Objective: To study students’ perspective on the key factors and effectiveness of problem-based learning (PBL) small-group discussions Methods: A qualitative study was conducted using participant observation and semi-structured interviews for data collection. The 4^(th)-year medical students from a Pathology and Pharmacology PBL Group Discussion course in 2016 were invited to join this study. The participants were chosen by purposive sampling and were interviewed after each class session. Results: A total of 17 medical students (eight men and nine women) were interviewed and included in the final analysis. The students considered that the key elements of PBL were motivation triggering, lesson plan design, pre-class preparation, in-class discussion, and teacher guidance. The effectiveness of PBL as perceived by the students included: the ability to search the literature and give an impressive presentation; enhancement of a tendency towards self-directed learning, logical thinking, expression, and communication skills; and improvement in interpersonal interactions. Conclusion: In the problem-based small-group discussion, the medical students were guided to develop clinical reasoning through the presentation of a patient's problems in a real-life setting. The knowledge and skill they learned in this class are expected to be useful in their future professional career when various resources could be combined, including prior knowledge, literature search, interpersonal skills, and reflection and reasoning skills.
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