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Over the last 40 years, problem-based learning (PBL) has swept the world of medical education. Small-group, self-directed, and self-assessed PBL is a use of the PBL tutorial which embodies most of the principles known to improve learning. The principle of self-directed learning is extremely important. Learners of today have to deal with enlarging and renewing knowledge of medical science. To create an environment in which learners would form selfdirected study habits that would become the bases for life-long self-education is essential. The PBL tutorial is a good option for creating this educational environment. There are social needs for doctors to practice evidence-based medicine. Today’s information explosion also affects patient attitudes toward their healthcare issues. Communication skills are also needed to create a partnership with patients and staff. Smallgroup learning in the PBL tutorial can be used to develop generic skills and attitudes, such as teamwork, cooperation, and presentation skills. PBL has positive effects on knowledge application and clinical performance rather than on knowledge acquisition. The PBL tutorial is a good educational method for dealing with these demands of today. Team-based learning is also an attractive educational method, but its concepts are different from those of PBL. We could design team-based learning to develop a linkage between lectures in a large classroom and PBL. There must be integrated institutional responsibility in a medical education program for the overall design, management, and evaluation of a coherent and coordinated curriculum. There is evidence that graduates of PBL curricula demonstrate equivalent or superior professional competencies compared with graduates of more traditional curricula. The concepts and philosophies of PBL embody the flexibility and adaptability necessary to meet the challenges of medical education. (日本医科大学医学会雑誌 2012; 8: 188―194)

Efficiency of Ultrasound for the Clinical Diagnosis of the Subcutaneous Tumor