[Simulation exercises, a problem oriented method of learning public health in medical education]

Using the case method of learning of American business schools, we introduced "Simulation Exercises (SE)," a problem oriented method of public health education for medical students. With SE, a group of students were given simulated cases of patients or situations (SC), and were asked to assume the role of physicians or other public health workers using their skills and knowledge of public health. Students learn on their own, with the aid of tutors, through discussion, role-play, investigation of literature, and a small field survey. There have been a whole variety of SC covering most of the current topics in public health ranging from mental health, dental health, industrial health, maternal & child health, elderly care, terminal care and international health. Each SC has 5 to 10 questions which stimulate and direct the students' group discussion. Some of the questions do not have a correct answer, but the criteria used to evaluate the students included clarity, consistency, and comprehensiveness of their ideas in addition to the positive commitment to the group discussion. At the end of the week-long group learning, each group demonstrated the results of their discussion. Role play was often used to demonstrate what they learned. As a result, students participated positively and concentrated and enjoyed the learning exercise very much. An anonymous survey shortly after SE showed that more than 80% of students felt a positive change in their rating of public health among the many subjects of study. Tutors also changed their rating of the students after observing their positive attitude and sometimes very creative ideas. In conclusion, we found SE to be useful for practical learning by medical students of public health.