Date post: | 16-Mar-2019 |
Category: |
Documents |
Upload: | hoangtuyen |
View: | 222 times |
Download: | 0 times |
1
Problem-based learning inMaastricht
Erik Driessen and many others
March 30, 2007 MEDC, Gifu University
Collegezaal rond 1798
Collegezaal rond 1998
A scientific/academic
approach to education in
which an optimal learning
environment is created, which
is based on rationality, theory
and evidence
What are we after?
2
The learning process
Instruction formats
Assessment formats
Management (of change)
Information technology, e-learning
Quality control
………..
And we know a lot………. Three C’s of education
Constructive
Contextual
Collaborative
The case of Maastricht
The case of Maastricht Characteristics of PBL
Problem-oriented
Self-directed
Interdisciplinary
Skills-oriented, early practicecontacts
Assessment tailored to educational
objectives
3
A student’s week
Mon Tue Wed Thu Fri
AM
PM
Attitude &
Communic.
Training
Practical
Tutorial
Group
Tutorial
Group
Lecture
Skills
Training
Health
Practice
Visit
A student’s week
Mon Tue Wed Thu Fri
AM
PM
Attitude &
Communic.
Training
Practical
Tutorial
Group
Tutorial
Group
Lecture
Skills
Training
Health
Practice
Visit
The tutorial group
Composition: - 8-10 students
- 1 chairman
- 1 recorder
- 1 tutor
Duration: - 2 hours
- 1 hour report
- 1 hour new case prep
Frequency: - Twice per week
Sample problemMr. Brown, aged 68, comes to your surgery and
tells you that he has been feeling dizzy recently.He is seriously worried because he has always
been healthy; he has never had any medicalproblems. But the complaints, which he has hadfor a few months, are now getting worse and
worse. The dizziness occurs when he gets out ofbed in the morning, but it can also be provoked by
a sudden movement of his head. "When ithappens, everything swims before my eyes and Ifeel unwell, light in the head and a little queasy.
When I sit down for a moment, the dizziness
slowly disappears."
1) Clarification
of terms
2) Definition of
problem(s)
3) Analysis of
problem(s)
(brainstorm)
4) Structuring
ideas
5) Formulate
learning
objectives
6) Collect new
information
(outside group)
7) Report and
synthesis of
information
The Seven
Jump
4
A student’s week
Mon Tue Wed Thu Fri
AM
PM
Attitude &
Communic.
Training
Practical
Tutorial
Group
Tutorial
Group
Lecture
Skills
Training
Health
Practice
Visit
A student’s week
Mon Tue Wed Thu Fri
AM
PM
Attitude &
Communic.
Training
Practical
Tutorial
Group
Tutorial
Group
Lecture
Skills
Training
Health
Practice
Visit
A student’s week
Mon Tue Wed Thu Fri
AM
PM
Attitude &
Communic.
Training
Practical
Tutorial
Group
Tutorial
Group
Lecture
Skills
Training
Health
Practice
Visit
5
A student’s week
Mon Tue Wed Thu Fri
AM
PM
Attitude &
Communic.
Training
Practical
Tutorial
Group
Tutorial
Group
Lecture
Skills
Training
Health
Practice
Visit
A student’s week
Mon Tue Wed Thu Fri
AM
PM
Attitude &
Communic.
Training
Practical
Tutorial
Group
Tutorial
Group
Lecture
Skills
Training
Health
Practice
Visit
A student’s week
Mon Tue Wed Thu Fri
AM
PM
Attitude &
Communic.
Training
Practical
Tutorial
Group
Tutorial
Group
Lecture
Skills
Training
Health
Practice
Visit
Scheduled educational activities
0
5
10
15
20
25
30
35
40
1.1 1.3 1.5 2.1 2.4 2.6 3.1 3.3 3.5 4.2 4.5 4.7
Curriculum units
Hours per week
11.25 hours on average per week
6
Scheduled educational activities
0
1
2
3
4
5
Year 1
Year 2
Year 3
Year 4
Hours per week
Tutorials Lectures Skills
Training
Practicals Health
Care
Contacts
7
Problems identified
PBL too uniform in format
PBL becomes a ritual3 jump
Attendance
Motivation/working hours by students
Tutors less motivated
Mismatch between assessment andcurriculum objectives (particularly block assessments)
Transition to clerkships (the shock of practice)
Contextual
Constructive
Collaborative
What PBL was….
C ontextual
What PBL became….
C onstructive
C ollaborative
Contextual
Constructive
Collaborative
What it needs to become…. How?
More authentic
problems
Increasing
complexity
Real life
projects
Authentic
assessmentContextual
Constructive
Collaborative
8
How?
