問題導向學習在病理教學之可行性

Problem-based learning (PBL) and small group tutoring originated in Canada, and has become a successful pedagogical trend over the last 20 years. Many medical schools in Taiwan and around the world are now employing and promoting these techniques in the teaching of medicine, with high rates of approval by both tutors and students, although the methods and results of PBL vary between countries and schools.
Pathology is the bridge linking clinical and basic medical science, and is therefore the most commonly selected subject when PBL is commenced. The purpose of this study was to partially implement PBL methods in the teaching of pathology. Data was then analyzed from questionnaires given to tutors and students at the end of semester to see if PBL fulfilled their needs. The results will form the basis of a totally integrated PBL course in the future. The study group consisted of 160 medical students and 36 small group tutors. The students were divided into 20 small groups of eight students per group, each of which were led by a tutor. Eleven cases were available for the PBL small group study, with four hours assigned for each case. The whole course was finished within 12 weeks, and two tutors’ meetings were held mid-course.
The results from the questionnaire were as follows: PBL was appreciated by the tutors and students, with more than 60% approving of the pathology teaching which comprised four hours of didactic lectures, four hours of PBL and four hours of laboratory work. Although the majority of the students (60%) didn’t want to return to traditional didactic lectures, many (78%) did not want PBL alone. The students benefited from PBL in terms of improved problem solving skills and knowledge (72%), and improved communication (62%). The studied group (52.7% of tutors and 63.6% of students) felt that PBL might become “small group teaching” if not well controlled, and that that the tutor need not be an expert-tutor. The study group were not concerned about the language of the written cased but took issue with the limitations of the library’s resources. In conclusion, both the students and tutors thought highly of PBL, with an improved learning effect when compared to didactic lectures in big classes alone, but were worried about PBL alone being used for tutoring in pathology. These results provide useful data and experiences that will assist in the development and promotion of PBL in medical education.