1. Problem based learning in Cancer Education Jakob de Vries MD PhD surgical oncologist Co director WHO CCCE Groningen University Hospital The Netherlands Europe

2. Learners are not vessels to fill but candles to lit

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7. A 53 y-o woman fractures her hip 4 yr after she was treated for breast cancer. Could there be any causative relation and what would you do ?

8. “You can only learn what you don’t know” Dr C.B. Mueller Professor emeritus, Surgery, McMaster University

10. GPEP Report … to keep abreast of new scientific information and new technology, physicians continually need to acquire new knowledge and learn new skills. Therefore a general professional education should prepare medical students to learn throughout their professional lives rather than simply to master current information and techniques. Active, independent, self ‑ directed learning requires among other qualities the ability to identify, formulate, and solve problems; to grasp and use basic concepts and principles; and to gather and assess data rigorously and critically … American Medical Colleges' Panel on the General Professional Education of the Physicians, 1984

11. Publications on PBL Medline Nr per year GPEP Report

12. World PBL Map

14. Contextual Learning Assessment portfolio Scientific training Junior doctor

15. Biological Psychologica l Society Science teacher student 4 3 1 5 Social patient Health Care System 2

16. Curriculum philosophy = Learning in context... for future application, knowledge gathered within the context of application is better accessible than knowledge not gathered within that context.

17. STUDENT ACTIVITIES in C2000 before time for studies23801260 hrs time for tutorials 400 0 hrs time for lectures 8402800 hrs

19. Europe 50 countries

20. European Union 15 members 6 candidates

21. RECOMMENDATIONS FOR UNDERGRADUATE MEDICAL EDUCATION Advisory Committee on Medical Training of the European Union 1993  The primary goal of the undergraduate curriculum is the provision of appropriate knowledge, skills, attitudes and ethical values;  The number of years should remain unchanged at six, or at least 5.500 hours of theoretical and practical teaching;  During his undergraduate training the student must be prepared to adjust to changes in medical practice during his postgraduate and continuing medical education;  The curricula should be composed of two core parts, the basic sciences and the elinical sciences, which may be integrated. The sciences basic to medicine include also psychology and human behaviour;  Basic sciences teaching should be medically oriented, more practical and tailored to the needs for clinical sciences teaching;  Attention should be drawn not to overload the medical curricula;  A switch should be made from passive instruction to active learning;  Core and options within the curricula should be reviewed regularly;  Clinical bedside teaching should be increased both by enlarging teacherlstudent and student/patient contacts;  Attention should be drawn to methods of learning and examinations. The latter must remain compatible with the leaming process;  Participation of students in evaluation of the curriculum should be stimulated;  Clinical teaching outside the hospital (ward) is recommended.  Medical education should concentratie on students and not on subject matter;  Attention for the learning of methods of finding, wording and solving specific, fundamental, but especially clinical problems, on the basis of a multidisciplinary approach;  Theoretical and practical training of elinical methodology are essential;  lt is further recommended to develop a European medical final examination and a systern of quality control.

22. Curriculum structures in Europe Numerus clausus Yrs of study

23. Countries with PBL curricula