医学免疫学复习资料：The advantages and defects of PBL learning in immunology

TheadvantagesanddefectsofPBLlearninginimmunologyBloom,B.S.;Engelhart,M.D.;Furst,E.J.;Hill,W.H.;

Krathwohl,D.R.

(1956).

Taxonomyofeducationalobjectives:Theclassificationofeducationalgoals.HandbookI:Cognitivedomain.NewYork:DavidMcKayCompany.Highercognitivethinkinginvitesafurtherunderstandingofcontentsuchas:ProblemsolvingMakingjudgementsEvaluationReflection

Airasian,PeterW.etal.,(2000).InAnderson,LorinW.etal.(eds).

Ataxonomyforlearning,teaching,andassessing:ArevisionofBloom'staxonomyofeducationalobjectives.AllynandBacon.

ISBN

978-0-8013-1903-7.RevisedBloom’staxonomy.WoodDF.ProblembasedlearningBritishMedicalJournal.2003326:328-30..WoodDF.ProblembasedlearningBritishMedicalJournal.2003326:328-30.DolmansD,GijbelsD.Researchon

problem-basedlearning:futurechallenges.Med.Educ.201347:214-8.

ComparingPBLwithlearninginconventionalclassrooms:Traditionallearningapproaches

tend

toproducebetteroutcomesonassessmentsofbasicscienceknowledge,butdon’talwaysdosoPBLapproaches

tend

toproducebetteroutcomesintermsofclinicalknowledgeandskillsMorerecentmeta-analysespointtotheimportantrolesofseveralmediatingvariablessuchasthetypeofproblemtasks

andlevelofassessment

inexplainingtheeffectsofPBLStrobelJ,

vanBarneveldA.

WhenisPBLmoreeffective?Ameta-synthesisofmeta-analysescomparingPBLtoconventionalclassrooms.

InterdisciplJProblemBasedLearn2009;3:44–58PBLsuperiorfor:LongtermmemoryretentionSkilldevelopmentStudentsatisfactionTeachersatisfactionTraditionalteachingsuperiorfor:Shorttermretention(asassessedbyexams)StrobelJ,

vanBarneveldA.

WhenisPBLmoreeffective?Ameta-synthesisofmeta-analysescomparingPBLtoconventionalclassrooms.

InterdisciplJProblemBasedLearn2009;3:44–58PBLissignificantlymoreeffectivethantraditionalinstructiontotraincompetentandskilled

practitionersandtopromotelong-termretentionof

knowledgeandskillsacquiredduringthelearning

experienceortrainingsession.Measuresofshort-termknowledgeacquisitionand

retentiongavemixedresults,buttendedtofavor

traditionallearningapproaches.AtUCL(UniversityCollegeLondon)weuseaMIXTUREofteachingmethodsAcoupleofexamplesofPBL(onescience-basedandonemoreclinical):Cellspecialisationintheimmunesystem-1Thecellsoftheimmunesystemprotectusfrompathogens,e.g.bacterial,viral,fungalorparasiticinfection.Mostofthecelltypesthatcomprisethissystemarederivedfrompluripotenthaematopoieticstemcellspresentinthebonemarrow.Thesestemcellsdifferentiatedowndifferentmyeloidorlymphoiddevelopmentalpathways(Figure1)intothevarioustypesofimmunesystemcells,eachspecialisedtocarryoutdifferentfunctions.Thedifferentiatedmaturecells,whicharereleasedtothe‘periphery’(atermimmunologistsusetodescribeanywhereoutsideofthebonemarrowandthymus),includethephagocyticneutrophilsderivedviathemyeloidpathway,

andtheB-lymphocytes

(B-cells)derivedviathelymphoidpathway.Cellspecialisationintheimmunesystem-2Thephagocytesengulfmicroorganismsintoastructurecalledaphagosome.Otherstructurespresentinthephagocytescalledlysosomescontain

microbicidesandfusewiththephagosomeleadingtosubsequentkillingofthemicrobe.Onetypeoflymphocyte,theT-cell,onlybecomesfullyformedafterdifferentiatinginthethymus.Anothertypeoflymphocyte,theB-cell,canfurtherdifferentiateintoplasmacellswhicharespecialisedtosecreteantimicrobialproteinscalledantibody.Theantibodymoleculesbindtothepathogenandthereby‘tag’itforsubsequentdestructionbyothercomponentsoftheimmunesystem,suchasphagocyticcells.NowlookatFigure2andanswerthequestions(onyourhandout)relatedtoneutrophilsandB-cells.Figure1-DifferentiationofhaematopoieticstemcellsintothespecialisedcellsoftheimmunesystemErythrocytePlateletsMonocyteB-cellNKcellDendriticcell(lymphoid)Self-renewingpluripotenthaematopoieticstemcellsCommonlymphoidprogenitorCommonmyeloidprogenitorT-cellDendriticcell(myeloid)MegakaryocyteThymusNeutrophilEosinophilBasophilMastcellBONEMARROWMacrophagePlasmacellMYELOIDDEVELOPMENTALPATHWAYLYMPHOIDDEVELOPMENTALPATHWAYPERIPHERYSelfrenewingpluripotenthaematopoieticstemcellBONEMARROWBLOODCIRCULATIONTISSUESMicrobes(+antibody)AntibodyzCelldifferentiation&specialisationB-cellFigure2-FOCUSONNEUTROPHILSANDB-CELLSNeutrophilEMEMNeutrophilEngulfmentLightmicroscopePlasmacellLightmicroscopeRecognition&bindingSecretionQuestions

1Whatdoyouthinkisresponsibleforinducingthechangesinthebonemarrowhaematopoieticstemcellthatallowsittobecomethedifferenttypesofcellsinthebloodcirculation,e.g.neutrophilsandB-cells?WhatisthesignificanceoftheB-celldifferentiatingintoaplasma

cell?WhatarethestructureslabelledXandYintheelectronmicrograph

(EM)oftheplasmacellandwhataretheirfunctions?

4Whatisthemainsecretedproductoftheplasmacell?5WhatwouldbetheconsequenceoftheabsenceofB-cellsin

patients?

Questions

6Whatisthedifferenceintheshapeoftheneutrophilnucleus

comparedtothenucleusoftheB-cellandplasmacell?

7WhatarethestructureslabelledZintheEMoftheneutrophiland

whatdoyouthinktheirfunctioncouldbe?

VIDEO-Phagocytosis

8Howdoyouthinkthataphagocytemightdetectthepresenceofa

microbe?

9Whydoyouthinkthatthebacteriaarenotkilledimmediately

followingengulfment?

Whatwouldtheconsequencebeifapatientdidnothaveany

phagocytes?4weekInfection&DefenceModuleforMedicalStudentsPBLCaseeachweek:Streptococcalsorethroat,TB,Malaria,HIVTheOrganism

Entry,spreadandvirulencefactors

Hostresponseandavoidance

Tissuedamage–mechanismsandcomplications

Diagnosis,treatmentandpreventionQUESTIONS:

InwhatwayisthediagnosisofHIVinfectionusuallymadeand

wh