Book•
Problem-based learning : an approach to medical education
01 Jan 1980-
TL;DR: This book presents the scientific basis of problem-based learning and goes on to describe the approaches to problem- based medical learning that have been developed over the years at McMaster University, largely by Barrows and Tamblyn.
Abstract: In this book, the authors address some basic problems in the learning of biomedical science, medicine, and the other health sciences Students in most medical schools, especially in basic science courses, are required to memorize a large number of ""facts,"" facts which may or may not be relevant to medical practice Problem-based learning has two fundamental postulates--the learning through problem-solving is much more effective for creating a body of knowledge usable in the future, and that physician skills most important for patients are problem-solving skills, rather than memory skills This book presents the scientific basis of problem-based learning and goes on to describe the approaches to problem-based medical learning that have been developed over the years at McMaster University, largely by Barrows and Tamblyn
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01 Feb 1992
TL;DR: The f1r5t 5ta9e, a c11n1ca1 pr061em 15 pre5ented t0 the 9r0up f0r c0n51derat10n, a 600k de519ned t0 a110w 9r 0up mem6er5 t051mu1ate 1nter-v1ew1n9 the pat1ent, 1982.
Abstract: the f1r5t 5ta9e, a c11n1ca1 pr061em 15 pre5ented t0 the 9r0up f0r c0n51derat10n. H15t0r1ca11y, 5tudent5 w0u1d enc0unter and ana1y2e a c11n1ca1 ca5e thr0u9h the Pr061em-8a5ed Learn1n9 M0du1e (P8LM), a 600k de519ned t0 a110w 9r0up mem6er5 t051mu1ate 1nter-v1ew1n9 the pat1ent [D15t1eh0r5t and 8arr0w5, 1982], c0nduct1n9 aphy51ca1 exam1nat10n, 0r re4ue5t1n91a60-rat0ry te5t5 and d1a9n05t1c pr0cedure5.7here 15 act1ve, c0ach-9u1ded exp10rat10n and f0rmu1at10n 0f the pr06-1em, 1n wh1ch the 5tudent5, re1y1n90n the1r pert1nent pr10r kn0w1ed9e, attempt t0 ana1y2e the pr061em and t01dent1fy area5 f0r further 1nd1v1dua15tudy. 0ne 0f the 5tudent5, tak1n9 the r01e 0f • 5cr16e • , rec0rd5 the th0u9ht5 and 1dea5 deve10ped 6y the 9r0up, 0r9an121n9 them 1n f0ur c01umn50n a 61ack60ard: Data (c11n1ca1 fmd1n95 a60ut the pat1ent), 1dea5 (hyp0the5e5 a60ut the nature 0f the pat1ent • 5 pr061em), Learn1n9155ue5 (1dent1f1ed kn0w1ed9e def1c1enc1e5 w1th1n the 9r0up) and Act10n5 (p1an5 f0r further eva1uat1n9 the pat1ent 0r f0r mana91n9 the pat1ent • 5 c0nd1t10n). 7he 9r0up then rece55e5 and the 5tudent5 pr0ceed, a9a1n w1th the c0ach • 59u1dance, t01dent1fy and ut1112e re50urce5-per50n, pr1nt and e1ectr0n1c-that w111 pr0v1de the add1t10na1 kn0w1ed9e nece55ary f0r under5tand1n9 and mana91n9 the pat1ent • 5 pr061em. F0110w1n95uch an ep150de 0f 5e1f-d1rected 5tudy, the 9r0up 15 rec0n-vened t0 app1y the new1y ac4u1red 1nf0rmat10n t0 the pr061em. 7h15 pr0ce550f ana1y21n9 the pr061em, 1den-t1fy1n9 new 155ue5 f0r 5tudy, 1ndependent1y 1nve5t19at-1n9 the5e 155ue5 and app1y1n9 the ac4u1red kn0w1ed9e 15 repeated unt11 a11 mem6er50f the team fee1 that the pr061em ha56een 5at15fact0r11y exp10red and under-5t00d. 7w0 add1t10na11mp0rtant 5ta9e50f 1earn1n9 f0110w: the A65tract10n and Ref1ect10n 5ta9e5. 1n the A65tract10n 5ta9e, the ca5e 15 exam1ned 1n the c0ntext 0f 0ther ca5e5 the 9r0up ha55een, t0 exp10re 51m11ar1-t1e5 and d1fference5.1n the Ref1ect10n 5ta9e, the 9r0up d15cu55e5 the1r c11n1ca1 pr061em-501v1n9 pr0ce55 a5 app11ed t0 the ca5e, mak1n9 exp11c1t the kn0w1ed9e and 5k1115 nece55ary f0r c11n1ca1 rea50n1n9. 7h155tra19htf0rward appr0ach t0 med1ca1 educa-t10n 15 n0t w1th0ut pract1ca1 d1ff1cu1t1e5, h0wever. 1n the pure P8L meth0d, the deta1150f a c11n1ca1 ca5e t0 6e 5tud1ed are n0tpre5ented a5 a c0mp1ete ca5e h15t0ry, 6ut are 1n5tead revea1ed thr0u9h a pr0ce550f 9r0up 1n4u1ry. 7he mechan1c50f 51mu1at1n9 an enc0unter w1th a pat1ent, h0wever, can 6e 4u1te cum6er50me. Further, 1t 15 n0t ea5y t0 f1nd 4ua11f1ed c0ache5 wh0 can 9u1de tut0r1a1 meet1n95 w1th0ut 1mp051n9 the1r v1ew5 and 1t 15 d1ff1cu1t f0r the c0ach t006ta1n (and ma1nta1n) a c1ear 5en5e 0f each 5tudent • 5 under5tand1n90f the current pr061em a51t 15 d15cu55ed 6y the 9r0up. 7here 15 a150 a need …
15 citations
01 Jun 2010
TL;DR: In this article, a trabalho objetiva avaliar os resultados of uma experience of pos-graduacao multiprofissional em saude ancorada em metodologias ativas, a partir da otica de seus egressos.
