Preparing faculty to develop problem oriented approach to teaching &

learning : our experience at Pramukhswami Medical College, India

Himanshu Pandya

Sarmishtha Ghosh

Pramukhswami Medical College, Karamsad, Gujarat

INTRODUCTION

• Globally medical education has adopted an integrated, student centered and problem based approach.

• Medical Council of India recommends integrated and problem based learning approach.

• Switching to PBL requires training of the trainers who are mostly conversant with didactic mode of teaching

• Faculty development should aim at creating awareness regarding concepts of PBL, role of teacher as facilitator, group dynamics and designing of case scenarios.

OBJECTIVES• Medical Education Unit [MEU] of Pramukhswami Medical College

at Karamsad, Gujarat decided to expose its academic staff to the concepts of PBL and allied teaching strategies supporting adult learning on the lines of recommendations by MCI

This paper reports data collected from two faculty development workshops :

Workshop I - Principles and methodology of PBL in the form of student experience

Workshop II -Techniques of writing and refining case scenarios for PBL sessions

METHODOLOGYWORKSHOP- I

[PBL]WORKSHOP- II [Case Writing]

Selection of faculty

2 faculty per department, irrespective of experience,

nominated by Head

StrategyFormation of Core group with experienced in house faculty. External expert from CMC, Vellore. Demonstration, small group discussions & large group interaction.

Schedule 2 days; morning- 4 hours

39Number registered

1 faculty per department, interested faculty invited

External expert from IIM-A. In house coordinators

Didactic lecture, small group discussion & large group

interaction

1day; 5 hours

25

Workshop I; Morning session : 4 hours, DAY 1

Didactic interactive lecture on PBL

Demonstration of a PBL session

Pre workshop testWhat is PBL

Roles & Responsibilities

of facilitator

7 steps of PBL

Question-Answer Session

STUDENT EXPERIENCE

Session- I

6-7 members/group, 1 facilitator; 6 groups

Small group activity

Large group presentation by group

representative

Case given

Morning session : 4 hours, DAY 2

STUDENT EXPERIENCE

Session- II

Small group activity contd

2nd page of Case revealed

Large group presentation

Question-Answer Session

Post Test & Evaluation of Workshop

1 hour

1 hour

Morning session : 4 hours, DAY 1

Case Writing Workshop

Afternoon Session- 2 hoursMorning Session - 3 hours

Small group activity

Introduction by External & Internal Experts

Small group activity

One real scenario designed differently

Case 1, groups 1,2,3

Case 2, groups 4,5,6

1 hour

Large Group Presentation

6 Preframed scenario

1 hour

Large Group Presentation

Evaluation with questionnaire

Proportion of faculty trained at Workshop I

0

10

20

30

40

50

60

Professor Addl.Professor

AssociateProfessor

AssistantProfessor

Lecturer/tutor

TotalParticipated

RESULTS - WORKSHOP I

33%6%

33%

28.6%

34.8%

Distribution of Faculty Participants according to their designation, N=39

Professor20%

Addl. Professor3%

Associate Professor

21%Assistant Professor

35%

Lecturer/ tutor21%

Improvement in the perception of faculty regarding Problem Based Learning before and after Workshop

0

20

40

60

80

100

120

1 2 3 4 5

Items in the Prestest and post test questionnaire

Perc

en

tag

e o

f re

sp

on

ses f

rom

Part

icip

an

ts

Pretest N=37 [100%]Post test N=26 [70.3%]

1. What is PBL?

2. PBL is same as CBL, PBL, PSL, Inquiry Driven Learning, None

3. Role of faculty in PBL

4. Responsibility of student in PBL

5. Characteristics of an effective tutor

Evaluation of PBL Workshop

0

2

4

6

8

10

12

14

16

understandingwhat is PBL

exploring howPBL works

understandingthe steps

involved in PBL

Items in Questionnaire

Nu

mb

er

of

resp

on

ses

Slightly Agreed

Strongly Agreed

Slightly Disagreed

Strongly Disagreed

Evaluation of PBL Workshop [contd.]

