Application Effect Evaluation Of PBL In Experiment Teaching Of Diagnostics

BackgroundAs a bridge course helping medical students to step into the learning of clinical medicine from fundamental knowledge, diagnostics has many more experiment teaching periods than theory periods. Diagnostic experiment teaching program is aimed not only to help medical students to master the basic clinical skills, but also to cultivate diagnostic thinking, that is, to teach students to obtain the first-hand information about patients by inquiry and physical examination and integrate it with the knowledge of anatomy, physiology and pathophysiology to make correct diagnoses. Therefore diagnostic experiment teaching program involves almost all fundamental and clinical courses, covering large numbers of abstract, boring, difficult concepts, operation standards, and normal or abnormal physiological indicators, which makes a hard task for medical students. Traditionally diagnostic knowledge such as operation skills and physiological readings is given by teachers and memorized by students, while students lack initiative in their studies and their ability to synthesize and process diagnostic information is not well developed. Thus scientific teaching method needs to be adopted to improve diagnostic experiment teaching results.ObjectiveProblem-Based Learning (PBL) is a student-centered pedagogy that is fulfilled by teachers’directions and students’discussion. In the process of PBL, students acquire valuable knowledge through discussing a specific topic or the treatment of a certain disease under teachers’guidance. It features learners’ engagement in active, self-directed, enquiry-driven, participatory and collaborative learning in small group discussions. Introduced by the integrated education programme of Western Reserve University School of Medicine in the U.S. in the 1950s, PBL has now been adopted globally. Studies both at home and abroad have shown that PBL enables students to solve various problems via active learning, effective communication and collaboration with other group members and enhances students’active-learning ability and problem-solving ability as well as their knowledge of medicine. This approach integrates knowledge-acquisition and ability-cultivation and effectively strengthens both students’theoretical knowledge and abilities to practice. PBL has been frequently adopted and succeeded in medical theory teaching, but no research is available on the application of PBL in experiment teaching of diagnostics. We tried PBL in our school to investigate its feasibility and advantages in experiment teaching of diagnostics.Method6 classes were chosen from the 20 classes of clinical medicine majors of grade 2011 via cluster random sampling and divided randomly into two groups:A and B. Altogether 218 students from 6 classes, two thirds of every class, were then randomly chosen via two-stage sampling to form an experimental group and a control group, either of which had 109 students. Taking into account different teachers having different teaching results, we had students of one diagnostic experiment teacher as our subjects. PBL was adopted in the experimental group while traditional method was used in the control group. We handed out questionnaires among the students before and after the course was conducted, collected the periodic test scores and the questionnaire results of both groups and made statistical analyses of the data with EXCEL and SPSS 17.0. The quantitative data were represented with "mean±standard deviation". The options A, B, C, D and E of Questionnaire 1 and 2 were separately valued 1-5 point(s), the intergroup comparison being performed with t test and χ2 test on two independent samples. The options A, B and C of Questionnaire 3 were separately valued 1-3 point(s), the intergroup comparison being performed with χ2 test on two independent samples. When P<0.05, the difference was considered statistically significant.ResultsWe found that the students didn’t have obvious differences in learning habits and professional attitudes before participating the course (P>0.05). PBL adopted in experimental diagnosis course considerably improved the students’ability to identify, analyze and solve problems. Compared with the control group, the students of the experimental group remarkably promoted their study habits, productive thinking, initiative of study and ability to communicate and created much better achievements in studies. Except that the difference in the scores of heart and lung auscultation test was not statistically significant (the experimental group averaged 7.27±1.14 points, while the control group 7.18±1.07, P>0.05),the experimental group got higher scores in other periodic tests than the control group (P<0.05):averaging 8.10±0.88 in physical examination, 8.39±1.11in case history writing, and totalling 23.75±2.22 in experiment test, while the control group’s scores of the same tests were separately:7.78±0.73, 7.95±0.76,and 22.91±1.61.Conclusions and suggestionsPBL is applicable and effective in experiment teaching of diagnostics. While at present it is impossible to adopt PBL in experiment teaching of diagnostics under all circumstances, we shouldn’t deny it has many advantages compared with traditional teaching methods. It is feasible to apply PBL with some modifications according to the reality of medical schools in diagnostic experiment teaching program.