pbl learning

8/13/2019 PBL learning

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Problem-based learning

Dr. Kieran Walsh,Editor,

BMJ Learning.


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Still a hot topic

Much debate

Become widespread


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Problem-based learning what is it

Learning in context of a problem

Student-driven

Student generates issues, finds answers,shares answers

Active learning

Group process

Facilitated > taught


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Problem-based learning why?

Help the student

Acquire necessary knowledge and skills

Learn how to apply this Become a life long learner


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Problem-based learning what is it

The curriculum

Worked example


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Problem-based learning Session 1

40 year old man with jaundice. Took 40

paracetamol tablets 72 hours ago. History of

asthma. Says he wants to die. Doesnt wantany treatment.

How will you deal with the issues that he

presents?


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Talk through scenario, understand it, decideon the problems

Define/analyse the problems

Brainstorming

Prioritise the problems, restructure

Decide on learning objectives

Every member has a task private study


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Feedback on what they have discovered

Everyone contributes

Reflection


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Problem-based learning what is a goodproblem?

Realistic, common, important

Sufficiently open

Complexity a number of components

Maybe a problem that actually happenedand that was poorly managed


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Problem-based learning what is a goodtrigger?

Clinical scenarios on paper

Laboratory data

Photograph Video

Real/simulated patient


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Problem-based learning - benefits

Natural

Motivational

Learn applied knowledge

Encourages preparation and homework Team based

Searching skills

Critical thinking and clinical reasoning

Close, more equal student-facultyrelationship

Enjoyable

Presentational skills


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PBL the problems with PBL

Cost

Time

Workload Tutor quality

Unscheduled time

Students with no supervision .. The

tutor takes over

One faculty member for each group ofstudents!


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PBL the problem with tutors

Need a facilitator > tutor

Problem first > subject first

Encouragement, guidance

Dont solve the problem, dont even hint at thesolution, dont even even tell them the problem

Not necessarily a subject expert

It wasnt like this in my day

Hospital super-specialists can feel uncomfortable

These are all difficult concepts for traditional medicalteachers


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PBL the problem with students

Products of didactic secondary schools

Lost

Not consulted in curriculum change Teach yourself medicine

Gaps in knowledge

Whilst medical educators wish to develop critical thinkers and life-long learners, the early years of PBL cause much anxiety amongst

young learners, many who enter directly from school.

Michelle McLean


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PBL the problem with cost

Cost depends on

Group size (6-8) Number of groups

Number of hours of facilitation per week


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PBL the problem with studies of itseffectiveness

What does effective mean?

Is what is being studied actually PBL?

Confounding What outcomes are we looking at?

Good evidence for enjoyment and

enthusiasm Apart from that PBL graduates are

indistinguishable from their traditionalcounterparts


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PBL the problem with studies of itseffectiveness

Most attempts at longitudinal, controlled

intervention studies in PBL have been

overtaken by events.Brian Jolly

Deciding whether problem based learning

produces better doctors requires, at least,clear consensus on what constitutes a better

doctor.

Lambert Schuwirthand Peter Cantillon
http://www.bmj.com/search?author1=Lambert+Schuwirth&sortspec=date&submit=Submithttp://www.bmj.com/search?author1=Lambert+Schuwirth&sortspec=date&submit=Submit


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Problem-based learning - assessment

Assessment drives learning Miller

If just factual recall, little motivation forPBL

Assessment should be blueprinted to thelearning outcomes


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PBL strategies to introduce

Preclinical clinical OR not

Established school/new school

Introduce PBL year by year or all at once Introduce PBL dept by dept or all at once

Change management


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Problem-based learning mixing it withother methods

Simulation/simulated patients

Interprofessional education should thegroup include nurses/AHPs?

E-learning


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Doesnt suit everything

E.g. learning resuscitation skills


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Problem-based learning last word?

PBL should be regarded as a tool, a means,

and not as an end.

Shimon Glick


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Problem-based learning - references

Donner RS, Bickley H. Problem-based learning in American medical education: an

overview. Bull Med Libr Assoc. 1993 Jul;81(3):294-8.

Wood DF. Problem based learning.BMJ. 2003 Feb 8;326(7384):328-30.

Kilroy DA. Problem based learning.Emerg Med J. 2004 Jul;21(4):411-3.

Walton HJ, Matthews MB. Essentials of problem-based learning.Med Educ. 1989

Nov;23(6):542-58.

Mellon AF, Mellon J. Logical debate on problem based learning.BMJ. 2006 Mar

4;332(7540):550-1.

Wood DF. Problem based learning.BMJ. 2008 May 3;336(7651):971.
http://www.ncbi.nlm.nih.gov/pubmed?term=%22Donner%20RS%22[Author]http://www.ncbi.nlm.nih.gov/pubmed?term=%22Bickley%20H%22[Author]http://www.ncbi.nlm.nih.gov/pubmed/12574050http://www.ncbi.nlm.nih.gov/pubmed/15208220http://www.ncbi.nlm.nih.gov/pubmed/2593886http://www.ncbi.nlm.nih.gov/pubmed/16513722http://www.ncbi.nlm.nih.gov/pubmed/18456594http://www.ncbi.nlm.nih.gov/pubmed/18456594http://www.ncbi.nlm.nih.gov/pubmed/16513722http://www.ncbi.nlm.nih.gov/pubmed/2593886http://www.ncbi.nlm.nih.gov/pubmed/2593886http://www.ncbi.nlm.nih.gov/pubmed/2593886http://www.ncbi.nlm.nih.gov/pubmed/15208220http://www.ncbi.nlm.nih.gov/pubmed/12574050http://www.ncbi.nlm.nih.gov/pubmed?term=%22Bickley%20H%22[Author]http://www.ncbi.nlm.nih.gov/pubmed?term=%22Donner%20RS%22[Author]

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