[Problem-based learning in a social medicine course--a concept for improving learning achievement and practice relevance].

In many medical curricula around the world, problem-based learning (PBL), i.e. inductive, usually interdisciplinary learning based on real or constructed cases, has been shown to improve the acquisition of knowledge. Additionally, it is valued positively by students. On the other hand, lecturing is usually valued negatively. Teaching of epidemiology and social medicine is further handicapped by the fact that students consider it irrelevant. In 1994/95, one of 18 social medicine courses for fifth year medical students at Hannover Medical School was problem-based. The following "cases" were used: 1. rheumatic patient with various social medical problems (losing sick pay, receiving status as handicapped person, early retirement etc.), 2. cluster of patients with leukaemia in the surroundings of a nuclear power plant and 3. recent newspaper articles on the effects of the 1993 Health Care Reform Law (dentists refusing to treat patients because of a fixed budget, introduction of prepayment methods in hospital etc.). Evaluation by the students at the end of the course revealed that PBL is well accepted in social medicine. Students rated learning success, relevance of the subject compared to other disciplines and the ability to transfer the acquired knowledge into medical practice well above the traditional courses. Besides lectures, practical courses and seminars, PBL should therefore be used as a standard method of learning in undergraduate medical education.