Skip to main content

Advertisement

SpringerLink
Log in

Educational Intervention on Undergraduate Cancer Awareness and Self-Directed Learning

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Traditional lecture-based learning (LBL) can increase cancer awareness in undergraduates. However, because of the rapidly changing knowledge base in medicine, undergraduates must develop skills required for lifelong self-directed learning (SDL). Problem-based learning (PBL) has been suggested as an SDL approach. This study used a nonequivalent control group with a pretest-posttest design for comparing PBL and LBL for their effectiveness in increasing cancer awareness and SDL among nonmedicine or nonnursing major undergraduates in a health-related general education course. Experimental groups 1 and 2 were instructed using PBL while the control group was instructed using LBL. Cancer educational programs were offered to experimental group 1 and the control group but not to experimental group 2. Among the 325 undergraduates who completed a questionnaire regarding cancer awareness and SDL in the pretest, 223 completed the 12-week follow-up survey of the posttest. Cancer awareness significantly improved between the pretest and posttest in the control group (P < 0.001). No significant difference in cancer awareness improvement was observed between experimental group 1 and the control group (P = 0.934). Cancer awareness improvement in experimental group 2 was significantly less than in the control group (P = 0.010). No statistically significant change in SDL was observed in the control group during the study (P = 0.897). However, the SDL of experimental groups 1 and 2 improved more significantly than that of the control group (P = 0.049 and 0.023, respectively). Therefore, PBL is an effective method of increasing cancer awareness and SDL in undergraduates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Makarem N, Lin Y, Bandera EV, Jacques PF, Parekh N (2015) Concordance with World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines for cancer prevention and obesity-related cancer risk in the Framingham offspring cohort (1991–2008). Cancer Causes Control 26:277–286

    Article  PubMed  PubMed Central  Google Scholar 

  2. Vineis P, Wild CP (2014) Global cancer patterns: causes and prevention. Lancet 383:549–557

    Article  PubMed  Google Scholar 

  3. Peltzer K, Pengpid S (2015) Correlates of healthy fruit and vegetable diet in students in low, middle and high income countries. Int J Public Health 60:79–90

    Article  PubMed  Google Scholar 

  4. Pengpid S, Peltzer K, Kassean HK, Tsala JPT, Sychareun V, Müller-Riemenschneider F (2015) Physical inactivity and associated factors among university students in 23 low-, middle-and high-income countries. Int J Public Health 60:539–549

    Article  PubMed  Google Scholar 

  5. Peltzer K, Pengpid S, Samuels T, Özcan NK, Mantilla C, Rahamefy OH, Wong ML, Gasparishvili A (2014) Prevalence of overweight/obesity and its associated factors among university students from 22 countries. Int J Environ Res Public Health 11:7425–7441

    Article  PubMed  PubMed Central  Google Scholar 

  6. Peltzer K, Pengpid S (2014a) Tobacco use, beliefs and risk awareness in university students from 24 low, middle and emerging economy countries. Asian Pacific journal of cancer prevention: APJCP 15:10033–10038

    Article  PubMed  Google Scholar 

  7. American College Health Association (2016) American college health association-National College Health Assessment II: reference group undergraduates executive summary fall 2015. American College Health Association, Hanover, MD

    Google Scholar 

  8. Seo D-C, Torabi MR, Chin MK, Huang SF, Chen CK, Mok MMC, Wong P, Chia M, Lee CG, Wang C (2012) A comparison of factors associated with physical inactivity among east Asian college students. IntJ Behav Med 19:316–323

    Article  Google Scholar 

  9. Adamowicz K, Zalewska M, Majkowicz M, Zaucha JM (2015) Evaluation of the impact of different types of health education on the adoption and preservation of prohealth attitudes in preventing cancer in juveniles younger than 18 years. J Cancer Educ 30:432–438

    Article  PubMed  Google Scholar 

  10. Hwang L-L (2013) Cancer awareness changes after an educational intervention among undergraduate students. J Cancer Educ 28:247–253

