Department of Molecular Biology and Biochemistry, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
Department of Rheumatology and Immunology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
BMC Med Educ. 2023 Feb 6;23(1):93. doi: 10.1186/s12909-023-04079-6.
The nature of student learning in problem-based learning (PBL) largely depends on the quality of the case scenarios presented to them. The effect of case scenarios with higher challenge degree, especially common disease with atypical symptoms (CDAS)- and rare disease (RD)-based case scenarios, on undergraduate medical students remains unclear. This study compared the impact of all scenarios pertaining to common disease with typical symptoms (CDTS) case scenarios, CDTS interspersed with CDAS case scenarios, and CDTS interspersed with RD case scenarios on perceptions of undergraduate students studying organ/system integration curriculum via PBL.
After finishing four CDTS case scenarios, 294 third-year medical students were randomly allocated into three groups: CDTS, CDAS and RD, studying via CDTS, CDAS and RD case scenarios, respectively. A questionnaire with 15 items was conducted to evaluate the students' perceptions. The students' responses were scored using a 4-point rating scale. The data were analysed using the Kruskal-Wallis test.
Among the three PBL conditions, the ones with a higher degree of challenge were rated higher by the students, which included the quality of the case scenarios and the overall performances of the students. The CDAS and RD cases were more effective in developing students' self-directed learning skills, stimulating them to acquire more knowledge required for future work. The satisfaction percentage of RD case scenario sessions was higher.
Of all the three kinds of case scenarios, both CDTS interspersed with CDAS and RD case scenarios had more positive effects on the self-evaluated performance of students. Increasing the challenge and variety of case scenarios by the inclusion of CDAS and RD especially RD might be an effective stimulus in improving students' performance in PBL sessions.
以问题为基础的学习（PBL）中学生的学习性质在很大程度上取决于呈现给他们的案例情景的质量。具有较高挑战性的案例情景，尤其是具有非典型症状的常见疾病（CDAS）和罕见疾病（RD）的案例情景，对本科医学生的影响尚不清楚。本研究比较了所有涉及常见疾病且具有典型症状（CDTS）的案例情景、CDTS 与 CDAS 案例情景穿插、CDTS 与 RD 案例情景穿插这三种情景对通过 PBL 学习器官/系统整合课程的医学生的影响。
在完成四个 CDTS 案例情景后，294 名三年级医学生被随机分为三组：CDTS、CDAS 和 RD，分别通过 CDTS、CDAS 和 RD 案例情景进行学习。通过问卷调查的方式对学生的认知进行评估，共 15 个条目，采用 4 分制评分。采用 Kruskal-Wallis 检验对数据进行分析。
在三种 PBL 条件中，挑战性较高的条件得到了学生更高的评价，包括案例情景的质量和学生的整体表现。CDAS 和 RD 案例更有效地培养了学生的自主学习技能，激发了他们获取未来工作所需的更多知识。RD 案例情景的满意度百分比更高。
在所有三种案例情景中，CDTS 与 CDAS 和 RD 穿插的案例情景对学生的自我评估表现有更积极的影响。通过纳入 CDAS 和 RD（尤其是 RD）增加案例情景的挑战性和多样性可能是提高学生 PBL 表现的有效刺激。
