title: Comparison of three problem-based learning conditions (real patients, digital and paper) with lecture-based learning in a dermatology course: a prospective randomized study from China.
abstract: BACKGROUND
  The precise effect and the quality of different cases used in dermatology problem-based learning (PBL) curricula are yet unclear.
  
  
  OBJECTIVE
  To prospectively compare the impact of real patients, digital, paper PBL (PPBL) and traditional lecture-based learning (LBL) on academic results and student perceptions.
  
  
  METHODS
  A total of 120 students were randomly allocated into either real-patients PBL (RPBL) group studied via real-patient cases, digital PBL (DPBL) group studied via digital-form cases, PPBL group studied via paper-form cases, or conventional group who received didactic lectures. Academic results were assessed through review of written examination, objective structured clinical examination and student performance scores. A five-point Likert scale questionnaire was used to evaluate student perceptions.
  
  
  RESULTS
  Compared to those receiving lectures only, all PBL participants had better results for written examination, clinical examination and overall performance. Students in RPBL group exhibited better overall performance than those in the other two PBL groups. Real-patient cases were more effective in helping develop students' self-directed learning skills, improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition, compared to digital and paper cases.
  
  
  CONCLUSIONS
  Both real patient and digital triggers are helpful in improving students' clinical problem-handling skills. However, real patients provide greater benefits to students.
authors.affiliation: Department of DErmatology, Xiangya Hospital, Central South University, Hunan, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.forename: Qing Ling
authors.initials: QL
authors.lastname: Li
authors.forename: Ji
authors.initials: J
authors.lastname: Li
authors.forename: Ming Liang
authors.initials: ML
authors.lastname: Chen
authors.forename: Hong Fu
authors.initials: HF
authors.lastname: Xie
authors.forename: Ya Ping
authors.initials: YP
authors.lastname: Li
authors.forename: Xiang
authors.initials: X
authors.lastname: Chen
mesh_terms: D002681:China; D002983:Clinical Competence; D003198:Computer Simulation; D003258:Consumer Behavior; D003880:Dermatology; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D010361:Patients; D010808:Physical Examination; D018794:Problem-Based Learning / Q000379:methods*; D011446:Prospective Studies; D013337:Students, Medical / Q000523:psychology*