Less direction
Increasing
independent
learning
Portfolio
assessment
Contextual
Constructive
Collaborative
How?
Smaller groups
Group
assignments
More ICT
support
Contextual
Constructive
Collaborative
“New” curriculum structure
Year C o n t e n t
1 EmergencyEmergency care and care and regulatoryregulatory systemssystems
2 Stages of Stages of lifelife and and diagnosticsdiagnostics
3 ChronicChronic disorders disorders
4 TheoryTheory and and practicepractice
5 ClerkshipsClerkships
6 ParticipationParticipation in research and in research and patientpatient care care
Practice Theory
Semi-classic PBL
Patient-based PBL
Guided Work-based
Learning (WBL)
Participatory WBL
Curriculum structure
Curriculum structure
Year 2 Stages of life and diagnostics
Year 5 Clerkships
Year 1-2Preparing for practice
Year 4-5Learning & working in practice
Year 3Transition from theory to practice
Year 6Participation in science (6 months) and Health Care (6 months)
Year 1 and 2
Classic PBL, but including:More authentic (and complex) problems, somethrough videoMore collaborative work through groupassignments or mini-projectsMore comprehensive unit assessment andlongitudinal assessment, including portfolio andprofessional behaviour assessmentEntire curriculum online, digital facilities in all PBLgroups.
9
Curriculum structure
Year 2 Stages of life and diagnostics
Year 5 Clerkships
Year 1-2Preparing for practice
Year 4-5Learning & working in practice
Year 3Transition from theory to practice
Year 6Participation in science (6 months) and Health Care (6 months)
Integration theory & practice
Instructional methods
Learner control
Teachers
Patients are starting point for learning
Educational objectives
Variability in instructionalmethods in which students
are required to be active
Active learningCollaborative learning
Self-directed learning
Teachers as coach
The learning cycle
Preparation in
tutorial group
Preparation with
clinical supervisor
Self study
Patient
encounterEvaluation &
Formulation learningobjectives
Self study
Report to
Tutorial group
Patient
vignette/case
Activities
around
patient
encounter
• 10 weak cycle
• n = 10
• 1x per week 4 hours
• presentation and
discussion of
patient problems(3 hours).
• Preparing next
patient encounter(1 hour)
• staff member iscoach
Tutorial group
Patient encounter preparation Patient encounter
10
Report to tutorial group Critical Appraisal of Topic
Final conclusions withrespect to the question
Comments on theusefulnes of the article
Judgement of the article
Motivating the articleused
Search terms used
Resources
Clinical question
Clinical scenario An “evidence-based” approach to answer
relevant and authentic clinical problemsfaced by students
The problems are dealing with
diagnosis
prognosistherapy and contra-indications
assessment of patient management
Criteria
Case report on ethics/health law
Ethics and Law
Make a report and prepare for
discussion about:
• making medical mistakes
• conflicting views
• privacy and confidentiality
• (non) compliance of patients
• informed consent
Family practice visits
Visiting a general practice
• 10-12 times per year
• clinical presentations are
linked to content of the
cluster
• during one day
• clinical presentations are
discussed in tutorial
group
Patient partner program
Visiting and following up
a chronic patient
• 4-6 times a year
• a chronic illness is
dominantly present
• clinical presentation is
discussed in a group
Curriculum structure
Year 2 Stages of life and diagnostics
Year 5 Clerkships
Year 1-2Preparing for practice
Year 4-5Learning & working in practice
Year 3Transition from theory to practice
Year 6Participation in science (6 months) and Health Care (6 months)
11
Structure:
• start week: preparatory
(theoretical) learning activities
• Clerkship rotation
• final week: evaluation, reflection,
closure
Year 4-5 clerkships - new developments
Teaching: focus on
• feedback is structured and planned
(several moments per week)
• students themselves are responsible to see a certain
amount of clinical presentations
(navigation plan)
• peer teaching
Year 4-5 clerkships - new developments
Assessment: focus on
• assessment on the work-place
• information for assessment
gathered from different sources during the clerkships
• observation of patient encounters
(weekly)
Year 4-5 clerkships - new developments
Curriculum structure
Year 2 Stages of life and diagnostics
Year 5 Clerkships
Year 1-2Preparing for practice
Year 4-5Learning & working in practice
Year 3Transition from theory to practice
Year 6Participation in science (6 months) and Health Care (6 months)
Year 6
18 weeks of participation in research
18 weeks of participation in health carePreparation through portfolio and mentorMotivated choices for context of research andhealth careSemi-independent participation by studentComputer Supported Collaborative Learning(CSCL)In-training WBL assessment (Mini-CEX,MSF (360 ), portfolio, mentoring)Final assessment through portfolio.
Thank you for your attention!Thank you for your attention!