Skip to main content
SpringerLink
Log in

Problemorientiertes Lernen in der Chirurgie

Erhöhte Lernmotivation bei geringerem Personalaufwand?

Problem-based learning for surgery

Increased motivation with less teaching personnel?

  • Originalien
  • Published:
Der Chirurg Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Traditionelle dozentenorientierte Lernstrategien werden den Gegebenheiten der Erwachsenenlehre häufig nicht gerecht. Die Einführung von Kleingruppen ist sehr personalintensiv. Problemorientiertes Lernen (POL) könnte bei geringerem Personalaufwand die Motivation der Lernenden erhöhen.

Methode

Medizinstudierende im 4. klinischen Semester (n=98) wurden randomisiert einem strukturierten chirurgischen Praktikum (SP) oder einem POL-Praktikum zugeordnet. Die Motivation der Studierenden und die Akzeptanz der beiden Praktikumsformen wurden am Ende des Semesters anhand eines anonymisierten Fragebogens ermittelt (1 sehr gut bis 6 ungenügend).

Ergebnisse

Sowohl die Struktur der Lehrveranstaltung als auch die Dozenten wurden von den POL-Studierenden besser bewertet (p jeweils <0,01). Die Motivation, sich über das Praktikum mit chirurgischen Fragestellungen zu beschäftigen, war nach dem POL mit 1,8 deutlich ausgeprägter als nach dem SP mit 3,1 (p<0,01). Das Gesamturteil des SP war mit 3,0 wesentlich schlechter als für das POL (1,4; p<0,01).

Schlussfolgerung

POL im chirurgischen Praktikum erhöht bei geringem Personalaufwand die Akzeptanz und Motivation der Lernenden. POL sollte in zunehmenden Maße in der Aus- und Weiterbildung eingesetzt werden.

Abstract

Background

Traditional teacher-centred education strategies often do not meet the needs and student abilities of adult learning. The introduction of small learning groups requires considerable increases in staff. Problem-based learning could increase the motivation to acquire knowledge but without being as staff-intensive.

Methods

Medical students (n=98) in their fourth clinical semester were randomly assigned to either a structured course (SC) or problem-based learning (PBL) for surgery. Their motivation and acceptance of the courses were recorded at the end of term in anonymous questionnaires using Likert scales, with scores ranging from 1 (very good) to 6 (unsatisfactory).

Results

Both course structure and the teachers received much better ratings from the PBL students (P<0.01 each). The motivation of students to deal with surgical problems beyond the course material was significantly higher after PBL, with 1.8 (0.7), than after the structured course with 3.1 (1.2) (P<0.01). The overall rating was substantially worse for the structured course, with 3.1 (1.2) than for PBL at 1.4 (0.6) (P<0.01).

Conclusions

Problem-based learning in the surgical curriculum increases student acceptance and motivation with little demand on staff. It should be increasingly implemented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Notes

  1. Die Autoren möchten sich an dieser Stelle bei den Mitarbeitern des Reformstudiengangs an der Charité Berlin recht herzlich für die Unterstützung bei der Erlernung der POL-Technik bedanken.

Literatur

  1. Albanese MA, Mitchell S (1993) Problem-based learning: a review of literature on its outcomes and implementation issues. Acad Med 68:52–81

    CAS  PubMed  Google Scholar 

  2. Antepohl W, Herzig S (1999) Problem-based learning versus lecture-based learning in a course of basic pharmacology: a controlled, randomized study. Med Educ 33:106–113

    Google Scholar 

  3. Barrows H (2000) Problem-based learning applied to medical education. SIU School of Medicine, Springfield IL

  4. Beard JD, Robinson J, Smout J (2002) Problem-based learning for surgical trainees. Ann R Coll Surg Engl 84:227–229

    Google Scholar 

  5. Blosser A, Jones B (1991) Problem-based learning in a surgery clerkship. Med Teach 13:289–293

    Google Scholar 

  6. Chang G, Cook D, Maguire T, Skakun E, Yakimets WW, Warnock GL (1995) Problem-based learning: its role in undergraduate surgical education. Can J Surg 38:13–21

    Google Scholar 

  7. Eagle CJ, Harasym PH, Mandin H (1992) Effects of tutors with case expertise on problem-based learning issues. Acad Med 67:465–469

