What is Problem - Based Learning ? Session 1 of the PBL tutor training

Learning Outcomes By the end of the session all participants should: be able to explain what PBL is be able to describe the 7-step process by which students learn PBL have experienced the different roles in carrying out PBL be able to evaluate PBL from the teachers point of view be able to explain how PBL could be used to help students understand, learn and remember clinical medicine / dentistry

First of all …. Consider your own experience as both student and teacher … WHICH teaching and/or learning activities produced the ‘best’ learning? And WHY?

What is PBL? Group of students working with a facilitator Problem-based learning Group of students working with a facilitator Students presented with a problem and identify learning needs for themselves International method – Mc Master, Canada, Monash, Australia, Maastricht, Netherlands Used throughout all 5 years at Barts Based on educational research

Problem-Based Learning Each student group is given a ‘problem’ to address Students are divided into groups of 6-8 (ideally) with a member of staff acting as a facilitator / tutor Students learn through team-work and self-study Learning is both student-centred and self-directed

What does research tell us about PBL? Studies in Maastricht and North America show that, relative to traditional medical graduates, PBL graduates: ~ are better at problem-solving ~ recall marginally less specific detail and have a slightly reduced body of knowledge 1990s Generated move towards ‘hybrid’ curriculum More positive outcomes see Albanese in Swanwick T (ed) (2010) Understanding Medical Education

Principles behind PBL Reactivates old knowledge Integrates subjects around people and their problems Emphasis on learning for professional practice Motivates students (fosters curiosity - gives ownership) Encourages active learning Encourages thinking, rather than learning by rote Topics are revisited at deeper / higher levels of complexity and understanding Encourages students to form and reject hypotheses Develops thinking skills appropriate to clinical reasoning Helps to develop generic skills - e.g. communication, group work, leadership

Types of ‘Problems’ a case-history a real or simulated patient experimental data a photograph a film extract a newspaper article an article from a scientific journal a pattern of inheritance

The Barts ‘Seven Step’ PBL Model 1. Clarify unfamiliar terms/words (if possible). 2. Identify the issues arising from the scenario. 3. Expand upon the issues (brainstorming). 4. Organise the material from Step 3 into a coherent framework, offering tentative solutions to any problems (by structuring, showing relationships, identifying gaps, etc.). 5. Devise learning questions (objectives) to be researched. 6. a) Collect information (before the next session); b) assemble the information. 7. Contribute to and organise a collective understanding of the issues (in the second PBL tutorial).

Roles within PBL All PBL participants have a ROLE to play, either as: SCRIBE CHAIR GROUP MEMBER FACILITATOR / TUTOR For each PBL scenario, students elect their own Scribe and Chair: these positions rotate around the group for the duration of the module

Role of Scribe To record points raised by the group during discussion in Steps 1~5 To help the group to order or link their points To participate as far as possible in the group discussion In practice the role of the scribe is key as a good scribe will be organising the ideas and suggestions as the discussion is progressing PBL1 2009 mc ~ 10

Role of Chair To encourage participation of all members of the group To lead the group through the 7 steps To encourage participation of all members of the group To maintain good group dynamics To keep the group to time To ensure the group adheres to the task in hand To check the Scribe accurately records the points raised in the discussion, and is keeping up (Steps 1~5)

Role of Group Member To follow the 7 steps in sequence To actively participate in discussions To listen actively to each others’ contributions To ask ‘open’ questions To independently research all the learning objectives/questions To share information with each other

Role of Facilitator / Tutor To encourage ‘deep’ understanding To ask ‘open’ questions To encourage participation by all members of the group To maintain good group dynamics To keep the group to time, and prevent side-tracking To advise the group on what is NOT relevant To act as a go-between for staff and students To evaluate group performance To support the role of the Chair in Step 7 (report-back step)

What Happens During Learning via PBL? Students: acquire and process knowledge in an active way learn to work systematically learn how to chair a meeting feel they have to do the work become good at explaining become good at listening become good at negotiating develop inter-personal skills

Limitations of PBL Organisation of knowledge may be poor ~ Study Guides help deal with this Loss for student of being enthused by ‘expert’ teacher / role-model Loss of ‘buzz’ for teacher in imparting knowledge Time and resourcing issues Facilitator (tutor) competence can make or break success

Advantages of (Successful) PBL Students: direct their own learning learn at their own pace learn in context develop inter-personal skills learn selectively are motivated and enjoy their learning integrate their knowledge learn ‘how to learn’ How many of these features did we recognise earlier?

References Albanese M.A. (2007) Problem-Based Learning Edinburgh: Association for the Study of Medical Education Albanese M. (2000) Problem-based Learning: why curricula are likely to show little effect on knowledge and clinical skills. Med. Educ. 34: 729-738. Albanese, M. (2010) Problem-Based Learning. In Swanwick T (ed) Understanding Medical Education Wiley-Blackwell, Edinburgh: Association for the Study of Medical Education Davis M. & Harden R. (1999) Problem-based learning: a practical guide. Medical Teacher 21 (2), p130-140. AMEE Guide 15. Feather A. & Fry H. (1999) Key Aspects of Teaching and Learning in Medicine and Dentistry. In: Fry, Ketteridge & Marshall (eds) A Handbook for Teaching and Learning in Higher Education, chapter 24; Kogan Page. Norman G.R. & Schmidt H.G. (2000) Effectiveness of PBL curricula: theory, practice and paper darts Med. Educ. 34: 721-728. Wood D.F. (2003) ABC of Teaching and Learning: Problem-Based Learning Br. Med. J. 326: 328-330. http://www.hss.coventry.ac.uk/pb : UK Problem-Based Learning website hosted by Coventry University and supported by the Learning and Teaching Support Network (LTSN) Generic Centre.