1. Group Emulating Workshop Advances
the Outcome in Teaching Evidence-Based Medicine
Taipei Medical University-Wan Fang Hospital
Department of Gastroenterology
Ming Shun Wu, M.D., Ph.D.
June
Professor Dorsey. Ladies and Gentleman. Thanks to Fu- Ren University for giving me this opportunity to talk about the application of PBL in Taipei Medical University. 1

2. PBL Partnership-Bonded Learning Problem-based learning
PBL not only offered knowledge-based learning, but the most important is interpersonal communication skills.
Population-Behavior-Life
Sciences
Properly-Balanced
Learning

3. To teach students in accordance with their aptitude by group discussion (因材施教)
子貢曰：「貧而無諂，富而無驕，何如？」子曰：「可也；未若貧而樂，富而好禮者也。」
子貢曰：「詩云：『如切如磋，如琢如磨』，其斯之謂與？」子曰：「賜也，始可與言詩已矣，告諸往而知來者。」
The Question-Answer concept had been innovated in the Confucius Era in China, about 2500 years ago. The teachers teach students in accordance with their aptitude by group discussion.

4. Recorder Chairman Tutor
This is a formal situation of PBL, the students divided into chairman, recorders and team members. They discussed each other with a clinical scenario and the tutor only observed and facilitated the processes.
Tutor

5. PBL process Step 1 Identify facts & problems
Step 2 Hypothesis generation
Step 3 List need to know
Step 4 Formulate learning objectives
Step 5 Self-directed learning
Step 6 Group discussion and communication
Step Feedback
As we know that PBL has 7 processes which covered problem solving and communication skills. The first 4 steps was applied in the first class.

6. Evidence-based medicine
Literature
EBM
Evidence-based medicine
In the mean time, my colleague had some problems about teaching EBM for the students are not so interested in the class. He ask me how to solve the problem of self-directed learning of EBM
Expectation
Patient
Experience
Clinician

7. 資訊分享 過程稽核 Part 1 問題形成 Part 2 文獻搜尋 Part 4 臨床應用 Part 3 文獻評讀
Then we go back to train the postgraduated doctors to learn PBL-EBM

8. PBL
EBM
This was a spotlight for us to solve the teaching problem of EBM. In another way, we developed tools to conquer the problem.

9. PDCA for PBL and EBM FeedbAck Clinical Application
Identify facts & Problems
PICO
Media show
Action
Plan
Check Do
Self-Directed learning
Data (literature) search
The PDCA is a very famous process improvement cycle. We integrated PBL and EBM in the improving cycle to find potential resolution.
Group Communication
Critical appraisal

10. 4th Asia-Pacific Conference on Problem-based learning in the Health science
INTEGRATION OF EVIDENCE-BASED MEDICINE AND PROBLEM-BASED LEARNING IN THE CLINICAL CURRICULUM OF CLERKSHIP
Wu, M.S., Lien, G.S., Chiu, W.T., Chen, C.F.
Taipei Medical University-Wan Fang Hospital, Taiwan
2003

11. Large class Mini-lecture for EBM

12. Small groups tutorials
Give a scenario Ask clinical questions group discussion for PICO Define learning objectives
Literature search group discussion for literature search Define learning objectives
Critical appraisal group discussion for literature searchDefine learning objectives

13. Small groups feedback and large class presentation
Back to the scenario  clinical application

14. Group Emulation Advances the Outcome in Teaching Evidence-Based Medicine
We published a document about team-based learning of EBM
2007

15. Group emulating workshop
Workshop is a practical way to clinicians, nurses and other medical staffs to learn evidence-based medicine (EBM).
According to learning pyramid, practice and teaching each others increase knowledge retention rate.
Group emulating workshop is an interesting way of practice and teaching.

16. （NTL, 1960’s） 5%
進行實證醫學的授課時，我們更感受到講授式的教學方式成效有限，根據「學習金字塔」理論(圖一)[2]得知，對成人而言，從講授式教學所獲得的長期成效，可能只剩下5%；相反地若以實際操作的方式學習，則成效可高達75%-90%，因此本研究設計一以實際操作為主的教學模式，對講求理論和實務並重的臨床醫學而言，實有其必要性。
[2] Wood EJ: Problem-based learning: exploiting knowledge of how people learning to promote effective learning. BEE-j :3-5.

17. Five sessions of the workshop
Formulate the possible questions of the topic
Draw up searching strategies
Critical appraisal
Answer the questions in an easy to understand academic way.
Group feedback.

18. Results-1 Formulate questions

19. Results-2 Literature search

20. Results-3 Critical appraisal

21. Team-based learning A potential solution to the problems of large classes
Principle 1 － Groups Must Be Properly Formed and Managed
Principle 2 － Students Must be Made Accountable Principle 3 － Team Assignments Must Promote Both Learning and Team Development Principle 4 － Students Must Receive Frequent and Immediate Feedback
After years of our innovation, we found the strategy is comparative to team-based learning
Michaelsen, L.K. et al. (1982) . Exchange: The Organizational Behavior Teaching Journal

22. Process of TBL in teaching EBM
Mini-lecture
5 steps of EBM
1. Ask a clinical question
2. Group discussion for PICO
3. Define appeal
4. Instructor feedback
Small group practice
PPT presentation
Feedback
In large classes, we divided them into several small group which contain 5-8 persons.
Phase 1
Phase 2
Phase 3

23. Conclusion Group emulation workshop can facilitate teaching EBM.
Network instruction in each small group improves the EBM learning process.
Group feedback is the key point in group emulation workshop.

24. Thank you!
The tutor’s role is to handle the speed of students with a link, not too fast or too lag. Thank you for your attention!