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PROBLEMBASEDLEARNING
WHATAND WHYDr. Arjun Singh
M.D.
Pathology
Visit on www.drarjunpatho.hpage.com for more information
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OBJECTIVE
Background
Definition
What is PBL
Why is PBL
References
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The goal of medical education isproduce physician we would like
to se if we are sick.--Melinkof
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CURRICULUMCHANGE - WHY?
Too much information - too little time
The need to foster the skills for self-
directed life-long learning
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PROBLEMBASEDLEARNINGIDEA
In study conducted by Gonella et al 1970on Resident of large general
hospital 50% are unable to performscreening activities on patients ofsuspected case of pyelonephritis
but when tested by MCQ the scorewas 82%
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People can possess knowledge
which they seem unable to applyOr
They know information but can not
use it.
Or
The way in which topic taughtdetermine what student can do withinformation acquired
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The three principles for acquiring anew information, (Anderson 1977)
PBL
Activation ofprior
knowledge
Elaborationof
knowledge
Encodingspecificity
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ACTIVATIONOFPRIORKNOWLEDGE
Defence
Mechanism
Againstinfections
1st
MBBS
4thMBBS
Rumelhart & Ortony 1977
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ENCODINGSPEFICITYTulving & Thomson 1973
Closer resemblance to the situation in which something islearned and the situation in which it is applied
Group A
Taught under waterExamine under water
Group B
Taught under water
Examine out side water
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ELABORATEKNOWLEDGEAnderson & Reder 1979
PBL
Discussion
Hypothesis
Making notes
Pear Learning
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A learning method based on the
principle of using problems as a
starting point for the acquisitionand integration of newknowledge.
H.S. Barrows 1982
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OBJECTIVESOFTHE PBL PROCESS
Knowledge- basic and clinical content incontext
Skills- scientific reasoning, critical appraisal,information literacy, the skills of self-directed,
life-long learning
Attitudes- value of teamwork, interpersonalskills, the importance of psychosocial issues
To develop:
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Traditional
Tutorial
Tutor
Students
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PBLTutorial
Tutor
Students
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PBL AND THEIR TIMING
2-3
Hr.
Case 1 Case 2
Case 1
Case 1
Case 1 Case 2
Case 2
Case 2
Wk1 Wk2 Wk3 Wk4 Wk5
Most programs schedule 1 case over 3 sessions, one
or two sessions a week
Some do 2-3 sessions a week - Case of the Week
Case 3
Intro,
ReviewProcess
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SEVENJUMPTHEORY(WOOD, DF 2003)
1. Clarify terms and concept not readily comprehensible
2. Define the problem3. Analyze the problem (use prior knowledge and common
sense and try to give as many explanations as possible)
4. Draw a systematic inventory of the explanations referredfrom step 3 (give structure to the outcome of the brainstorm, hypothesize and set up a model or produce acoherent description)
5. Formulate learning objectives.
6. Collect additional information outside the group.
7. Report the finding in the tutorial group.(integrate theknowledge and check whether the information you haveobtained meet the objectives of the case)
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THEPROCESSESOFTHETUTORIAL
Return to the problem1. Ill-structuredProblem
2. Clarifyingconcept
3. Defining the problem
4. Analysing theproblem/brainstorming
5. Problem analysis / systematicclassification
6. Formulating andproioritizing learningobjectives
7. Self study
8. Reporting
Assessment
SEVENJUMPTHEORY(WOOD, DF 2003)
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Tutorial 1-1
Introduction tothe group and
to PBL
What is your
background?
What is your
understanding
of the PBL
process?
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Tutorial 1-2
Starting the
problem
What dowe know
What do weneed to
knowDiscuss &
list learningissues
Organizewho does
what
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STUDENT PBL
Read the caseWhat do you know about this scenario?
