Problem-based Learning

Cherdsak IramaneeratDepartment of Surgery

Faculty of Medicine Siriraj Hospital

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Problem-based Learning (PBL)

• An instructional method that challenges the students to “learn to learn”, working cooperatively in groups to obtain solutions to real world problems (Dutch et al, 2001)

• Key feature: The problem is presented to students first before students have substantial knowledge about the subjects.

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PBL: Characteristics

• Learning is driven by challenging, open-ended problems.

• Students work in small collaborative groups.

• Teachers take on the role as “facilitators” of learning.

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History

• PBL was first introduced in 1969 by McMaster University Faculty of Health Sciences in Canada.–Objectives

• Promote active learning• Improve correlation between basic sciences and clinical sciences

• Improve the transferability of learned knowledge into practice

• Help prepare students to be life-long learners

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Benefits of PBL• Problem-solving• Self-directed learning• Lifelong learning• Resource identification and evaluation• Critical reasoning• Creative thinking• Transfer of learning to real-life situation

• Incorporation of social and ethical aspects of medicine

• Cooperative and collaborative learning• Communication skills

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PBL Process

• Key steps (for students)–Problem presentation–Small group discussion–Self-directed learning (4 – 7 days)

–Tutorials

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PBL Process(Instructors’ View)

1.Writing a case2.Prepare PBL tutors3.Meeting with case writers4.Setting the pace and tone5.Session one6.Self-directed learning7.Session two

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Steps in Writing a Case

• Review the course schedule• Identify a few possibilities for cases that address the topics listed in the course

• Select a case that fulfill the learning objectives of the course

• Gathering the necessary information (e.g., laboratory results, x-ray, pathology report)

• Modify the case to make it more interesting• Peer review of the case

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PBL Tutors

“The PBL tutors set the stage for learning and present themselves as models of the learning process. In doing so, they exercise an unprecedented influence on students. PBL sessions succeed or fail in direct proportion to the tutors’ preparedness and training for the task, interpersonal skills and sensitivity to students.” (Mayo, Donnelly,Schwartz, 1995)

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Tutor’s Roles and Responsibilities

• Facilitator• A resource person• Coordinator of the PBL sessions

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Effective Tutors• Should

– Give up the role of the expert– Intervene at appropriate times– Facilitate the group discussion by asking probing questions

– Encourage brain-storming and problem solving

– Foster critical thinking– Encourage student collaboration– Foster communication skills

• Should not– Lecture– Dominate the group discussion– Be authoritarian

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The Tutor Guide

• Description of the problem• All the diagnostic materials• Glossary of specific terminology• The phenomena that need to be explained

• List of important concepts with short explanations

• A list of possible questions• A hypothesis scheme• Issues needed to be avoid

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Improving the Case

• Dynamic of the case writing process–Select a case that fits the course objectives

–Compile necessary information–Prepare a tutor guide–Peer review of your materials–Meet with all the tutors for a discussion and to make amendments to the case

–Obtain feedback from tutors and students–Make amendments before reusing the case

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Meeting with Case Writers

• Objectives–Identify the learning issues of the case

–To provide case writers’ perspectives (e.g., the rationale of choosing the case)

–To clarify obscure points in the case

–Provide feedback to case writers on how to improve the case

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Setting the Pace and Tone• A tutor (facilitator) creates a comfortable setting that is conducive to learning.

• Strategies– Make sure everybody has eye-contact with each other (seating arrangement)

– Make sure that all students understand the objectives

– Allow introduction of group members– Address everybody by name– Clarify the roles and responsibilities of the group members

– Assign a group leader and a scribe15PBL

Session One

• Six fundamental steps–Defining the problem–Activating prior knowledge–Brainstorming–Generating hypotheses–Formulating learning issues–Identifying learning resources

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Session Two

• Three important tasks–Determination of the accuracy and validity of the information obtained

–Application of the new knowledge to the problem and integration of knowledge• Re-analyze the problem• Critique, refine, and reformulate hypotheses

• Develop major concepts or principles relevant to the case

–Assessment of their own performance17PBL

Students’ Behaviors during PBL• Respect of others• Communication

– Speaks clearly– Verbal and non-verbal language

• Responsibility– Punctual– Complete the assignment– Present relevant information

• Self-awareness/self-evaluation– Acknowledge own lack of knowledge– Acknowledge own strengths and weaknesses

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Objectives of Student Assessment in PBL

• Assessment of problem identification and problem solving

• Provision of feedback to students and tutors

• Application of knowledge into practical situations

• Contribution to group process19PBL

Assessment during PBL Sessions

• Informal: –Rating scale at the end of the session• Responsibility• Information processing• Communication• Critical analysis• Self-awareness• Overall performance

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Objective Examinations

• Multiple-choice questions exam

• Modified-essay questions exam

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Implementing a PBL

• PBL in new medical schools• PBL in existing medical schools–Parallel track–Pilot program–Complete shift to PBL curriculum

–Hybrid curriculum22PBL

Cherdsak.ira@mahidol.ac.th

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