    Google Scholar 

  8. Haidet P, Morgan RO, O’Malley K, Moran BJ, Richards BF (2004) A controlled trial of active versus passive learning strategies in a large group setting. Adv Health Sci Educ Theory Pract 9:15–27

    Google Scholar 

  9. Itani KM, Miller CC, Church HM, McCollum CH (1997) Impact of a problem-based learning conference on surgery residents‘ in training exam (ABSITE) scores. American Board of Surgery in Training Exam. J Surg Res 70:66–68

    Google Scholar 

  10. Kaufman DM, Mann KV (1996) Comparing students‘ attitudes in problem-based and conventional curricula. Acad Med 71:1096–1099

    Google Scholar 

  11. Kaufman DM, Mann KV (1998) Comparing achievement on the Medical Council of Canada Qualifying Examination Part I of students in conventional and problem-based learning curricula. Acad Med 73:1211–1213

    Google Scholar 

  12. Kilroy DA (2004) Problem based learning. Emerg Med J 21:411–413

    Google Scholar 

  13. Kneebone R, ApSimon D (2001) Surgical skills training: simulation and multimedia combined. Med Educ 35:909–915

    Google Scholar 

  14. Konig S, Markus PM, Becker H (2001) Lehren und Lernen in der Chirurgie — das Göttinger Curriculum. Chirurg 72:613–620

    Google Scholar 

  15. McGregor DB, Arcomano TR, Bjerke HS, Little AG (1995) Problem orientation is a new approach to surgical education. Am J Surg 170:656–658

    Google Scholar 

  16. Nash PP, Schwartz RW, Middleton JL, Witte FM, Young B (1991) A student-centered, problem-based surgery clerkship. Acad Med 66:415–417

    Google Scholar 

  17. Newman M (2003) A pilot systematic review and meta-analysis on the effectiveness of Problem Based Learning.http://www.ltsn01.ac.uk

  18. Rice LT, Solis MM, Rogers JJ, Dalton ML (1996) Surgical clerkship performance of traditional and nontraditional students in a problem-based learning environment. Am J Surg 172:283–285

    Google Scholar 

  19. Richards BF, Ober KP, Cariaga-Lo L et al. (1996) Ratings of students‘ performances in a third-year internal medicine clerkship: a comparison between problem-based and lecture-based curricula. Acad Med 71:187–189

    Google Scholar 

  20. Schwartz PL, Loten EG (2004) Influence of type of curriculum on students‘ perceptions of the medical course: a compilation of results from the Cognitive Behavior Survey, Attitudes Toward Social Issues In Medicine survey, and Learning Environment Questionnaire. Teach Learn Med 16:123–132

    Google Scholar 

  21. Schwartz RW, Donnelly MB, Nash PP, Johnson SB, Young B, Griffen WO Jr (1992) Problem-based learning: an effective educational method for a surgery clerkship. J Surg Res 53:326–330

    Google Scholar 

  22. Schwartz RW, Donnelly MB, Nash PP, Young B (1992) Developing students‘ cognitive skills in a problem-based surgery clerkship. Acad Med 67:694–696

    Google Scholar 

  23. van Gessel E, Nendaz MR, Vermeulen B, Junod A, Vu NV (2003) Development of clinical reasoning from the basic sciences to the clerkships: a longitudinal assessment of medical students‘ needs and self-perception after a transitional learning unit. Med Educ 37:966–974

    Google Scholar 

Download references

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

Author information

Authors and Affiliations

  1. Universitätsklinik für Allgemein-, Visceral-, Gefäß- und Thoraxchirurgie, Universitäre Medizin Berlin—Charité Campus Mitte

    C. Langelotz, T. Junghans, N. Günther &  W. Schwenk

  2. Universitätsklinik für Allgemein-, Visceral-, Gefäß- und Thoraxchirurgie, Universitäre Medizin Berlin—Charité Campus Mitte, Schumannstraße 20/21, 10117 , Berlin

    W. Schwenk

Authors
  1. C. Langelotz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Junghans
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. Günther
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. W. Schwenk
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. Schwenk.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Langelotz, C., Junghans, T., Günther, N. et al. Problemorientiertes Lernen in der Chirurgie. Chirurg 76, 481–486 (2005). https://doi.org/10.1007/s00104-004-0987-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00104-004-0987-5

Schlüsselwörter

Keywords

Search

Navigation