Harden R, Crosby J, Davis M H, Howie P W, Struthers A D
Centre for Medical Education, University of Dundee, UK.
Med Educ. 2000 May;34(5):391-7. doi: 10.1046/j.1365-2923.2000.00698.x.
Integrated teaching and problem-based learning (PBL) are powerful educational strategies. Difficulties arise, however, in their application in the later years of the undergraduate medical curriculum, particularly in clinical attachments. Two solutions have been proposed - the use of integrated clinical teaching teams and time allocated during the week for PBL separate from the clinical work. Both approaches have significant disadvantages. Task-based learning (TBL) is a preferred strategy. In TBL, a range of tasks undertaken by a doctor are identified, e.g. management of a patient with abdominal pain, and these are used as the focus for learning. Students have responsibility for integrating their learning round the tasks as they move through a range of clinical attachments in different disciplines. They are assisted in this process by study guides.
The implementation of TBL is described in one medical school. One hundred and thirteen tasks, arranged in 16 groups, serve to integrate the student learning as they rotate through 10 clinical attachments.
This trans-disciplinary approach to integration, which incorporates the principles of PBL offers advantages to both teachers and students. It recognizes that clinical attachments in individual disciplines can offer rich learning opportunities and that such attachments can play a role in an integrated, as well as in a traditional, curriculum. In TBL, the contributions of the clinical attachments to the curriculum learning outcomes must be clearly defined and tasks selected which will serve as a focus for the integration of the students' learning over the range of attachments.
整合式教学和基于问题的学习(PBL)是强大的教育策略。然而,在本科医学课程后期应用这些方法时会出现困难,尤其是在临床实习中。已提出两种解决方案——使用整合式临床教学团队以及在一周内安排与临床工作分开的时间用于PBL。这两种方法都有明显的缺点。基于任务的学习(TBL)是一种更可取的策略。在TBL中,确定医生所承担的一系列任务,例如腹痛患者的管理,这些任务被用作学习的重点。学生在不同学科的一系列临床实习中负责围绕这些任务整合他们的学习。学习指南在这个过程中为他们提供帮助。
描述了一所医学院实施TBL的情况。113项任务分为16组,用于在学生轮转10次临床实习时整合他们的学习。
这种跨学科的整合方法,融入了PBL的原则,对教师和学生都有好处。它认识到各个学科的临床实习可以提供丰富的学习机会,并且这种实习在整合式课程以及传统课程中都可以发挥作用。在TBL中,必须明确临床实习对课程学习成果的贡献,并选择作为学生在一系列实习中学习整合重点的任务。