No abstract available.
Problem-Based Learning*

OBJECTIVE: To describe outcomes of two simulation teaching methods in developing intubation skills of year level six medical students (clinical clerks).
METHODS: Students were shown a 6-minute video on intubation. Students were exposed to video-assisted learning, video-assisted learning with instructor-guided simulation, and video-assisted learning with experiential learning. Each student was assessed by a non-graded 11 point objective structured clinical examination.
RESULTS AND DISCUSSION: The three learning strategies: 1. Video-assisted learning, 2. Video-assisted learning with instructor-guided simulation, 3. Video-assisted learning with experiential learning (self-discovery learning) simulation showed OSCE mean scores (standard deviations) of 5.76 (2.16), 7.21 (2.35) and 7.60 (1.72), respectively. Failure of intubation was 21% (8/38), 2% (1/40) and 0% (0/36), respectively. There is an absolute risk reduction of 27-30% in failure of intubation when either VGL or VEL is used. Students recognized the contribution of the simulation-based activities to the development of their intubation skills. They appreciated the opportunity to actually perform intubation in a rehearsal setting before doing the procedure on real patients.
CONCLUSION: Medical simulation enhanced student skills development. Experiential learning or self-discovery learning method may be as effective as instructor guided simulation.

RESEARCH QUESTION: Is there a difference in the proportion of students who will achieve a score of > 60 percent in the posttest on Otitis Media under the Problem-based learning and Traditional didactic lecture? STUDY DESIGN: Randomized controlled trial SETTING: Tertiary teaching hospital SUBJECT: Junior interns rotating at the department of Otolaryngology-Head &Neck Surgery. METHODOLOGY: All Junior Interns rotating in the Department of Otolaryngology-Head and Neck Surgery in a tertiary teaching hospital from September 2002 to February 2003 were included in the study. They were divided into 2 groups rotating every 15 days with a total of 12 groups enrolled during the study period. The group was randomly allocated by lottery to either traditional didactic lecture or problem-based learning. RESULTS: There was a statistically significant improvement (p=0.000) from the pre to the posttest scores of students in both groups. The TDL group had a higher proportion (91 percent) of interns who achieved a grade of > 60 percent compared with PBL group (84 percent) although there was no significant difference between the 2 groups in the proportion of the students who passed the posttest examination. CONCLUSION: There is insufficient evidence to show that a difference exists between problem-based learning and traditional didactic lecture in the proportion of the students who achieved >60 percent in the posttest on Otitis Media. (Author)
PROBLEM-BASED LEARNING OTITIS MEDIA

PURPOSE: This study describes the experience of using multiple types of visual educational tools in the setting of problem-based learning (PBL). The author intends to demonstrate their roles in diverse and efficient ways of clinical reasoning and problem solving. METHODS: Visual educational tools were introduced in a lecture that included their various types, possible benefits, and some examples. Each group made one mechanistic case diagram per week, and each student designed one diagnostic schema or therapeutic algorithm per week, based on their learning issues. The students were also told to provide commentary, which was intended to give insights into their truthfulness. Subsequently, the author administered a questionnaire about the usefulness and weakness of visual educational tools and the difficulties with performing the work. Also, the qualities of the products were assessed by the author. RESULTS: There were many complaints about the adequacy of the introduction of visual educational tools, also revealed by the many initial inappropriate types of products. However, the exercise presentation in the first week improved the level of understanding regarding their purposes and the method of design. In general, students agreed on the benefits of their help in providing a deep understanding of the cases and the possibility of solving clinical problems efficiently. The commentary was helpful in evaluating the truthfulness of their efforts. Students gave suggestions for increasing the percentage of their scores, considering the efforts. CONCLUSION: Using multiple types of visual educational tools during PBL can be useful in understanding the diverse routes of clinical reasoning and clinical features.
Humans ; Learning ; Problem-Based Learning ; Surveys and Questionnaires

The University of Yonsei College of Medicine is implementing a new undergraduate curriculum that emphasizes active, self-directed learning. The aims of this study were to investigate the factors affecting problem-based le arning(PBL). We surveyed 169 senior students of medical college in Yonsei University. Among them, 137(82.0%) students answered. We developed a question form on seven areas, centering the factors affecting problem-based learning: small-grouping learning, teachers, teaching-learning environments, learning methods, working problem, assessment, the awareness on the problem-based learning method. Those questions were developed as five point scale and were conducted on April 26, 1997. The results of this study are like this: First, the factors affecting problem-based learning appear as working problem, teaching-learning environments, teaching-learning materials. Second, no difference based on working problem form was found. However, the group which used Harvard Working Problem proved to be think more positively than the group which used Illinois Working Problem. As the most important factors affecting problem-based learning appeared as working problem, teaching-learning environments and learning materials, so we should develop the environments and materials promoting self-regulated learning. Finally, the continuous and systematic study on problem-based learning is needed.
Curriculum ; Humans ; Illinois ; Learning ; Problem-Based Learning*