02468

1012141618

understanding thegroup dynamics in

PBL

understanding theresponsibilities of

students

understanding therole of good PBL

fcailitator

Items in Questionnaire

NU

mbe

r of

Res

pons

es

Slightly Agreed

Strongly Agreed

Slightly Disagreed

Strongly Disagreed

Proportion of faculty trained in Case Writing, N=135

0

10

20

30

40

50

60

Prof Addl Prof Assoc Prof Assist Prof Lect/Tutor

Designation

Num

ber of

Par

ticip

ants

TotalPartcipated

Distribution of faculty participants according to Designation at Case Writing Workshop; N=25

Professor32%

Addl. Prof4%

Associate Prof28%

Assistant Prof36%

RESULTS - WORKSHOP -II

Evaluation of Case Writing Workshop; N=25, Responses elicited 21 [84%]

0

2

4

6

8

10

12

14

16

18

understandingrelevance of a case

scenario in PBL

exploring how PBLcase scenario can

be developed

exploring the skillsnecessary to refine

a PBL case

Items in Questionnaire

Nu

mb

er o

f R

esp

on

ses

Slightly Agreed

Strongly Agreed

Slightly Disagreed

Strongly Disagreed

Workshop I Workshop II

Valuable Aspects Integrated groupdiscussion and role playPractical demonstrationand understanding ofPBL concept as a newway of teaching,

Group dynamics,Integrated self learningBrain storming sessionsand Exchange of views

Clarification Needed Role and qualificationsof a facilitatorDesigning a casescenario

Quality of a facilitator,Ways to develop a casescenario by defininglearning objectives fordifferent standards oflearners

Suggestions forImprovement

Frequent workshopswith longer sessionsand video clips ofrecording of asuccessful standardPBL session

More frequentworkshops,Providewebsites where suchcasess would beavailable, formation ofa core group pooledfrom all specialties

Conclusion• Comprehensive faculty development programs

are essential for initiating curricular change• High satisfaction and considerable change in

attitude was observed amongst faculty members

• Some faculty expressed concern regarding implementation of PBL in present setting and the assessment of the same

• Further workshop involving more faculty need to be conducted on a regular basis.

Acknowledgement• CMCL-FAIMER Regional Institute• Mr. Sandeep Desai, CEO, H M Patel Centre for Med Care & Edu• Dr. H. H. Agravat, Dean, Pramukhswami Medical College• Dr. Rashmi Vyas, Christian Medical College, Vellore• Dr. Dileep Mavlankar, Indian Institute of Management, Ahmedabad• Core faculty of Pramukhswami Medical College- Dr. Barna

Ganguly, Dr. Suman Singh, Dr. Praveen Singh, Dr. Anuradha Joshi

• Medical Education Unit,Pramukhswami Medical College• Participant faculty at Workshop I & II.

1. Physicians for the twenty First century: Report of the panel on the General Professional Education of the Physicians and College preparation for medicine, Association of American Medical Colleges, Washington, 1984.

2. Schmidt H: Problem based Learning: rationale and Description, Med Educ 1983; 17: 11-16.

3. Medical Council of India. Salient features of Regulations on Graduate Medical Education, 1997 Available http://www.mciindia.org/know/rules/rules_mbbs.htm, accessed Oct 08, 2007

4. Wood, DF (2003): ABC of learning and teaching in medicine: Problem based learning, BMJ 326; 328-330. Available at http://bmj.com.cgi.content/full/326/7384/328, accessed on 11.10.2007

5. Barrows HS, Peters MJ: How To Begin Reforming The Medical Curriculum, Southern Illinois School of Medicine, Springfield. Ill. 1984: 21-27

6. Des Marchais JE, Jean P, Delorme P: basic training program in medical pedagogy: a 1- year program for medical faculty. Can Med Assoc J 1990; 142: 734-740

References