Problem based learning (SGL)

Objectives

By the end of this presentation the participants will be able to:

Recognize the importance of the principles behind running SGL sessions

Identify the unique circumstances and techniques used in SGL and techniques to improve group interaction

Describe some of the strengths and difficulties with SGL Manage some of the challenges facing the facilitator

during SGL sessions To determine the ways of providing feedback to students

Tell me and I will forget

Show me and I may remember

Involve me and I will surely learn

Long-term Memory and Different Forms of Teaching

What is problem based learning?

In problem based learning (PBL) students:• use “triggers” from the problem case or scenario to

define their own learning objectives.

Subsequently: they do independent, self directed study before returning

to the group to discuss and refine their acquired knowledge.

Thus, PBL is not about problem solving per se,

but rather it uses appropriate problems to increase knowledge and understanding.

So, group learning facilitates • the acquisition of knowledge • communication skills• Teamwork problem solving• independent responsibility for learning• sharing information• and respect for others.

What happens in a PBL tutorial?

• A typical PBL tutorial consists of a group of students (usually eight to 10) and a tutor, who facilitates the session

• Students elect a chair for each PBL scenario and a “scribe” to record the discussion using

suitable flip charts or a whiteboard• The roles are rotated for each scenario

At the start of the session• either the student chair reads out the scenario

or• all students study the material

Roles of participants in a PBL tutorial

Benefits of SGL

Enable learners to take part in: DiscussionActive participationFeedback and reflectionConsolidate learningClarify understandingExplore ideas and concepts.

Needs

SGL is more demanding of staff, rooms, resources and time than lectures;

However, well-designed SGL has clear benefits for student learning in terms of:

Retention of information&

Critical thinking

Objectives of Early Clinical and Professional Development Module

1.The student knows the features of good doctor.

2.The student knows his responsibilities as future doctor.

3.The student knows the communication skills and ethics required for history and clinical examination.

4.The student knows the communication skills and ethics required for difficult situations

Designing and implementing a curriculum module using PBL supported by other teaching methods

Writing PBL scenarios

• PBL is successful only if the scenarios are of high quality.

• In most undergraduate PBL curriculums the faculty identifies learning objectives in advance.

• The scenario should lead students to a particular area of study to achieve those learning objectives

How to create effective PBL scenarios

• Learning objectives likely to be defined by the students after studying the scenario and should be consistent with the

faculty learning objectives• Problems should be appropriate to the stage of the

curriculum and the level of the students’ understanding• Scenarios should have sufficient intrinsic interest for the

students or relevance to future practice• Basic science should be presented in the context of a clinical

scenario to encourage integration of knowledge

How to create effective PBL scenarios (continue)

• Scenarios should contain cues to stimulate discussion and encourage students to seek explanations for the issues presented

• The problem should be sufficiently open, so that discussion is not restricted in the process

• Scenarios should promote participation by the students in seeking information from various learning resources

Staff development

Introducing PBL into a course makes:• new demands on tutors,• requiring them to function as facilitators for small

group learning rather than acting as providers of information.

• Staff development is essential and should focus on enabling the PBL tutors to:

• acquire skills in facilitation and in management of group dynamics (including dysfunctional groups).

• acquire basic expertise about the subject.

Tutors should be also given information about the institution’s educational strategy and curriculum programmers.

so that,• they can help students to understand the learning

objectives of individual modules in the context of the curriculum as a whole

• Methods of assessment and evaluation should be described and time should be available to discuss anxieties.

An Effective Small Group TeacherGuides the discussion rather than steal the show• Involves the students in the discussion rather than

giving the answer• Calls on individual students if no one volunteers

information• If one student always talks, asks him to wait while

others talk• Add humor• Interject personal experiences, when appropriate

An Effective Small Group Teacher(continue)

Manages time• Is punctual• Starts on time • DOESN’T go over the scheduled time• Watches students’ time if they are spending

too long on a given subject

3 Keys to Motivating Students to Learn

• Enthusiasm• Show your care• Encouragement

Assessment of PBL

• Assessment of students’ activities in their PBL groups is advisable.

• Tutors should give feedback or use formative or summative assessment procedures as dictated by the faculty assessment schedule.

• It is also helpful to consider assessment of the group as a whole• Feedback should be constructive rather than

punitive

Importance of Feedback

• Feedback drives learning• Give feedback on non-technical skills as well

as technical skills and knowledge • Students need to know how they are

perceived• We need to help students learn how to

accurately self-assess

• Individual’s assessment schedule based on:• Student’s attendance• adherence to the process• communication skills• respect for others• and individual contributions.• award of a group mark added to each individual’s

assessment schedule encourages students to achieve the generic goals associated with PBL.

