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: The recommendations of the General Medical Council in Tomorrow’s Doctors renewed efforts to define core knowledge in undergraduate medical education and encouraged better use of the medical knowledge base in nurturing clinical judgement, critical thinking, and reflective practice.
Abstract: Context
The recommendations of the General Medical Council in Tomorrow’s Doctors renewed efforts to define core knowledge in undergraduate medical education. They also encouraged better use of the medical knowledge base in nurturing clinical judgement, critical thinking, and reflective practice. What then does the medical world understand by ‘science’, ‘critical thinking’ and ‘competence’, given the need to address both growth and uncertainty in the knowledge base and to practise evidence-based healthcare?
Aim and objectives
This review aims to outline the role of these key concepts in preparing undergraduate medical students for professional practice. Specifically, it explores: the fallibility of the ‘scientific’ foundations of medical practice; the role of understanding and thinking in undergraduate medical education; the need for a broad interpretation of competence and its relationship to transferability, and the nature of clinical judgement.
Comment
Tensions are seen to lie in the varying interpretations of clinical decision making as art or science; the varying characterizations of the nature of skilled performance in the novice, the competent and the expert practitioner, and the varying reactions to the acceptability and usefulness of ‘meta-’ concepts in capturing the essence of professional practice. Habitual self-conscious monitoring of mental processes may be the key to the flexible transfer and application of knowledge and skills across the contexts, characterized by uncertainty and incomplete evidence, for which doctors must be prepared.
92 citations
TL;DR: This paper examined student workload after a change in teaching style from lecture to Problem Based Learning and Cooperative Learning, and its relationship with student outcomes, and found that the change clearly overloads students if it is not adequately planned and monitored.
91 citations
Cites background from "Problem-based learning : an approac..."
...Here, students learn by solving problems and reflecting on their experiences (Barrows & Tamblyn, 1980)....
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TL;DR: It is concluded from the results of the present study that it is possible to have a problem-based learning module in the form of case-oriented problem-solving tutorials coexistent with the traditional didactic lecture modules in the first year of medical education under a conventional curriculum.
Abstract: The Department of Physiology of Pramukhswami Medical College at Anand, Gujarat, India, started using problem-based learning in a modified way along with didactic lectures to improve students' understanding and motivate them toward self-directed study. After the didactic lectures were taken for a particular system, clearly defined short clinical problems related to that system were given to the students in the tutorial classes. Each tutor was assigned three to four groups of five to six students each. Problems were accompanied with relevant questions so as to streamline the thought processes of the first-year undergraduates. The tutor then facilitated the study process, and the students discussed among themselves to derive their solutions. At the end of the sessions, feedback was taken from the students through a planned questionnaire on a three-point scale. Of a total of 278 students over a span of 3 yr from 1999 to 2002, 74.4% of students favored a judicious mixture of didactic lectures and case-oriented problem solving in tutorial classes to be an efficient modality in understanding a system under study, and 84% of students stated the mixture of didactic lectures and case-oriented problem solving to be beneficial in relating a clinical condition to the basic mechanism; 82% of students believed that this module helped with better interactions among their batch mates, and 77.2% of students hoped to perform better in the university examination due to this new teaching/learning modality. They also expressed that this gave them ample motivation to do self-directed learning. It may therefore be concluded from the results of the present study that it is possible to have a problem-based learning module in the form of case-oriented problem-solving tutorials coexistent with the traditional didactic lecture module in the first year of medical education under a conventional curriculum.
91 citations
TL;DR: Both subject-matter knowledge and process-facilitation skills are necessary but not individually sufficient characteristics of effective tutors, as well as overall effectiveness, in PBL tutors.
Abstract: Evidence for the superiority of particular characteristics in PBL tutors in medical curricula is generally inconclusive. Most studies have investigated the effectiveness of content experts compared with that of non-experts as measured either by student satisfaction or academic achievement. A few have compared academic staff tutors with student tutors. The purpose of this study was to investigate the relationship between students' perception of overall tutor effectiveness, particular tutor behaviours, clinical qualifications and academic appointment. A questionnaire designed to evaluate particular aspects of PBL tutoring technique, related either to subject-matter knowledge or to process-facilitation skill, as well as overall effectiveness, was distributed to students in first year of a PBL medical program at the end of each of three tutor terms. A total of 76 tutor terms were included in the study. Data analysis compared clinical with non-clinical tutors, and staff with non-staff tutors. Clinically qualified tutors used their subject-matter knowledge significantly more than non-clinical tutors and were seen as being more empathic with their students. Staff tutors placed more emphasis on assessment than non-staff tutors and were seen as having greater skill in establishing and maintaining an environment of cooperation within their PBL groups than non-staff tutors. These results suggest that both subject-matter knowledge and process-facilitation skills are necessary but not individually sufficient characteristics of effective tutors.
91 citations
TL;DR: This study was designed to investigate how students evaluate tutors in PBL tutorials and whether student evaluations of tutors change with the progress of students in P BL tutorials.
Abstract: Objective
The problem-based learning (PBL) tutor plays a role that is different from the role of a teacher in a conventional teaching format. In the Faculty of Medicine and Health Sciences, United Arab Emirates, all students are Arab nationals and tutors are expatriates with different sociocultural backgrounds from the students. This study was designed to investigate how students evaluate tutors in PBL tutorials and whether student evaluations of tutors change with the progress of students in PBL tutorials.
Methods
Differences in tutor performance evaluation by male and female students were also analysed. The students evaluated 12 tutor skills in a scale of 1–3, 1 being `below average' and 3, `outstanding'. Student responses from a total of 314 (98·1%) completed forms collected over 2 academic years were analysed statistically. A total of 14 tutors participated in the PBL programme.
Results
The analysis revealed that tutors as a group were rated as having average to outstanding tutor skills in 10 items of the evaluation form. Students and faculty perceptions were different for the tutor skills of guiding students for information management. The students expected more support from tutors, whereas the tutors tried to emphasize self-learning in the PBL curriculum. Lower scores to the tutors in the `problem' bringing sociocultural and religious issues for discussion showed that a gap in sociocultural/religious understanding between students and tutors might influence tutor skills.
Conclusions
Differences in tutor evaluation by male and female students indicate necessity of adopting different strategies by tutors in a different sociocultural background. The results of the study have direct implications for faculty development.
90 citations