What do you need to know?Discuss & list learning issues
Discuss & list potential sources ofinformation
Organize who (theoretically) will do what
Evaluate how you performed as a groupwww.drarjunpatho.hpage.com
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An important part of PBL is the learning
between sessionswww.drarjunpatho.hpage.com
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KEYPRINCIPLESINA PBL CURRICULUM (AFTERENGEL, 1991 AND 1992)
Active learning
Integrated learning
Cumulative learningConsistency in learning
Learning for understanding
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PBL i PBL i t
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PBL is PBL is not
Problem Based Learning Problem based teaching
Acquisition of knowledge Transfer of knowledge
The use of several hand books The use of single hand bookLong term memory Short term memory
Motivation for life long Disinterest in acquiring new informa
Understanding Rote learning
Student centered Teacher centered
Self motivating Organization of teaching
Learning through problems Learning to solve problems
Interacting with staff Listening to staffActive Passive
Challenging Discouraging
Asking questions Giving answers
Lightening a heart fire Filling a bucketwww.drarjunpatho.hpage.com
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NEPALSTUDY
The report of study conducted on PBL in B P KoiralaInstitute of Health Science, Dharan, Nepal concludes thatPBL11
Useful and enjoyable (96%)
Facilitate integration (100%)
Help in development of self directed learning (88%)
Help in problem solving skill (81%)
Provide opportunity to learn from pears (73%) Help in understanding an principle (96%)
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CHARACTERISTICSOFAPBLTUTOR
A knowledge of the process of PBL
Commitment to student-directed learning
Ability to generate a non-threateningenvironment while still acting to promote
discussion and critical thinking
Willingness to make constructive evaluationof student and group performance
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Prompt and present for all sessions
A knowledge of the process of PBL
Commitment to self/student-directed learning
Active participation in discussion and criticalthinking while contributing to a friendly, non-intimidating environment
Willingness to make constructiveevaluation of self, group and tutor
CHARACTERISTICSOFAPBLSTUDENTS
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THE ADVANTAGESOF PBL Emphasis on Meaning, Not Facts
By replacing lectures with discussion forums, facultymentoring, and collaborative research, students becomeactively engaged in meaningful learning.
Increased Self Direction
As students pursue solutions to their classroom problem,
they tend to assume increased responsibility for theirlearning.
Higher Comprehension and Better Skill Development
Students are able to practice the knowledge and skills in afunctional context, thereby to better imagine what it will belike using the knowledge and skills on the job .
Interpersonal Skills and Teamwork
This methodology promotes student interaction andteamwork, thereby enhancing students' interpersonal skills.
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Self-Motivated Attitude
Students think problem based learning is a more interesting,stimulating, and enjoyable learning method, and that it offersa more flexible and nurturing way to learn.
Facilitator-Student Relationship
The aspect faculty liked most is the tutor-student relationship(Vernon, 1995). Faculty also consider problem basedlearning a more nurturing and enjoyable curriculum, and
believe the increased student contact is beneficial to thecognitive growth of the student (Albanese & Mitchell, 1993).
Level of Learning
Problem based learning medical students score better thantraditional students with respect to learning skills, problem-
solving, self-evaluation techniques, data gathering,behavioral science, and their relation to the social-emotionalproblems of patients (Albanese & Mitchell, 1993).
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PROBLEMSWITH PBL INHYBRIDCURRICULA
Finding enough tutors - 1 for each 6 students
Faculty busy with traditional curriculum
The range of topics which can be discussed isa limiting factor - quality control is difficult
Heavy on library, computer resources, support
Objective evaluation of PBL is difficult
Inherent conflict with lectures - waste of time
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REFERENCES
Singh A. Kumar J. Problem based learning: Obstacles
and strategy to overcome. J College of medical science,Nepal 2008, vol5,No.1, 1-5.
Singh A. Student performance and their perception of apatient-oriented problem-solving approach with
audiovisual aids in teaching pathology: a comparisonwith traditional lectures. Advances in Medical Educationand Practice; 2010; 1: 1-7.
Anderson, J. & Graham, A. A Problem in Medical
Education; Is there an information overload ? MedicalEducation; 1980; 14: 4-7.
Schmidt, H.G. Problem based learning; Rational andDescription. Medical Education; 1983; 17:11-16.
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REFERENCES
Barrwos H.S. & Tamblyn, R.M. Problem Based Learning;An Approach to Medical Education. Springer; New York1980.
Dutch B., Gron. S. Allen D. The Power of Problem BasedLearning. eds 2001;Stylus Publishing.
Chapagain, M. L., Bhattacharya, N., Jain, B.K., Kaini,K.R.,Koirala,S. and Jayawickramarajah, P.T. Introducingproblem based learning in to an organ systemprogramme. Medical Teacher; 1998; 20: 6; Short
communication. De Goeij; A.F.P.M. Problem Based Learning: what is it?
What is it not? What about the Basic Sciences?Biochemical Society Transactions;1997;25:288-293.
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Clarke, R.N. Design and implementation of the Curriculum in a
new medical school. Programmed learning and educationaltechnology. 1979;16:288-295.
Jayawickramarajah, P.T. Problems for Problem BasedLearning: A Comparative Study of Documents. Medicaleducation; 1996;30:272-282.
Jayawickramarajah, P.T. Problem Based Curriculum Chapter 2.Reprinted from Adhikari R.K. and Jayawickramarajah,P.T.(Eds)Essentials of Medical Education Health learningmaterial centre (A WHO Collaborating Centre) Institute ofMedicine, Tribhuvan University, Kathmandu, Nepal, 1996.
Wood, D. F. ABC of Learning and Teaching in Medicine:Problem Based Learning. British Medical Journal;2003;326:328-330.
REFERENCES
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The biggest obstacle
to educational change
is our memories.
-- Dr. Allen Glenn
OBSTACLES
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