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Transcript of PBL learning
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Problem-based learning
Dr. Kieran Walsh,Editor,
BMJ Learning.
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Problem-based learning
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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Problem-based learning Session 1
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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Problem-based learning Session 2
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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Problem-based learning
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]