Clemens Megan, Avery Susan, Dawe Russell
Faculty of Medicine, Memorial University of Newfoundland, St. John's, CAN.
Cureus. 2024 Nov 1;16(11):e72818. doi: 10.7759/cureus.72818. eCollection 2024 Nov.
Problem-based learning (PBL) in medical education is centered around a problem or case and is learner-led, involving small groups and problem-solving. PBL is ubiquitous in North American undergraduate medical education (UGME) due to reported learner satisfaction, efficacy, and long-term knowledge retention; however, its application to postgraduate medical education (PGME) is less defined. This review addresses the knowledge gap on the use and efficacy of PBL in PGME, specifically among primary care specialties due to their unique training needs, using the Kirkpatrick model as the theoretical basis for interpreting results. A search for articles using PubMed resulted in 17 selected articles that included primary care PGME learners undergoing at least one PBL session led by another learner. Learners were overwhelmingly satisfied with PBL, reporting increased confidence and comfort in the subject area. While none of the studies measured behavior change objectively, over half reported increased comfort in diagnosing, prescribing, and managing patients. This review extends the positive feedback found from PBL in UGME settings to apply to PGME and highlights the suitability of PBL for primary care due to increased confidence, learner satisfaction, perceived knowledge gain, and objective learning outcomes.
医学教育中的基于问题的学习（PBL）以问题或病例为核心，由学习者主导，涉及小组讨论和问题解决。由于学习者满意度、效果和长期知识保持方面的报道，PBL在北美本科医学教育（UGME）中很普遍；然而，其在研究生医学教育（PGME）中的应用定义较少。本综述探讨了PBL在PGME中的应用和效果方面的知识空白，特别是在初级保健专业中，因为它们有独特的培训需求，使用柯克帕特里克模型作为解释结果的理论基础。通过在PubMed上搜索文章，筛选出17篇文章，这些文章涉及接受至少一次由其他学习者主导的PBL课程的初级保健PGME学习者。学习者对PBL的满意度极高，报告称在该学科领域的信心和舒适度有所提高。虽然没有一项研究客观地测量行为变化，但超过一半的研究报告称在诊断、开处方和管理患者方面的舒适度有所提高。本综述将在UGME环境中从PBL获得的积极反馈扩展到PGME，并强调了PBL因信心增强、学习者满意度、感知知识收获和客观学习成果而适用于初级保健。
