Clinical Problem-based Learning Research Articles

“Evaluate the effectiveness of Clinical Problem Based Learning regarding the care of the patient with Diabetic foot among I year B.Sc. Nursing students of selected Colleges of Nursing in Kasaragod, Kerala.”

BACKGROUND: A Quasi-experimental study was undertaken to evaluate the effectiveness of Clinical Problem Based Learning (CPBL) in the care of the patient with Diabetic foot among I year BSc. Nursing students in selected colleges of Nursing in Kasaragod, Kerala.AIM: The objectives of this study were to assess the knowledge of I year B.Sc. Nursing students regarding the care of patients with Diabetic feet in experimental and control groups, evaluate the effectiveness of CPBL in the care of the patient with Diabetic feet in the experimental group, compare the post-test knowledge scores in the experimental group and control group and find out the association between the pretest level of knowledge of I year B.Sc. Nursing students regarding the care of patients with Diabetic foot with their selected variables.METHODS: The study was conducted at selected Colleges of Nursing in Kasaragod.The research approach for the study was an evaluative, pretest-posttest control group design. The sampling technique used for the study was purposive, and the research tool was the Structured Knowledge Questionnaire.RESULTS: The result of the study showed that the mean post-test knowledge score (22± 1.71) was higher than the pre-test knowledge score (12± 2.50). The calculated ‘t’ value of 13.38 was greater than the table value (t39=2.09) at a 0.05 level of significance.It was also found that there was no association between the pretest level of knowledge and selected variables.CONCLUSION: Thus, it was proved that Clinical Problem Based Learning was an effective teaching method for creating awareness regarding the care of the patient with a Diabetic foot.

Effect of integration of humanistic concern into problem-based learning in the teaching of anorectal surgery

Objective To investigate the feasibility and practical value of the integration of humanistic concern into clinical problem-based learning (PBL) teaching. Methods A total of 112 undergraduate medical interns in Department of Colorectal Surgery were enrolled and randomly divided into experimental group receiving PBL teaching integrated with humanistic concern and control group receiving PBL teaching alone. Theoretical examination, operation examination, and patient satisfaction survey were performed after practice training to evaluate the teaching effect of the two groups. GraphPad Prism 6 software was used for statistical analysis of data, and the t-test was used for comparison of continuous data between the two groups. Results Compared with the control group, the experimental group had significantly higher scores of medical history collection (22.57±2.63 vs 20.87±3.08, t=3.124, P=0.002) and operation skills (31.42±2.89 vs 29.87±4.72, t=2.107, P=0.037), but there were no significant differences between the two groups in the scores of theoretical examination (90.60±3.19 vs 90.52±3.38, t=0.129, P=0.898) and medical record writing (20.78±2.79 vs 20.65±3.51, t=0.215, P=0.830). Compared with the control group, the experimental group had a significantly higher degree of patient satisfaction with service attitude (3.94± 1.07 vs 3.22±1.09, t=3.256, P=0.002), trust (3.85±1.16 vs 3.22±1.05, t=2.759, P=0.007), and communication skills (3.92±1.03 vs 3.16±1.03, t=3.652, P=0.000), but there were no significant differences between the two groups in the scores of operating skills (3.60±1.09 vs 3.67±1.10, t=0.281, P=0.779) and arrangement of medical procedures (2.74±1.10 vs 3.02±1.02, t=1.312, P=0.193). Conclusion The integration of humanistic concern into PBL teaching of anorectal surgery can improve students’ clinical operation ability and degree of patient satisfaction. Key words: Problem-based learning; Humanistic concern; Anorectal surgery; Teaching method

Novel Insulins and Fixed-Ratio Combinations—Effect of Case-Based Online Education on Physician Knowledge and Competence

