Bernstein P, Tipping J, Bercovitz K, Skinner H A
Department of Behavioural Science, University of Toronto, Faculty of Medicine, Ontario, Canada.
Acad Med. 1995 Mar;70(3):245-7. doi: 10.1097/00001888-199503000-00019.
The University of Toronto Faculty of Medicine is implementing a new undergraduate curriculum that emphasizes active, self-directed learning. The aims of this study were to (1) evaluate shifts in students' attitudes after initial direct experience with problem-based learning (PBL), (2) describe faculty experiences, and (3) develop guidelines for further implementation of PBL.
Questionnaires were administered at the beginning of the first PBL session and at the close of the last session (five weeks later) to the 250 second-year students in 1992-93 and to their 15 faculty tutors. Quantitative data were analyzed using multivariate analysis of variance and univariate tests. Open-ended questions were categorized based on common patterns that emerged.
Of the 250 students, 196 (78%) responded to the pretest, and 207 (83%) responded to the posttest. There was a statistically significant shift in the students' perceptions from pretest to posttest in agreeing that PBL is more effective than traditional teaching methods (increasing from 38% to 52%). The students rated traditional methods as better for knowledge acquisition, whereas PBL methods were rated better for improving teamwork and doctor-patient relationships. At pretest, the most common themes concerned a perceived danger that PBL would result in knowledge gaps, reinforce the wrong information, and make inefficient use of valuable time. Perceived advantages of PBL included that it is more stimulating and enjoyable, and it teaches students how to learn rather than to memorize. At posttest, there was an increase in favorable comments by the students. Virtually all of the attitudes expressed by the students were shared by the faculty. In addition, at pretest the faculty were anxious about the perceived lack of structure in PBL.
Direct experience with PBL led to more favorable attitudes among the students and faculty. Recommendations are suggested for other schools and programs seeking to implement PBL curricula.
多伦多大学医学院正在实施一项新的本科课程，该课程强调主动、自主学习。本研究的目的是：（1）评估学生在初次直接体验基于问题的学习（PBL）后态度的转变；（2）描述教师的体验；（3）制定进一步实施PBL的指导方针。
在1992 - 1993学年，对250名二年级学生及其15名教师导师在第一次PBL课程开始时和最后一次课程结束时（五周后）进行问卷调查。使用多变量方差分析和单变量检验对定量数据进行分析。根据出现的常见模式对开放式问题进行分类。
250名学生中，196名（78%）对前测做出了回应，207名（83%）对后测做出了回应。从预测试到后测试，学生们在认为PBL比传统教学方法更有效的看法上有统计学意义的转变（从38%增加到52%）。学生们认为传统方法在知识获取方面更好，而PBL方法在改善团队合作和医患关系方面更好。在预测试时，最常见的主题涉及一种认知到的危险，即PBL会导致知识差距加剧、强化错误信息以及低效利用宝贵时间。PBL的认知优势包括它更具刺激性和趣味性，并且它教会学生如何学习而不是死记硬背。在后测试时，学生们的正面评价有所增加。学生们表达的几乎所有态度都得到了教师们的认同。此外，在预测试时，教师们对PBL中缺乏结构感到担忧。
PBL的直接体验使学生和教师的态度更加积极。为其他寻求实施PBL课程的学校和项目提出了建议。
