【正文】 s problem. ? Students are required also to extend their discussion beyond the biomedical and clinical sciences and consider the public health, socioeconomic, ethical and legal aspects of the case. How do I get started with PBL? Develop problems that: Capture students’ interest by relating to realworld issues. Draw on students’ previous learning and experience. Integrate content objectives with problemsolving skills. Require a cooperative, multistaged method to solve. Necessitate that students do some independent research to gather all information relevant to the problem. Design assessment tools that: Account for process (. research, collaboration) as well as content skills. Are closely tied to course learning objectives. Balance individual and group performance. How to create effective PBL scenarios ? Learning objectives likely to be defined by the students after studying the scenario should be consistent with the faculty learning objectives ? Problems should be appropriate to the stage of the curriculum and the level of the students39。 understanding ? Scenarios should have sufficient intrinsic interest for the students or relevance to future practice ? Basic science should be presented in the context of a clinical scenario to encourage integration of knowledge ? Scenarios should contain cues to stimulate discussion and encourage students to seek explanations for the issues presented ? The problem should be sufficiently open, so that discussion is not curtailed too early in the process ? Scenarios should promote participation by the students in seeking information from various learning resources CHECKLIST FOR PROBLEM CONSTRUCTION ? Is the content of the problem geared to students39。 psychosocial histories, physical exam, lab. tests. Additional information Further discussion with her GP reveals that Ms Smith’s chest pain and shortness of breath e on following exercise, particularly in a cold environment. When she bees particularly short of breath, she starts to wheeze. She sometimes has a dry cough and has never had haemoptysis. There is no recent history of physical trauma and no personal or family history of heart disease. She had eczema in childhood but has never had asthma. She has smoked for the past 5 years and increased her smoking to 40 cigarettes a day since she broke up with her intimate friend 3 months ago. She takes an oral contraceptive pill but no other medication. New information Revising their hypotheses Discard / Rerank / Other hypotheses ? Anxiety attacks with hyperventilation ? Possible thromboembolic disease due to oral contraceptive use ? Asthma ? Cardiac problem ? Broken rib 5. Defining learning objectives Once the students have decided on a preferred hypothesis (., allergy), they must explain the biomedical science mechanisms that link their hypothesis to the presenting problems. ? What students know? ? What they do not know? ? What they need to know? to further their understanding of the underlying mechanisms, and their ability to solve the clinical pr