Purpose: To determine if case-based online medical education for diabetologists/endocrinologists (diabs/endos) and primary care physicians (PCPs) can improve knowledge and competence regarding the role of novel insulins and their fixed-ratio combinations (FRCs) in treatment strategies for patients with T2DM. Methods: This educational initiative incorporates branching logic to individualize clinical problem-based learning via case-based instruction. Each of two patient cases included both clinical decision questions (CDQs) and knowledge assessment questions (KAQs). Tailored feedback and clinical consequences were provided for CDQs and percent of correct answers on second attempt after feedback was recorded. Pre- and post-assessment choices were compared for the KAQs and a paired 2-tailed t-test was used for statistical analysis. Effect sizes were calculated with Cohenߣs d. The activity launched March 24, 2017; data were collected until April 24, 2017. Results: Participation in the activity significantly advanced knowledge/competence of diabs/endos (n=115) and PCPs (n=568). 43%-81% of diabs/endos and 27%-75% of PCPs answered a CDQ correctly on the first attempt while 16%-47% of diabs/endos and 19%-60% of PCPs improved their clinical decisions after receiving tailored feedback with an overall large effect size of 1.88 (diabs/endos) and 1.87 (PCPs). Correct responses of KAQs were 2%-13% higher for diabs/endos and 5%-28% for PCPs after activity completion with an overall small effect size of 0.085 (diabs/endos) and 0.1(PCPs). Conclusions: Participation in this innovative, case-based CME activity resulted in improved competence and knowledge regarding the utility of novel insulins and their FRCs for patients with T2DM. Despite notable improvement, both diabs/endos and PCPs would benefit from additional education on the optimal integration of these novel insulin formulations into treatment regimens for their patients with T2DM. Disclosure A. Philis-Tsimikas: Research Support; Self; Dexcom, Inc.. Advisory Panel; Self; Dexcom, Inc., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk A/S, Sanofi. Research Support; Self; Novo Nordisk A/S, Sanofi, Mylan. Stock/Shareholder; Spouse/Partner; Novo Nordisk A/S. Employee; Spouse/Partner; Ionis Pharmaceuticals, Inc.. Stock/Shareholder; Spouse/Partner; Esperion Therapeutics, Ionis Pharmaceuticals, Inc.. Advisory Panel; Self; AstraZeneca. G.A. Griffith: None. J. Trier: None.

Instructing introductory pharmacology in large undergraduate classes by using clinical problem-based learning (PBL) cases improves the generic problem-solving skills of students

After completing their studies at university, most pharmacology and pharmacy graduates will work in small-group settings with colleagues they do not choose. They will be required to independently navigate large volumes of scientific literature, searching for reliable sources of information about various drugs and clinical conditions; prioritize their tasks and hypotheses; problem solve; network and work effectively in a team environment; and evaluate the job performance of their co-workers. Although these skills are valued by the majority of science students and their potential employers, most standard university curricula are focused on delivering the course content. These standard curricula provide very few opportunities for students to work on their essential workplace skills.

The effectiveness of clinical problem-based learning model of medico-jurisprudence education on general law knowledge for Obstetrics/Gynecological interns

ObjectiveThe effective education method of medico-jurisprudence for medical students is unclear. The study was designed to evaluate the effectiveness of problem-based learning (PBL) model teaching medico-jurisprudence in clinical setting on General Law Knowledge (GLK) for medical students. Materials and methodsSenior medical students attending either campus-based law curriculum or Obstetrics/Gynecology (Ob/Gyn) clinical setting morning meeting from February to July in 2015 were enrolled. A validated questionnaire comprising 45 questions were completed before and after the law education. ResultsThe interns attending clinical setting small group improvisation medico-jurisprudence problem-based learning education had significantly better GLK scores than the GLK of students attending campus-based medical law education course after the period studied. ConclusionPBL teaching model of medico-jurisprudence is an ideal alternative pedagogy model in medical law education curriculum.

Exploration and experience of oncology clinical teaching under the atmosphere of medical education reform

Based on the characteristics of oncology clinical teaching and the defects of current teaching methods,we launched teaching reform including the combination of basic and clinical medical curriculum,the practice of clinical problem-based learning (CPBL) method and the introduction of some guidance for medical practice.The teaching reform was effective,but there were drawbacks for improvement. Key words: Clinical teaching; Oncology; Teaching reform

