A PBL approach to learning - A/Prof Wan's Case Studies
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A PBL approach to learning - A/Prof Wan's Case Studies

Author's Preface

Assoc Prof. Michael WanI have great pleasure to introduce this new book to you. The book is designed for undergraduate or postgraduate medical students in both pre-clinical and clinical years and would also serve as a useful reference for undergraduate nursing students.

Problem based learning (PBL) tutorials have been adopted by many medical schools to enhance learning in the pre-clinical years. The rationale behind using this PBL approach is to enable the students to become a clinically competent medical professional by training them to reason through a case to reach a diagnosis. (Van Der Vleuten & Newble 1995). Clinical competence not only involves diagnosing known illnesses, but also being able to reason and make diagnoses in clinical problems which are as yet defined. (Helfer et al 1971).

In this book, I have compiled together 24 common and important clinical cases that I have managed during my practice as a clinician over the years. Each case is presented with an initial symptom just like what you would encounter in the real-life scenario. Co-authors of this book are the first cohort of medical students from the School of Medicine, Sydney (The University of Notre Dame Australia). They contribute to the PBL approach sections by answering the typical questions: 'What do you know?', 'What else would you like to know?', 'What are your differential diagnoses?' follow by generating the relevant likely hypotheses. Each case is concluded with the management implemented and a summary targeting the relevant learning outcomes.

The book is specifically divided into 3 coloured sections representing the progression of learning using the PBL approach. As you cruise along the 3 stages, you will notice significant changes in the approach to answering the same questions even with similar presenting symptoms. This progression is very similar to the development of your clinical reasoning skills from the pre-clinical to the clinical years. At the 3rd coloured-stage of the book, the student will be asking targeted questions and performing focused examinations.

The appendix contain the Mnemonics section in which we have collected some very useful acronyms to guide you in asking relevant questions during the history taking session so as to generate appropriate hypotheses on the underlying diagnosis. These are compiled from the various PBL groups in the pre-clinical years.

After studying through all the sections of this book, you will be able to:

  • identify the relative significance of the important clinical information presented in a scenario
  • ask appropriate questions in the history and perform relevant targeted physical examinations and formulate the working and differential diagnoses using your clinical reasoning skills
  • generate and prioritise hypotheses using the relevant information in the scenario
  • generate the causes and underlying mechanisms for common presenting symptoms and signs related to the clinical condition
  1. Van der Vleuten C, Newble D. 1995. How can we test clinical reasoning? Lancet 345:1032-1034.
  2. Helfer RE. 1971. Measuring the process of solving clinical diagnostic problems. British Journal of Medical Education 5:48-52.


Assoc Prof. Michael Wan
Assoc Prof. Michael Wan
M.B.Ch.B., M.R.C.P. (UK) , F.R.C.P. (Edinburgh) , F.H.K.C.P.,
Graduate Certificate in University Teaching (GCUT),
F.H.K.A.M. (Medicine), Specialist in Advanced Internal Medicine (HK),
Specialist in Cardiology (HK), RQP (GB)