oriented Simulation System for Medical Diagnosis / 医学教育

We developed a problem-oriented simulation system for medical diagnosis which works on personal computers without special equipment. In this simulation system the history of illness can be presented by voice, and physical findings are presented audiovisually through the student's actions, in a manner that closely resembles an actual medical examination. The laboratory findings are also presented through the student's actions. Students compile a database with information that they collect, create a problem list, and devise an initial diagnostic plan for the patient's most important problem. This computer-assisted system will help medical students learn diagnostic strategies in a simulated clinical setting. We believe that this system is a promising method that will facilitate problem-oriented learning in the virtual multimedia environment with special convenience for medical students to share time and facilities and to lower costs.

Problem Oriented System to Diagnosing Learning Teaching Hitting the Target / 中华医学教育探索杂志

Problem oriented system teaching method has been put into practice,and contrast has been made with traditional teaching method in the teaching of diagnostics in the technical secondary school of Chinese and western medicine special field.Result indicates that the improved teaching effect has been obtained and the students'initiatives and their ability to learn independently have been cultivated.

Comparison of student Self-Evaluations and Teacher Evaluations During Pediatric Bedside Learning / 医学教育

Student self-evaluations in pediatric bedside learning based on a problem-oriented system (POS) were compared with teacher evaluations of the same items. Self-evaluations were also compared with two different methods: unsigned and signed submissions. Students evaluated themselves poorly in the ability to recall pediatric knowledge and highly in the ability to investigate and summarize suggested topics. They evaluated themselves more highly on signed submissions than on unsigned submissions left in a box. Evaluations by teachers were higher than or equal to student self-evaluations. There were few critical evaluations or complaints about POS-bedside learning, but the ratio of criticism was four-fold higher on unsigned submissions. Bedside learning based on POS was accepted willingly by students.