Book•
Problem-based learning : an approach to medical education
01 Jan 1980-
TL;DR: This book presents the scientific basis of problem-based learning and goes on to describe the approaches to problem- based medical learning that have been developed over the years at McMaster University, largely by Barrows and Tamblyn.
Abstract: In this book, the authors address some basic problems in the learning of biomedical science, medicine, and the other health sciences Students in most medical schools, especially in basic science courses, are required to memorize a large number of ""facts,"" facts which may or may not be relevant to medical practice Problem-based learning has two fundamental postulates--the learning through problem-solving is much more effective for creating a body of knowledge usable in the future, and that physician skills most important for patients are problem-solving skills, rather than memory skills This book presents the scientific basis of problem-based learning and goes on to describe the approaches to problem-based medical learning that have been developed over the years at McMaster University, largely by Barrows and Tamblyn
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TL;DR: In this paper, students at a Pakistani medical college were surveyed using instruments taken from Western research and found that the students who perceived that their assessment and workload were inappropriate preferred a transmissive approach to teaching and adopted a surface approach in their learning and studying.
16 citations
01 Dec 2002
TL;DR: This paper examines how the design and implementation of problem solving tools used in programming instruction are complementary with both the fundamental theories of problem-based learning (PBL) and the pedagogy and practices of distributed education environments.
Abstract: Discussions of pedagogy and instructional design often entail their impact upon the cognitive systems of learners, knowledge transfer, and efforts to organize, facilitate and evaluate learning activities. Learning systems have undergone a demonstrable shift in focus from those based in instructivist theory and approaches (logical positivism and identifiable/fixed truth) to constructivist concepts (knowledge as a social construction) and practices, particularly as they take shape in the activities comprising problem-based learning (PBL). A technological one has accompanied this pedagogical shift. The Internet has made possible a transformation and increase in the methods of implementing the best practices and reaching greater numbers of potential learners through systems of distributed education. This paper examines how the design and implementation of problem solving tools used in programming instruction are complementary with both the fundamental theories of problem-based learning (PBL) and the pedagogy and practices of distributed education environments. A discussion of how such learning tools can be used to bridge the constructivist foundation of PBL with the needs of distributed education is suggested. We then consider how combining PBL, web-based distributed education and a problem solving environment can create effective learning environments in a variety of disciplines and modes.
16 citations
Cites background from "Problem-based learning : an approac..."
...objectives, regardless of their clinical location and variable patient exposure" (1)....
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TL;DR: This paper conciliate cognition and consciousness in medicine through analysing the phenomenology of perception in clinical reasoning and compares the application of phenomenology to clinical reasoning with the attempt to model clinical reasoning on Aristotelian practical wisdom or phronesis.
Abstract: Clinical reasoning has been defined as a form of cognition applied to evaluating and managing a patient's medical problem. As a kind of cognition, a product of the human psyche, it is logical to expect that clinical reasoning should be best understood through methods derived from psychology, neuropsychology and the cognitive sciences. However, the application of scientific methods to evaluating clinical reasoning is unable to analyse clinical reasoning in terms of first-person experience and consciousness. By reducing clinical reasoning to its cognitive components the cognitivist approach tends to ignore the larger context in which clinical reasoning occurs. By reducing its conception of clinical reasoning to its cognitive components, the neuropsychological approach fails to acknowledge clinical reasoning as a form of intentionality, a gestalt, grounded in human perception. A full epistemology of clinical reasoning requires a phenomenological analysis that can make sense of the relation between pre-reflective consciousness and explicit forms of knowing. In this paper I conciliate cognition and consciousness in medicine through analysing the phenomenology of perception in clinical reasoning. I compare the application of phenomenology to clinical reasoning with the attempt to model clinical reasoning on Aristotelian practical wisdom or phronesis. Finally, I analyse empathy as a type of perception critical for effective clinical interaction and exemplary for reflecting on perception as the intersubjective foundation of clinical reasoning.
16 citations
Cites background from "Problem-based learning : an approac..."
...It has been defined as a particular form of cognition applied to evaluating and managing a patient’s medical problem [1]....
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01 Jan 2011
TL;DR: In this paper, a travers deux recits cliniques, nous decrivons les processus analytiques (reflexifs) and non analytique (intuitifs), identifies dans la litterature scientifique.