Abstract: Este trabalho objetiva avaliar os resultados de uma experiencia de pos-graduacao multiprofissional em saude ancorada em metodologias ativas, a partir da otica de seus egressos. O desenho metodologico consiste numa pesquisa avaliativa que articula as abordagens quantitativa e qualitativa. Como instrumento de coleta de dados, trabalha-se com questionario estruturado, entrevista semiestruturada e grupo focal. O tratamento quantitativo dos dados consiste na descricao frequencial, utilizacao do Teste Qui-quadrado e extensao do Teste Exato de Fisher. Em termos qualitativos, utilizou-se o metodo de interpretacao de sentidos baseado nas perspectivas hermeneutica-dialetica. Dentre os principais resultados destaca-se a significativa positividade atribuida ao curso. Tambem foram constatados limites na aplicacao dos resultados do curso na pratica profissional, sobretudo por conta de questoes estruturais. Conclui-se que a utilizacao de metodologias ativas pode contribuir para a formacao profissional, em nivel de pos-graduacao, mais alinhada a atual politica nacional de saude.
15 citations
TL;DR: In conclusion, excellence of case scenarios, 6th-year student tutors, and content-expert clinicians show positive impact on tutor evaluation in a PBL curriculum.
Abstract: Problem-based learning (PBL) is a teaching and learning method designed to develop clinical reasoning skills. Tutor performance in PBL affects both the process and outcome of student learning. In this study, we investigated the factors that influence the evaluation by undergraduate students on the performance of tutors in medical education. From April 2009 to February 2010, 49 PBL sessions were conducted for 191 3rd- and 4th-year medical students at Saga Medical School in Japan. Twenty-nine 6th-year students and 205 faculty members tutored these sessions. After each session, students evaluated their tutor by a Likert scale. This evaluation score was dichotomized and used as the dependent variable. A multivariate logistic regression analysis was used to assess the contribution of student's gender and year level (3rd or 4th), the tutor's gender and background, and the quality of the case scenario to evaluation ratings. A total of 4,469 responses were analyzed. Male student and tutor background were associated with excellent tutor evaluation. Concerning the tutor background, compared with basic scientists, the 6th-year students and content-expert clinicians were positively associated with excellent tutor evaluations (ORs of 1.77 [95% CI: 1.15-2.72] and 1.47 [95% CI: 1.11-1.97]), while non-content-expert clinicians received negative evaluations (OR of 0.72 [95% CI: 0.55-0.95]). The quality of the case scenario was also associated with excellent tutor evaluation (odds ratio [OR] of 12.43 [95% CI: 10.28-15.03]). In conclusion, excellence of case scenarios, 6th-year student tutors, and content-expert clinicians show positive impact on tutor evaluation in a PBL curriculum.
15 citations
TL;DR: The authors of this issue offer both normative and descriptive elements in their accounts, which include the importance for clinical reasoning of tacit knowing, risk assessment, narrative and hermeneutics, wisdom, and virtue epistemology.
Abstract: This article is an introduction to a special issue of Theoretical Medicine and Bioethics on clinical reasoning. Clinical reasoning encompasses the gamut of thinking about clinical medical practice—the evaluation and management of patients’ medical problems. Theories of clinical reasoning may be normative or descriptive; that is, they may offer recommendations on how clinicians ought to think or they may simply attempt to describe how clinicians actually do think. This article briefly surveys these approaches in order to show the complexity of clinical reasoning and the inadequacy of any one theory for capturing the full richness of clinical reasoning. The authors of this issue offer both normative and descriptive elements in their accounts. Topics discussed include the importance for clinical reasoning of tacit knowing, risk assessment, narrative and hermeneutics, wisdom, and virtue epistemology.
15 citations
TL;DR: In this article, a metodologia de auto-aprendizaje en entornos simulados (MAES©) is presented, a metodo activo de ensenanza-ap-rendizajae with simulacion clinica de alta fidelidad.
15 citations