Treat your weakest student as you treat your best student

Expect them to succeed

PBL tutorial process

• Step 1—Identify and clarify unfamiliar terms presented in the scenario; scribe lists those that remain unexplained after discussion

• Step 2—Define the problem or problems to be discussed; students may have different views on the issues, but all should be considered scribe records a list of agreed problems

• Step 3—“Brainstorming” session to discuss the problem(s), suggesting possible explanations on basis of prior knowledge; students draw on each other’s knowledge and identify areas of incomplete knowledge; scribe records all discussion

• Step 4—Review steps 2 and 3 and arrange explanations into tentative solutions (analysis); scribe organizes the explanations and restructures if necessary

• Step 5—Formulate learning objectives; group reaches consensus on the learning objectives; tutor ensures learning objectives are focused, achievable, comprehensive, and appropriate

• Step 6—Private study (all students gather information related to each learning objective).

• Step 7—Group shares results of private study (students identify their learning resources and share their results; tutor checks learning and may assess the group

PBL tutorial group Designs

Compare between these two pictures

Challenges

Problems associated with leading effective small groups

• The teacher gives a lecture rather than guiding the group.• The teacher talks too much• Students cannot be encouraged to talk except with

difficult situations, they will not talk to each other, but will only respond to questions from the tutor

• Students do not prepare for the sessions• One student dominates the discussion• The students want to be given the solutions to problems

rather than discuss them.

Kinds of students inside the group and how the tutor dealing with each of them

The persistent talker

• Summaries their main points and divert the discussion to others;

• Interrupt with a yes/no question and ask someone else to comment

Quiet people

Shy and timid:They may speak quietly or cannot find the words to say what they mean.

• You can help them by allowing time for them to respond

• Asking ‘easy’ questions• Protecting them from mockery or teasing• Acknowledging their contribution

Negative attitude

These people may like to talk but have a negative attitude that can affect others.

Superior : They appear to know everything• Flatter a little by indicating how others can

learn from their experience• Ask for specific examples• Ask the group to comment

Negative attitude

Clown : ridicules discussion by joking or making irritating remarks

• Ask them for a serious contribution• Acknowledge any valid contribution• Be direct and say that although this was

amusing, the group must move on to complete its task.

Advantages and disadvantages of PBL

• Advantages of PBL• Student centred PBL—It fosters active learning,

improved understanding, and retention and development of lifelong learning skills

• Generic competencies—PBL allows students to develop generic skills and attitudes desirable in their

future practice

• Integration—PBL facilitates an integrated core curriculum

• Motivation—PBL is fun for students and tutors, and the process requires all students to be engaged in the learning process

• “Deep” learning—PBL fosters deep learning (students interact with learning materials, relate concepts to everyday activities, and improve their

understanding)• Constructivist approach—Students activate prior

knowledge and build on existing conceptual knowledge frameworks.

Disadvantages of PBL

• Tutors who can’t “teach”—Tutors enjoy passing on their own knowledge and

understanding so may find PBL facilitation difficult and frustrating• Human resources—More staff have to take

part in the tutoring process

• Other resources—Large numbers of students need access to the same library and computer resources

simultaneously• Information overload

Design of case scenario for 2nd year medical students

• Salma a 25 years old pregnant lady in her 5 months gestation, came to the PHCC complaining of dyspnea during her regular house work, specially when floor sweeping.

She gave history of attacks of dyspnea during sleep which forced her to rise from bed and go to a nearby window for some fresh air. The doctor inquired about a previous joint problems which was not present, but she gave history of abnormal hand movement during childhood, she was clumsy and dropping things which was cleared by itself without any diagnosis or treatments. The doctor referred her to the consultant physician in Tikrit Teaching Hospital. The consultant physician admitted her in the hospital for further investigations as ECG, CXR, Echocardiography.

Consultation was done to a gynecologist which revealed pregnancy with no complication. During hospitalization orthopnea continued inspite of intesive medical treatment. He introduced the information which were gained from this patient to his program in the computer.

The consultant physician decided to refer her to cardiac surgeon for emergency surgery to Baghdad Medical City. The consultant physician phoned the cardiac surgeon who was his friend and knew from him that they are going to do an urgent valvotomy.

Learning Objectives

• By the end of this week, the student should be able to:• Describe the structure of cardiac valves and its locations• Identify the characteristics of normal valvular functions.• Describe the pathogenesis of valvular damage in valvular heart

disease (V.H.D).• Indicate the abnormalities in ECG in (V.H.D).• Describe the bacteriological features causing valvular diseases.• Identify pathophysiology of the heart in valvular diseaes.• Describe the cardiac chambers• Describe the histopathological features of the cardiac valves.• Describe the histopathological features of endocardium• Appraise the use of computers as a resource for data analysis

Further reading

• Davis MH, Harden RM. AMEE medical education guide number15: problem-based learning: a practical guide. Med Teacher1999;21:130-40.

• Norman GR, Schmidt HG. Effectiveness of problem-based learning curricula: theory, practice and paper darts. Med Educ 2000;34:721-8.

• Albanese M. Problem based learning: why curricula are likely to show little effect on knowledge and clinical skills. Med Educ 2000;34:729-38.