    Article  PubMed  Google Scholar 

  11. Peltzer K, Pengpid S (2014b) Awareness of breast cancer risk among female university students from 24 low, middle income and emerging economy countries. Asian Pacific J Cancer Prev 15:7875–7878

    Article  Google Scholar 

  12. Knowles MS (1975) Self-directed learning: a guide for learners and teachers. Follett, Chicago

    Google Scholar 

  13. Peine A, Kabino K, Spreckelsen C (2016) Self-directed learning can outperform direct instruction in the course of a modern German medical curriculum-results of a mixed methods trial. BMC medical education 16:158

    Article  PubMed  PubMed Central  Google Scholar 

  14. Frambach JM, Driessen EW, Chan LC, van der Vleuten CPM (2012) Rethinking the globalisation of problem-based learning: how culture challenges self-directed learning. Med Educ 46:738–747

    Article  PubMed  Google Scholar 

  15. Ding X, Zhao L, Chu H, Tong N, Ni C, Hu Z, Zhang Z, Wang M (2014) Assessing the effectiveness of problem-based learning of preventive medicine education in China. Scientific reports 4(5126):1–5

    Google Scholar 

  16. Okubo Y, Matsushita S, Takakuwa Y, Yoshioka T, Nitta K (2016) Longitudinal PBL in undergraduate medical education develops lifelong-learning habits and clinical competencies in social aspects. Tohoku J Exp Med 238:65–74

    Article  PubMed  Google Scholar 

  17. Lee Y-M, Mann KV, Frank BW (2010) What drives students’ self-directed learning in a hybrid PBL curriculum. Adv in Health Sci Educ 15:425–437

    Article  Google Scholar 

  18. Neufeld VR, Barrows HS (1974) The "McMaster philosophy": an approach to medical education. J Med Educ 49:1040–1050

    CAS  PubMed  Google Scholar 

  19. Barrows HS (1996) Problem‐based learning in medicine and beyond: A brief overview. In: Wilkerson L, Gijselaers WH (eds) Bringing problem-based learning to higher education: Theory and practice. New directions for teaching and learning. Jossey-Bass Publishers, Francisco, 68:3–12

  20. Gijbels D, Dochy F, Van den Bossche P, Segers M (2005) Effects of problem-based learning: a meta-analysis from the angle of assessment. Rev Educ Res 75:27–61

    Article  Google Scholar 

  21. Dolmans DH, Loyens SM, Marcq H, Gijbels D (2016) Deep and surface learning in problem-based learning: a review of the literature. Adv in Health Sci Educ 21:1087–1112

    Article  Google Scholar 

  22. Lim WK (2012) Dysfunctional problem-based learning curricula: resolving the problem. BMC medical education 12:89

    Article  PubMed  PubMed Central  Google Scholar 

  23. Yew EH, Chng E, Schmidt HG (2011) Is learning in problem-based learning cumulative? Adv in Health Sci Educ 16:449–464

    Article  Google Scholar 

  24. Rijdt C, Rijt J, Dochy F, Vleuten C (2012) Rigorously selected and well trained senior student tutors in problem based learning: student perceptions and study achievements. Instr Sci 40:397–411

    Article  Google Scholar 

  25. Boelens R, De Wever B, Rosseel Y, Verstraete AG, Derese A (2015) What are the most important tasks of tutors during the tutorials in hybrid problem-based learning curricula? BMC medical education 15:84

    Article  PubMed  PubMed Central  Google Scholar 

  26. Pease MA, Kuhn D (2011) Experimental analysis of the effective components of problem-based learning. Sci Ed 95:57–86

    Article  Google Scholar 

  27. Cheng S-F, Kuo C-L, Lin K-C, Lee-Hsieh J (2010) Development and preliminary testing of a self-rating instrument to measure self-directed learning ability of nursing students. Int J Nurs Stud 47:1152–1158

    Article  PubMed  Google Scholar 

  28. Guglielmino LM (1977) Development of the Self-Directed Learning Readiness Scale. Doctoral dissertation. University of Georgia. Dissertation Abstracts International, 38, 6467A.

