Effectiveness of the application of small private online course combined with PBL model based on massive open online course in the teaching of neurology | BMC Medical Education

Neurology is highly specialized and difficult to understand, and is closely related to multiple basic medical disciplines, including anatomy, pathology, and diagnostics. The intersection and integration of these knowledge systems increases the difficulty of teaching neurology and also affects students’ enthusiasm for learning this subject [16,17,18]. Almost all chapters of neurology require students to review neural anatomy beforehand, but the anatomy course is typically offered in the first year of college and has been forgotten because of a long interval. Given the limited total class hours of this course, it is impractical to complete the review, learn new knowledge, and interact with students during class time [7]. Although the traditional LBL teaching model has unique advantages in classroom teaching [19, 20], the one-sided output of teachers makes students feel bored and unfocused. Teachers only completed the teaching task, were unable to fully understand the students’ grasp of the important and difficult points in each class, and were unable to guide students to analyze and solve problems independently [21]. In addition, it has entered the era of “knowledge explosion,” and traditional LBL teaching has been affected by time, space, and equipment, which can no longer meet current needs [22, 23]. MOOC is a large-scale open online course developed by Dave Cormier [24]. As the name suggests, all MOOC courses are openly accessible, not only online [25], but also in various flexible ways for students to acquire educational resources [26]. SPOC combines face-to-face classroom learning with online self-study, forming a sharp contrast with fully online MOOC [27]. It reintegrates the online and offline classrooms.

Practical implications of this study

This study utilized the advantages of SPOC to divide the teaching process into three stages: before class, during class, and after class. The effective of a hybrid teaching model can fully utilize Internet resources, making it more diverse than traditional single-classroom teaching in the past. Before class, teachers will publish the learning objectives and tasks of each chapter on the learning platform, allowing students to specify and quantify the content of the chapter and clearly understand what they should learn and to what extent they should learn. Students were allowed to learn at their own pace. In addition, for basic medical knowledge that has been learned a long time ago, such as complex neuroanatomy and pathology, teachers can put all of them online in diverse forms, such as videos and 3D animation for students to review before class [28]. Students can repeatedly watch and post questions about the learning process online so that teachers can understand the problems existing in students’ learning.

In this study, the PBL teaching method was interspersed in the middle stage of an offline class. Due to sufficient preparation before class, students have laid a good foundation for the mastery of the important and difficult knowledge in the chapter, and teachers have enough time to teach and interact with students. Students discuss this in groups, and teachers can summarize or expand the relevant frontier knowledge points appropriately. After class, the teacher publishes homework that repeatedly emphasizes the important and difficult points in the chapter, then corrects the homework, and finally explains the answers online. This study employed a hybrid teaching model of SPOC and PBL, aiming to guide students to focus on understanding and applying knowledge and to promote teacher-student interaction and improve the utilization of time. M. Chi et.al reported that the flipped-classroom teaching mode based on a SPOC combined with PBL on nursing teaching can promote students’ abilities of autonomous learning, communication and cooperation, and clinical and critical thinking; improves their academic performance; and is recognized and welcomed by them [8]. Consistent with the results of M. Chi’s research, this study also showed that the teaching method of SPOC combined with PBL was significantly better than the traditional LBL teaching method in improving learning engagement, communication ability, and clinical thinking ability, and the differences were statistically significant (P < 0.05). In addition, this study has reformed the student assessment model, and the neurology course has used the traditional evaluation method, which is based on closed-book examination results. After the reform of SPOC combined with the PBL teaching model, diversified assessment methods were adopted, including online preview, interaction, and preview test accounting for 30%, and the unit test closed book score accounted for 50%. The mistaken belief of cramming for exams to pass was abandoned, and more attention was paid to students’ participation in learning and flexible use of knowledge. The results of the satisfaction survey showed that the satisfaction of the SPOC combined with PBL group was significantly higher than that of the traditional LBL group.

Pedagogical implications

In this study, by comparing the written scores of unit tests between the two groups, it was found that the average score and the proportion of high-scoring students of SPOC + PBL group significantly higher than that of LBL group. Therefore, after the implementation of the teaching reform of SPOC and PBL, the academic performance of students can be significantly improved, the teaching effect is good, and teaching efficiency is also improved. The results of this study are consistent with those of other researchers [7]. This combined teaching method is helpful in improving students’ ability to combine theory and clinical practice and in improving the teaching effect. Meanwhile, students have overcome their “neural fear” in problem-based learning [29], cultivated good habits such as independent learning and literature review, and become more confident and willing to express their opinions. Through full interaction with students, teachers can discover their own problems, continuously improve their teaching methods, achieve self-growth, and enhance teaching quality. This is what is known as “teaching and learning benefit each other”.

At present, the PBL teaching method is widely used in neurology [7,8,9,10]. The main problem with the application of SPOC combined with the PBL teaching method is that teachers are required to fully prepare online video content and publish online interactive test questions. Since there is still a lack of unified syllabus to standardize online neuroanatomy teaching content, it takes a lot of time and effort for teachers to prepare online teaching content, whether it is to produce teaching videos or connect different Internet platforms. Therefore, for teachers, the application of SPOC combined with the PBL method in the teaching of neurology still needs to continuously accumulate experience and improve the process. For students, teachers also have higher expectations because the teaching method requires students to have strong self-learning and problem-solving skills.

This study is the initial stage of our research, focusing mainly on exploring the preliminary effects of the new teaching methods and practices, aiming to obtain an overall directional understanding and practical experience feedback. In the follow-up research, we will further enrich our research results and provide more comprehensive and valuable references for teaching practice. We will seriously consider organically combining PBL with SPOC or other teaching models, and further explore the impact of the synergistic effect of multiple teaching methods on students’ learning effects, so as to enrich our research results and provide more comprehensive and valuable references for teaching practice.