Yu H Y, Wu Z A, Su M S, Yen D J, Luk H R, Chao Y C, Liao K K, Lin K P, Yu S M, Liu H C
Neurological Institute, Taipei Veterans General Hospital, Taiwan, ROC.
Zhonghua Yi Xue Za Zhi (Taipei). 2000 Aug;63(8):598-604.
Problem-based learning (PBL) in small-group tutorials has been a trend in medical education. Chinese students are known to be reserved and passive; thus, they may not be adaptable to PBL. Neuroanatomy, important to clinical neurology, is difficult to learn. We incorporated clinical neurology with PBL, complementary to the traditional neuroanatomy curriculum, to evaluate the feasibility of PBL for Chinese students in Taiwan.
Forty-two second-year medical students and seven tutors participated in the clinical neurology PBL small-group tutorials. Twelve case reports were discussed weekly beginning in February, 1999. Each case was designed to meet the progressive curriculum of the neuroanatomy course. The tutors evaluated the students by the degree of their preparation, participation, key-point comprehension and interaction. All tutors and students filled out questionnaires at the end of each session.
The majority of the students and tutors agreed that the case materials were clearly written. Ninety percent of the students agreed that the case materials matched the traditional content of neuroanatomy. Eighty-five percent of students and 71% of tutors were satisfied and found the class rewarding. Ninety-one percent of students and 74% of tutors were in favor of PBL being continued.
This preliminary PBL, small-group tutorial learning in clinical neurology showed satisfactory results and was, indeed, complementary to a traditional neuroanatomy course. The students, as early as during the second year of their medical school education, were able to learn through the PBL. More integration of basic and clinical sciences by PBL may be considered in future curricula designs.
在小组辅导中采用基于问题的学习（PBL）已成为医学教育的一种趋势。众所周知，中国学生较为内敛和被动，因此他们可能不太适应PBL。神经解剖学对临床神经病学很重要，但学习起来有难度。我们将临床神经病学与PBL相结合，作为传统神经解剖学课程的补充，以评估PBL对台湾中国学生的可行性。
42名二年级医学生和7名导师参加了临床神经病学PBL小组辅导。从1999年2月开始，每周讨论12个病例报告。每个病例的设计都符合神经解剖学课程的进阶式教学安排。导师根据学生的准备程度、参与度、关键点理解能力和互动情况对学生进行评估。所有导师和学生在每节课结束时填写问卷。
大多数学生和导师都认为病例材料书写清晰。90%的学生认为病例材料与神经解剖学的传统内容相符。85%的学生和71%的导师感到满意，并认为课程很有收获。91%的学生和74%的导师赞成继续采用PBL。
这种在临床神经病学中进行的初步PBL小组辅导学习取得了令人满意的结果，确实是对传统神经解剖学课程的补充。学生早在医学院学习的第二年就能通过PBL进行学习。未来的课程设计可考虑更多地通过PBL将基础科学和临床科学整合起来。