Abstract: Le raisonnement clinique est au coeur de la competence medicale. Pourtant, dans le domaine de l’urgence, il a fait l’objet d’une attention tres modeste de la part des chercheurs, au regard des autres determinants de la performance des medecins. Le raisonnement clinique designe les processus cognitifs mobilises pour etablir des diagnostics et decider d’actions therapeutiques. A travers deux recits cliniques, nous decrivons les processus analytiques (reflexifs) et non analytiques (intuitifs) identifies dans la litterature scientifique. Ceux-ci ont tres majoritairement concerne les disciplines dites « conventionnelles ». Nous mettons en evidence le role determinant de la pratique clinique, dans la mesure ou elle permet aux praticiens d’elaborer des connaissances organisees et stockees en memoire a long terme, qui sous-tendent le fonctionnement des processus de raisonnement. Nous evoquons egalement l’influence considerable du contexte sur le raisonnement, afin de justifier l’interet de mener des travaux de recherche visant a identifier si les medecins urgentistes mobilisent des processus cognitifs particuliers, au regard des specificites qui caracterisent leur cadre d’exercice. La connaissance, par les praticiens, de la facon dont ils raisonnent est associee a des enjeux majeurs en termes de pratique de la medecine d’urgence et de formation dans cette discipline.
16 citations
Cites background from "Problem-based learning : an approac..."
...Le raisonnement clinique est défini comme l’ensemble des processus cognitifs permettant aux praticiens d’évaluer et de gérer les problèmes de santé d’un patient [6]....
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TL;DR: The students are generally happy with the Unitra tutors, and psychosocial issues into the tutorial process, minimizing teaching in the tutorial room, giving feedback to individuals, and giving appropriate guidance to students in the hypothetico-deductive clinical reasoning process are the major challenges facing the UnitRA tutor.
Abstract: lIgContext.l/Ig The Unitra (now Walter Sisulu University) medical
programme is problem- and community-based, offered in a
small-group tutorial setting under a tutor. The first 3 years of
the programme are integrated horizontally and vertically. The
hypothetico-deductive format, with progressive disclosure, is
utilised in the tutorial process. Regular training of tutors is
carried out to assist faculty in adapting to the new methods of
training. Performance of tutors is regularly assessed by
students.
lbrglIgObjectives.l/Ig To describe the students' perceptions of the faculty
performance as tutors over the past 10 years of the problembased
learning/community-based education programme and
to construct a profile of a Unitra tutor.
lbrglIgDesign.l/Ig Aprospective longitudinal study.
lbrglIgSetting.l/Ig The first 3 years of the medical programme is divided
into 10 blocks lasting 10 weeks each. At the end of each block,
students evaluate their tutors using a pre-designed form with
items pertaining to both process and content facilitation. For
each item, the tutor is assigned a score on a scale that ranges
from 'unacceptable' to 'superlative'. Students' evaluations over
the years were reviewed and the findings were analysed for
trends and similarities. Main outcomes.l/Ig Process facilitation and content facilitation.
lbrglIgResults.l/Ig Evaluations from 460 individual tutorial groups, and of
83 tutors, were analysed. Process facilitation.l/Ig Tutors were regular in attendance, were
punctual and showed enthusiasm for the tutorial process. They
were proficient in keeping the group on track, in giving
feedback to the group, and in helping the group to function.
They were less proficient in managing group time and in
giving feedback to individuals within the group. They did not
give students adequate direction in the clinical reasoning
process. Content facilitation.l/Ig Tutors were proficient in asking probing
questions, in encouraging students to pursue learning issues,
in integrating basic and clinical sciences and in identifying
learning errors, and they often shared their experiences with
students. They tended to teach within the tutorial session, and
did not lay strong emphasis on psycho-social issues raised by
the cases.
lbrglIgConclusion.l/Ig The students are generally happy with the Unitra
tutors. Content is better facilitated than process. Integrating
psychosocial issues into the tutorial process, minimising
teaching in the tutorial room, giving feedback to individuals,
and giving appropriate guidance to students in the
hypothetico-deductive clinical reasoning process are the major
challenges facing the Unitra tutor.
16 citations
Cites methods from "Problem-based learning : an approac..."
...The cases are formatted in a manner similar to the practice-based learning described by Barrows and Tamblyn.2 The first session begins with a brief statement regarding the patient’s chief complaint....
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...The cases are formatted in a manner similar to the practice-based learning described by Barrows and Tamblyn.(2) The first session begins with a brief statement regarding the patient’s chief complaint....
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