The implementation of the PBL curriculum is now a mandate not a choice. However, for the established schools with large numbers of students and insufficient resources, the whole-scale conversion from traditional curriculum to PBL is almost impossible. Various alternative curricula have been introduced to many institutions, but they all have more or less shortcomings that impede the advantages of PBL approach. To solve this dilemma, I proposed a new alternative PBL curriculum, the 'Triple-phase PBL Curriculum', which is consisted with pre-PBL, PBL, and Post-PBL phase. I also explained its rationale and advantages over other alternatives.
Curriculum ; Humans ; Problem-Based Learning* ; Schools, Medical*

PURPOSE: Mechanistic case diagram (MCD) was recommended for increasing the depth of understanding of disease, but with few articles on its specific methods. We address the experience of making MCD in the fullest depth to identify the pros and cons of using MCDs in such ways. METHODS: During problem-based learning, we gave guidelines of MCD for its mechanistic exploration from subcellular processes to clinical features, being laid out in as much detail as possible. To understand the students' attitudes and depth of study using MCDs, we analyzed the results of a questionnaire in an open format about experiencing MCDs and examined the resulting products. RESULTS: Through the responses to questionnaire, we found several favorable outcomes, major of which was deeper insight and comprehensive understanding of disease facilitated by the process of making well-organized diagram. The main disadvantages of these guidelines were the feeling of too much workload and difficulty of finding mechanisms. Students gave suggestions to overcome these problems: cautious reading of comprehensive texts, additional guidance from staff about depth and focus of mechanisms, and cooperative group work. From the analysis of maps, we recognized there should be allowance of diversities in the appearance of maps and many hypothetical connections, which could be related to an insufficient understanding of mechanisms in nature. CONCLUSION: The more detailed an MCD task is, the better students can become acquainted with deep knowledges. However, this advantage should be balanced by the results that there are many ensuing difficulties for the work and deliberate help plans should be prepared.
Education, Medical ; Humans ; Problem-Based Learning*

PURPOSE: This study aimed to inquire into the educational implication of peer evaluation in PBL in relation to the evaluation system. METHODS: 89 third and fourth-year medical students in PBL courses participated in this study. Descriptive statistics analysis and correlation analysis were performed. RESULTS: Based on the results of the interviews with all the forth-year students, the feedback method of peer evaluation was modified and the peer evaluation sheet was revised. On the new peer evaluation system, the percentages of indiscriminant scores were significantly lower than those on the previous system. Peer evaluation on the new evaluation system was positively related to tutor evaluation, written examination, and quizzes. Correlations between the peer evaluation scores each units were higher than those of the tutor evaluation scores. All third-year students within the bottom ten percent on the peer evaluation score failed to successfully complete that year. CONCLUSION: The peer evaluation with feedback based on faculty counseling and a user-friendly evaluation sheet can be used as an effective method for assessing student performance in PBL and to screen for maladjusted students.
Counseling ; Humans ; Problem-Based Learning* ; Students, Medical

Diseases of oral mucosa are characterized by complex etiology, diverse and confused clinical manifestations, as well as lack of special therapeutic drugs and methods. So it has always been a non-evasive teaching conundrum. This paper explored a multiple three-dimensional interactive teaching mode, a combination of problem-based learning (PBL), case-based learning (CBL), multimedia, internet and evidence-based medicine. It is hoped that its application in the teaching of the diseases of oral mucosa will arouse the students' learning interest, broaden their professional perspective, cultivate their self-learning ability to find, ask, analyze and solve problems, and strengthen their clinical practice capacity.
Humans ; Mouth Mucosa ; Problem-Based Learning ; Students

This descriptive study identifies nursing students' methods of studying related to the learning stages, based on a sample of 251 nursing students in a Korean university. The main findings of the study are as follows. The major learning styles of nursing students were accomodation (68.6%), divergen (53.6%), and convergence (38.8%) for the first, second, third, and fourth year group. For all students, the majority (71.3%) showed accomodation or the divergence. The learning styles for grade level were significantly different, (x2=110.021, df=9, p=0.001). The stage of concrete experience was the majority for all of the first year group (51.8%), the second year group (57.1%), and the third year group (61.3%). But, active experimentation (41.9%) was the majority for the fourth year group. Also there were significant differences between the stages of learning by age (x22= 64.391, df=9, p=0.001). The most significant result of the study was the establishment of different modes of learning stages by year, thus supporting the experiential learning theory. The greatest change of style from the first year group to the second year group was reflective observation (7.3%-->12.9%). That from the second year group to the third year group was the abstractive conceptualization (14.3%-->21.3%); and that from the third year group to the fourth year group was active experimentation (12.0%-->41.9%). This reflects the same cycle as indicated by the experimental learning theory of Kolb. According to the study, nursing students' learning stages tended to be more unbalanced as year increases. Therefore this calls for a careful review of the current nursing curriculum.
Curriculum ; Humans ; Learning* ; Nursing* ; Problem-Based Learning ; Students, Nursing