PBL courses have been introduced to mainland China for less than ten years, and many medical schools have only been launched in the past five years. Everyone knows that there are many problems in the current medical education model, including the disconnect between basic medicine and clinical medicine in the way of teaching, the disconnect between theoretical and practical courses, and the initiative of students to learn.And insufficient consciousness, narrow knowledge, serious lack of clinical thinking training and so on. Problem-based learning can theoretically make up for these problems well, and the practice of European and American countries has also proved this.

However, at present, because PBL is still a new thing in China, related training materials are relatively lacking, and the level of course content is uneven, and many of them are out of touch with clinical practice; on the other hand, the teachers of PBL courses are mainly clinical first-line physicians. Although they are clinically experienced, their teaching experience is often insufficient and they don't know much about learning.Therefore, there is no guidance on how heuristic teaching should be for students at different stages of learning. In other words, the teachers who guide students in the PBL classroom also need someone to give guidance.

Of course, there is still a lack of teaching materials in this area in China, and the teaching materials for clinical cases have been developed by themselves.

However, the big ship PBL has finally started. After three years of teaching, I have some personal experiences and insights that I want to communicate with you. Some ideas are not mature enough. I hope you will give me more opinions.

1. When is it better to start the PBL course?

Many teachers report that they started PBL teaching in their sophomore year. Because many students have insufficient medical knowledge, they are often unable to participate in discussions in depth. Therefore, it is recommended to start PBL courses in their junior year and continue until their senior year.

My view on this is the opposite. I think the earlier this course starts, the better. There are several reasons：

1. During the sophomore year, there are fewer medical courses and students have more time. Students can invest more time in making PPT and writing articles. After the junior year and senior year, the courses increase, and the time students invest in PBL will conflict with other study time, and the quality of their homework may not be guaranteed.

   
   

2. The basic medical courses that I started to come into contact with in the second semester of my freshman year, such as anatomy, physiology, and biochemistry, are more abstract. Students work harder to learn, and many students don't know the use of learning these. Therefore, when studying clinical knowledge and clinical internships in the later stage, these basic courses are often forgotten early. PBL courses are to deepen students' understanding and practical application of basic courses through specific cases, while increasing interest in learning and improving learning efficiency.

   
   

3. The key to the PBL course is to teach students effective clinical medical thinking skills, including observation, analytical reasoning, imagination, etc. The earlier these abilities are cultivated, the better.

2. Content setting of PBL course

Many teachers will reflect that some course content is not suitable for clinical practice, such as the story of a journalist assassinated by a highly poisonous drug in the first PBL class for exposing political shady. Since the vast majority of clinicians have never encountered such an incident in their daily work, clinical teachers have no way to discuss such cases, so they hope to exchange some cases excavated from the clinic (see "How to Learn the First PBL Course").

I thought the same way in the beginning. When I first came into contact with PBL, I didn't know how to start. After all, I had no training. But after these three years of courses and three sessions of classmates, I found that in the process of interacting with my classmates. I was gradually inspired, and found that this lesson was actually very good. I have a special article to restore the class scene at that time. In fact, I found that this lesson can be very effective, because the article provides a lot of information, which allows people to enter from different angles. For example, there are spy movies in this story, which gives students a sense of substitution; there are many details in the story, which allows students to learn to capture clues; in the description of the disease, although the story is simple, it also allows students to learn to grasp the characteristics of the disease and deduce the possible through the mind map.Diseases and related relationships.

On the contrary, some of the course content in the first semester of my junior year of study was not very good, such as the detailed description provided by "Mr. Wang with Abdominal Pain" and the related examination results and the evolution of the condition, etc. The details are not perfect. Therefore, the PBL curriculum should have a sufficient amount of information from which teachers can inspire students to think.

Of course, PBL courses are best combined with clinical practice as much as possible, but in fact, many of the cases we encounter clinically are of high quality and can inspire students to think well. It is necessary for our clinical teachers to produce textbooks suitable for our national conditions on the basis of learning textbooks from European and American countries.

3 How to train PBL teachers

Although students are the main body of the curriculum in the PBL curriculum, and they are gradually developing around the content of the curriculum, the teacher plays a vital role in it. He dominates the rhythm of the classroom and the direction of discussion, mobilizes the atmosphere of the classroom, encourages and praises the students who are actively discussing, and makes high-profile evaluations of novelty and innovation.Creative ideas spur and motivate restrained and shy classmates.

However, since clinical teachers are limited to their respective clinical majors, if it is a topic discussed by their own majors, they may be able to guide their classmates from a professional perspective. If it is another major, they may not understand it themselves, so it is difficult to effectively guide their classmates in the classroom. At the same time, different teachers have different perspectives, personal experiences and levels of knowledge on the problem, and they may have different views on the same topic. How can they have effective discussions during class preparation to achieve the similarity of views?

The PBL teacher training I envisioned does not require specific class training, but everyone brainstormes together. Before each class, everyone spends an hour sitting down. The teachers of the relevant majors in this class will be the “teachers”, and the others will be the “students”. Everyone will speak like students, and one person will make relevant records. The "teacher“ provides corresponding guidance and explanations based on the characteristics of the major, while the ”students" put forward all the questions they can think of, bombarding them in turns, digging deeper and deeper into the problem, so that the relevant issues can be clarified thoroughly.

In the actual classroom, each PBL class is unique, because different students' understanding, thinking, and reaction cannot be the same, so teachers have to adapt to specific circumstances. Moreover, the classroom format may not necessarily be rigid or rigid, but should be flexible and changeable, which can mobilize everyone to participate in enthusiastic classes, and even have performances.