A model of clinical problem-based learning for clinical attachments in medicine

Problem-based learning (PBL) has been widely adopted in medical curricula for early-years training, but its use during clinical attachments has not been extensively explored. Objectives This study aimed to develop and evaluate a new model, 'clinical problem-based learning' (CPBL), to promote learning skills, attitudes and knowledge during clinical attachments. The CPBL model takes the principles of PBL and applies them to learning during clinical attachments. Real patient encounters are guided by a list of broadly defined case types to ensure curriculum coverage. By discussing history taking and examination in the context of differential diagnosis and problem listing, students generate learning objectives relating to clinical skills, disease mechanisms and clinical management. These are explored through self-directed learning before the second tutorial, in which the tutor takes the role of 'expert', demonstrating how learned material translates into clinical practice. We evaluated which components contributed most to the success of the model using semi-structured questionnaires, focus groups and a consensus (Delphi process) method. Students found CPBL a positive learning experience. Identification of suitable cases for discussion was readily achieved, although follow-up was sometimes difficult. The tutor's level of expertise and a non-threatening learning environment, conducive to student questioning, were highly rated contributors to successful CPBL. Comments reinforced the view that CPBL is a parallel teaching approach that helps structure the teaching week, but does not replace traditional bedside teaching. Clinical problem-based learning was well received in clinical placements. Key elements were the learning interval, the involvement of expert tutors and a non-threatening learning environment.

Physician Assistant Students Take the Plunge

INTRODUCTION The Department of Physician Assistant Studies at Wake Forest University School of Medicine is a graduate-level program that has a history of curricular innovation using clinical problem-based learning (PBL) strategies that emphasize a small-group approach to learning. Graduates of the program complete a 24-month course of study, and one class of 48 students is enrolled in early June each year. In the spring of 2007, just prior to the clinical year for the students in the class of 2008, the Northwest Area Health Education Center assisted the PA faculty in revising the AHEC’s Community Plunge program, developed initially for primary care interns, for PA students. The faculty felt that the Community Plunge experience would enhance the PA program’s current efforts, which include digitally delivered PowerPoint cases and master’s projects, by providing direct interaction with various community organizations that serve the diverse needs of our community and its members. Such exposure can stimulate ideas and discussion to enrich the clinical expertise and cultural competence of the PA students and aid them in their understanding of patient perspective. The goals of the Community Plunge were:

Paired basic science and clinical problem-based learning faculty teaching side by side: do students evaluate them differently?

Many studies have evaluated the desirability of expert versus non-expert facilitators in problem-based learning (PBL), but performance differences between basic science and clinical facilitators has been less studied. In a PBL course at our university, pairs of faculty facilitators (1 clinician, 1 basic scientist) were assigned to student groups to maximise integration of basic science with clinical science. This study set out to establish whether students evaluate basic science and clinical faculty members differently when they teach side by side. Online questionnaires were used to survey 188 students about their faculty facilitators immediately after they completed each of 3 serial PBL cases. Overall satisfaction was measured using a scale of 1-7 and yes/no responses were gathered from closed questions describing faculty performance. results: Year 1 students rated basic science and clinical facilitators the same, but Year 2 students rated the clinicians higher overall. Year 1 students rated basic scientists higher in their ability to understand the limits of their own knowledge. Year 2 students rated the clinicians higher in several content expertise-linked areas: preparedness, promotion of in-depth understanding, and ability to focus the group, and down-rated the basic scientists for demonstrating overspecialised knowledge. Students' overall ratings of individual faculty best correlated with the qualities of stimulation, focus and preparedness, but not with overspecialisation, excessive interjection of the faculty member's own opinions, and encouragement of psychosocial issue discussion. When taught by paired basic science and clinical PBL facilitators, students in Year 1 rated basic science and clinical PBL faculty equally, while Year 2 students rated clinicians more highly overall. The Year 2 difference may be explained by perceived differences in content expertise.

Clinical Problem-Based Learning: A Workbook for Integrating Basic and Clinical Science

One distinct memory of my vestal clinical year is that of being in awe of a certain professor who could obtain a pertinent history, rapidly and efficiently perform a detailed examination (often homing in on systems that did not seem relevant), invoke bedside diagnostic maneuvers either not found or found only in fine print in the physical diagnosis books, and then construct an elaborate (and usually correct) explanation for the patient's symptoms, even going so far as to predict the appearance of the chest x-ray. I recall being somewhat discouraged (as we trooped over to radiology to witness the fulfillment of the prophecy) because our textbooks— though extremely helpful about specific disease entities and the pathophysiology of symptoms—provided little clue to this intuitive, almost spiritual process that we witnessed at the bedside. This delightful book would have been most reassuring had it been available. It is an outgrowth of a