Is problem-based learning an experimentation platform in Chinese medical schools?

Dear Sir

We read with great interest Fan et al.’s (2014) article on the status of problem-based learning (PBL) in China. We performed a similar study with a larger sample size in 2012. The deans or directors in charge of teaching affairs from 102 medical schools in mainland China were invited to join an email-based questionnaire survey, and we finally received responses from 52 medical schools. Among them, 44 (85%) have introduced PBL into the curricula, the proportion of which is higher than Fan et al.’s data (79.1%). Of the 44, 25 (57%) medical schools expressed satisfaction with the effectiveness of PBL implementation. Interestingly, we noticed a relatively low proportion of PBL within the general curricula: 30 (68%) medical schools only used it for less than 10% of their entire curricula, which is much higher than Fan et al.’s data (37.5%). This can be explained by the fact that Fan et al.’s samples are all categorized as “first class” medical schools, which may be more willing to adopt PBL into their teaching practices.

The conflict between the positive feedback of PBL and its low proportion within the general curricula led to the assumption that PBL in Chinese medical schools remains as small-scale platform for experimenting with new learning strategies by respective schools. We noticed that several schools have already begun to utilize the value of this PBL as an experimentation platform, particularly in the fields of testing better integration of basic sciences with clinical medicine and diversifying the assessment methods of students. Among the 28 (64%) schools that have traditional discipline-based curricula, 6 schools are trying to innovatively implement PBL in either organ-based or cross-disciplinary fashion. Likewise, 26 (59%) medical schools claimed having adopted performance appraisal as a means for assessing students in addition to the traditional written exam. Adoption of oral test and presentation as well as combinatory evaluation instruments were also observed.

Although the effect of PBL implementation in the context of Chinese educational background will still be a hot debate in the near future, the small-scale implementations in many medical schools nowadays have shown great promise indeed. Its unique role as an experimentation platform will prove to be beneficial to medical schools willing to invite continuous update to their educational expertise and strategies.

(Presented at the 11th Asia Pacific Medical Education Conference, Singapore, January 15–19, 2014)

Declaration of interest: The authors report no conflicts of interest.