  29. Robb K, Stubbings S, Ramirez A, Macleod U, Austoker J, Waller J, Hiom S, Wardle J (2009) Public awareness of cancer in Britain: a population-based survey of adults. Br J Cancer 101:S18–S23

    Article  PubMed  PubMed Central  Google Scholar 

  30. Liang K-Y, Zeger SL (1986) Longitudinal data analysis using generalized linear models. Biometrika 73:13–22

    Article  Google Scholar 

  31. Zeger SL, Liang K-Y (1986) Longitudinal data analysis for discrete and continuous outcomes. Biometrics 42:121–130

  32. Duek JE, Wilkerson L, Adinolfi T (1996) Learning issues identified by students in tutorless problem-based tutorials. Adv in Health Sci Educ 1:29–40

    Article  CAS  Google Scholar 

  33. Hartling L, Spooner C, Tjosvold L, Oswald A (2010) Problem-based learning in pre-clinical medical education: 22 years of outcome research. Med Teach 32:28–35

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The author is grateful to the undergraduate students who completed the questionnaires for the research. The author thanks the reviewers for their insightful comments and suggestions on the earlier version of this paper.

Author information

Authors and Affiliations

  1. Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, 5 De Ming Rd., Gui Shan District, Taoyuan County, 333, Taiwan

    Lih-Lian Hwang

Authors
  1. Lih-Lian Hwang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lih-Lian Hwang.

Ethics declarations

Funding

This work was supported by the National Science Council of Taiwan [grant number NSC 101-2511-S-130-002-]. The funding authorities did not participate in data collection, analysis, interpretation, or writing of the manuscript.

Conflict of Interest Statement

None declared.

Appendix A

Appendix A

Two examples of PBL cases for cancer (translated from traditional Chinese)

PBL case 1

Every day after school, an eighth grade student ate a grilled sausage purchased from a street vendor, as he usually did since second grade. One day, he had severe abdominal pain, prompting his family to take him to the hospital immediately. Although he had no family history of cancer, tests revealed a large tumor in the large intestine that had spread. He died 4 months after surgery. The doctor indicated that the number of patients aged 20–30 years with advanced bowel cancer has risen. The common habits of such young bowel cancer patients are eating an abundance of grilled foods, high-fat fast foods, and red meat.

PBL case 2

One day, Jean heard from her grandmother that she felt dizzy while doing laundry on the balcony; therefore the family immediately took grandma to the nearest hospital. The doctor said that Jean’s grandma had hypochromia, according to a blood test. Additional examinations revealed a tumor causing internal bleeding in the large intestine, indicating stage III colon cancer. Jean was shocked that her grandmother had had bloody stool for years, thinking that it was caused by hemorrhoids. The doctor discussed the following treatment options with Jean’s family: 1. Surgery to remove the part of the colon containing the tumor and fit a colostomy bag and administer chemotherapy. 2. Chemotherapy drugs. 3. Hospice care. Considering that grandma was already 83-year-old and she had undergone other surgeries earlier, the family decided to opt for chemotherapy drugs, which cause fewer side effects. During the therapy, hair loss, vomiting, and dementia were observed. Jean’s mother stopped working to take care of grandma. Grandma’s health condition worsened and she had jelly-like bloody stools, and she required assistance to get up. Jean’s mom was exhausted because she had to look after grandma all day and could not sleep well at night. Therefore, the family decided to hire a nursing assistant. Ultimately, grandma was becoming extremely weak, and the family could not bear to watch her suffer from the chemotherapy anymore; therefore, they accepted hospice care. In the last days of grandma’s life, the family went to the hospital almost every day and even slept beside her hospital bed.

  1. 1.

    What are the problems in the above cases?

  2. 2.

    Generate your own learning issues while discussing the cases and problems with your team members.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hwang, LL. Educational Intervention on Undergraduate Cancer Awareness and Self-Directed Learning. J Canc Educ 33, 592–601 (2018). https://doi.org/10.1007/s13187-017-1210-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-017-1210-y

Keywords

Search

Navigation