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health problem is assessed using information on mortality morbidity, and the
efficacy and effectiveness of preventive or treatment measures (MacDonald et
al. 1989). Problem-based learning methods are used to develop the students'
problem-solving abilities.
Problem-based learning makes use of realistic clinical scenarios described and
presented on paper. In this way, students acquire the background knowledge
and concepts necessary to understand health issues as if they were actually
the doctors and decision-makers depicted. This method contrasts with the
lecture or textbook-oriented approach, which may cover similar material, but
lacks the immediacy and clinical relevance that often determine the usefulness
of the concepts and facts the student is learning.
Although learning by this method has been shown to be no more effective
than conventional techniques, its strengths are twofold (Norman 1988). The
students' level of enjoyment and engagement in the learning process is higher
than with conventional approaches, probably as a result of the opportunity to
put oneself "in the shoes" of the clinician and decision-maker. The second
advantage, based on psychological theory, is that knowledge is much better
remembered in the context in which it was originally learned. By associating
the learning process with life-like scenarios, the assumption is that the relevant
knowledge will be more easily retrieved and applied when an actual clinical
problem arises. In the context of CTPB learning, the student also has the
opportunity to apply and consolidate his or her ability to evaluate population
health information; and to assist in determining the magnitude of a given
health problem within a community and the effectiveness of a prevention
program.
Goals in developing the CTPB
pesticide module
As a predominately agricultural country, issues of population health and
medical education in Thailand are particularly relevant in examining how the
current system addresses health problems associated with the use of pesticides.
Traditionally, medical training and the provision of services have been
largely aimed at the treatment of poisoning cases at the hospital level. At
present, it is unlikely that a conventionally trained physician has an appreciation
of the scope of the problem or the skills and support to help implement
effective programs, such as community-directed education and village surveys,
that could lead to the prevention of most unintentional poisonings.
In 1989-1990, a problem-based learning package on pesticides and their health
effects was developed for use in Thai medical schools at the Faculty of
Medicine, Chulalongkorn University. This subject was selected because:
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