Norman G R
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Med Educ. 1988 Jul;22(4):279-86. doi: 10.1111/j.1365-2923.1988.tb00754.x.
This paper reviews the empirical evidence in support of the three concepts in the title. To the extent that a skill should be a general strategy, applicable in a variety of situations, and independent of the specific knowledge of the situation, there is little evidence that problem-solving skills, as described and measured in medical education, possess these characteristics. Instead there is an accumulation of evidence that expert problem-solving in medicine is dependent on (I) a wealth of prior specific experiences which can be used in routine solution of problems by pattern recognition processes, and (2) elaborated conceptual knowledge applicable to the occasional problematic situation. The use of problem-based learning (PBL) as an educational strategy is explored. In particular, the evidence suggesting the compatibility of PBL with this theory of expertise is discussed. Finally, I review some issues in the design of PBL curricula from the perspective of the proposed model of expertise.
本文回顾了支持标题中三个概念的实证证据。就一项技能应是一种通用策略而言，它适用于各种情况，且独立于对具体情况的特定知识，但几乎没有证据表明医学教育中所描述和衡量的解决问题的技能具备这些特征。相反，有大量证据表明，医学领域的专家解决问题依赖于：（1）丰富的先前特定经验，这些经验可通过模式识别过程用于常规问题的解决；（2）适用于偶尔出现的疑难情况的详尽概念知识。本文探讨了将基于问题的学习（PBL）作为一种教育策略的应用。特别是，讨论了表明PBL与这种专业知识理论相兼容的证据。最后，我从所提出的专业知识模型的角度回顾了PBL课程设计中的一些问题。
