All teaching processes were accomplished by the same teaching faculty. The PBL problems presented through 4 cases were discussed and set by the faculty. The cases were designed not to convey a definite diagnosis but to present a complex situation and to elicit sequencing problems. For example, a case called “Impulsive Uncle Lee” started with a patient in the clinic with hypertension and a bleeding eye but without significant impairment of sight, followed by acute vision loss 1 month later. Table 1 provides the curriculum content covered by the 4 cases. Initially, the cases were outlined according to their description in the literature but, later, the corresponding clinical data were collected and recorded. Simulated patient scenarios were developed that included but were not limited to the signs and symptoms of ophthalmic patients. Amateur actors (medical graduate students and clinical staff) presented the simulated patient scenarios. The results and procedures for the physical examination, ophthalmologic examination, laboratory tests, and assistant examination were recorded by means of video and photography. All fragments were edited to create different digital cases. Each case was divided into 6 phases: (1) patient encounter; (2) illness presentation; (3) review of body systems; (4) personal, familial, and social background; (5) physical examination; and (6) laboratory findings and other diagnostic procedures. Fragments were presented to the students in succession, and new learning issues were generated. The PBL faculty members switched from their traditional role of “teacher-instructor” to that of “facilitator of learning.” The digital and paper-based cases were brought to the separate groups as learning objectives and those cases triggered extensive discussion and exploration. Students in the PBL course used a wide range of resources, including journal articles, textbooks, educational Web sites, and multimedia CD-ROMs to analyze the problem presented by the case and to identify its critical contents. Each member of the group was encouraged to play an active role in this self-directed learning process. Self-evaluations and peer evaluations were performed during the entire process. The tutorial sessions lasted 2 hours, took place twice a week, and consisted of the following steps: (1) information obtained from the case simulation, (2) generation of an explanatory hypothesis based on abnormal findings, (3) identification of relevant learning issues, (4) an independent study period, and (5) review of learning issues obtained from the consultation of reference resources.