Entwicklung und Evaluation von POL-Fällen zum Thema zentrale Bewegungsstörungen für den Studiengang Physiotherapie sowie Beurteilung dieses POL-Systems

This paper describes the development, presentation and evaluation of pbl-cases for the course of bachelor and master of physiotherapy, founded 2001 as a cooperation of the department of medicine at the Philipps-University of Marburg and the department of “care and health” at the college of Fulda. Three clinical cases about “degenerative diseases” and three clinical cases about “central movement disorders” have been modified to fit the pbl-system. The modification and explanatory texts should support preparation for future tutors. The evaluation afterwards allowed further improvement of the case-reports and gave useful feedback about the success and the students understanding of pbl. The evaluation-results have been very similar for both of the major themes (degenerative diseases and central movement disorders). Complicated cases, cases that were not straightforward, received better grades. Good structure of the case-presentation as well as during the final discussion has resulted in better grades, too. It was necessary for the students that there was an expert during the final discussion. An explicit answer to whether the tutor needs to be an expert or not could not be given. However, the experience the tutor gained in past sessions contributed a lot to the success of the pbl-session. A short exam before and after the pbl-session showed a slight improvement. Since the sessions were just one part of the curriculum, it cannot be seen as simply due to the pbl-course. Besides this individually experiences, I looked to find results that are more objective in literature. Although discussion began just after the initial use of pbl in medicine, the first reviews were not done until last centuries early 90s. “Does pbl improve the knowledge?”, “Is it better for live-long learning?”, “Does it change the way students ‘think’?” and “Are pbl students better prepared for the modern health-care system?” were just a few questions literature wanted to answer. Most of the literature was limited to simple case-reports on how pbl was integrated in a particular surrounding. Especially financial aspects were important. Smaller groups require new facilities and a change in teaching habits. Who is supposed to fulfil those needs? Especially the idea of a “tutor” is important when answering this question. Yet, literature still is undecided whether a tutor should be an expert or a non-expert. Groups lead by experts received better results as those lead by non-experts, but they probably have been more directed in their work on the cases. New literature still delivers more or less case-reports on how the curriculum was changed at certain universities. There will never be an objective answer to the question: Is pbl the better way of teaching? Too many aspects have to be considered. Especially when thinking about the financial aspect it should be clear that good medical education always requires more effort and can never be cheap. “Good value”: yes, “cheap”: no.