Practice and Deliberation of Integration of PBL with CBL Teaching Mode on the Teaching of Precision Medicine for Diabetes in Undergraduate Students

Li-mei Liu, Gui-hua Jian, Yan-jun Liu

Abstract


In recent years, the transition in the classification of diabetes and the establishment of four types of diabetes are the evidence for diagnosis and treatment of diabetes to orient and challenge precision medicine. Maturity onset diabetes of the young (MODY) is the most common form in special type of diabetes. The misdiagnosis rate of MODY is extremely high in diabetes due to its overlapping with type 1 diabetes and type 2 diabetes in some non-characteristic phenotypes. Therefore it is no time to delay to start the education on precision medicine of diabetes in undergraduate students. Integration of problem-based learning (PBL) with case-based learning(CBL) teaching mode was applied in the teaching for precision medicine of diabetes in undergraduate students, wherein a proposed case with MODY, was misdiagnosed as type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) successively, and eventually the classificatory diagnosis and individualized drug targeted therapy of this case were completed by etiological analysis and screening of pathogenic genes regarding to phenotypes and mechanism. Practice has proved that starting and implementing precision medicine teaching for diabetes by the application of integration of PBL with CBL teaching mode in undergraduate students, may effectively promote the precise classification and precise treatment, which is regarded as the goal for the process of precision medicine of diabetes.


Keywords


Diabetes; Precision medicine; Problem-based learning (PBL); Case-based learning (CBL); Integration

Full Text:

PDF (简体中文)

References


Reardon S. Precision-medicine plan raises hopes[J]. Nature, 2015, 517(7536): 540. https://doi.org/10.1038/nature.2015.16774

贺林. 新医学是解决人类健康问题的真正钥匙——需“精准”理解奥巴马的“精准医学计划”[J]. 遗传, 2015, 37(6): 613-614.

殷燕, 任牡丹, 卢新兰, 等. 结合精准医学的PBL教学法在临床医学八年制教学中的应用[J]. 西北医学教育, 2016, 24(3): 341-343.

Mirnezami R, Nicholson J, Darzi A. Preparing for precision medicine [J]. N Engl J Med, 2012, 366(6): 489- 491. https://doi.org/10.1056/NEJMp1114866

Yu Xu, Limin Wang, Jiang He, et al. Prevalence and control of diabetes in Chinese adults[J]. JAMA, 2013, 310(9): 948-958. https://doi.org/10.1001/jama.2013.168118

American Diabetes Association. Diagnosis and classification of diabetes mellitus [J]. Diabetes Care, 2010, 33: S62-69. https://doi.org/10.2337/dc10-S062

American Diabetes Association. Classification and Diagnosis of Diabetes [J]. Diabetes Care, 2017, 40 (Suppl. 1): S11-S24. https://doi.org/10.2337/dc17-S005

Vaxillaire M, Froguel P. Monogenic diabetes in the young, pharmacogenetics and relevance to multifactorial forms of type 2 diabetes [J]. Endocrine Reviews, 2008, 29(3): 254-264. https://doi.org/10.1210/er.2007-0024

刘丽梅. MODY的特点、基因诊断与转化医学. 中华糖尿病杂志[J]. 2014, 6 (1): 5-9.

Fajans SS, Bell GI. MODY: history, genetics, pathophysiology, and clinical decision making [J]. Diabetes Care, 2011, 34(8): 1878-1884. https://doi.org/10.2337/dc11-0035

Shields BM, Hicks S, Shepherd MH, et al. Maturity-onset diabetes of the young (MODY): how many cases are we missing [J]? Diabetologia, 2010, 53(12): 2504-2508. https://doi.org/10.1007/s00125-010-1799-4

Pihoker C, Gilliam LK, Ellard S, et al. Prevalence, characteristics and clinical diagnosis of maturity onset diabetes of the young due to mutations in HNF1A, HNF4A, and glucokinase: results from the SEARCH for Diabetes in Youth. J Clin Endocrinol Metab 2013, 98: 4055-4062. https://doi.org/10.1210/jc.2013-1279

Gilkison A. Problem-based learning, tutor expertise: the need for different questions[J]. Medical Education, 2004, 389(2): 921-926. https://doi.org/10.1111/j.1365-2929.2004.01939.x

周庆, 周峰, 吴彩霞, 等. PBL 在临床教学中的应用研究[J]. 中华医学教育探索杂志, 2012, 11(6): 591-594.

俞方. 美国医学课程改革历程探索[M]. 北京: 人民卫生出版社, 2010: 48-52.

陶靖. PBL与CBL双轨教学模式在留学生眼科见习中的应用[J]. 西北医学教育, 2013, 21(5): 933-936.

刘丽梅, 贾伟平. 病因选择治疗:青少年的成人起病型糖尿病开启糖尿病精准医疗时代[J]. 中华糖尿病杂志, 2016, 8(6): 329-332.

Li-mei Liu. Exploration of the new teaching mode for the reform in the integration of genetics and diabetology in the learning curriculum systems [J]. Journal of Education in New Century, 2015, 3(2): 15-18. http://dx.doi.org/10.14725/jenc.v3n2a1272




DOI: http://dx.doi.org/10.14725/jenc.v4n2a1699

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

Journal of Education in New Century

 ISSN 2372-6539 (Print)  ISSN 2330-9121 (Online)