Problem-based learning (PBL) is a method for student-centred learning. It uses a learning process and specifically written problems (cases) to support precise, identified areas of learning, as well as both cognitive and attitudinal or behavioural development.
At Three Counties Medical School, students are usually in small groups of eight for each PBL session. One member acts as chair and one as a scribe, and all members participate in the group’s working.
The cases are carefully written to trigger learning in specific curriculum areas and are composed of patient stories, perhaps including pathology results, images and other data. Cases are intended to be authentic and realistic, drawn from practice to cover a wide spectrum of learning outcomes, from the microscopic to the macroscopic, and also to trigger thinking about practice.
The PBL process is often described as a seven-step process.
Firstly, the case is read and details are clarified. At Three Counties Medical School, this starts on a Monday morning with a plenary ‘map reading’ session identifying the journey for the week ahead.
The individual groups then each identify areas of interest for consideration. The group discusses these various areas, using pre-existing knowledge and intuition. After what is often a free-wheeling discussion, the group summarises areas of focus which might include diagnoses. The group then crystallises for itself what members feel needs to be learnt or investigated further in the form of generating learning outcomes.
All members of the group independently study all of the learning outcomes over the coming week, using resources collated and provided within the Medical School as well as independent study. These resources include simulation exercises, procedural skills practice and integrated clinical methods as well as reusable learning objects, such as podcasts, and a ‘resource carousel’ that might comprise anatomical models and life drawing.
On Friday, the group reports back on the results of their study and research. Jointly, group members clarify the learning.
The cases and the group members are the first two important elements of the group processes, but the problem-based learning facilitators also play a key role.
At Three Counties Medical School, they are clinicians who can provide the clinical contextualisation. They skilfully stimulate, challenge and guide the group discussions, facilitating extrapolations from the case details, and they can offer clinical anecdotes.
They have a key role in protecting the ‘integrity’ of the group, keeping discussion on track and encouraging productive discussions. In addition, a key function of the problem-based facilitator is as a role model to support the development of a professional identity.
PBL fulfils an important role in Medical School, but also sows seeds for life-long learning.
Working collaboratively and effectively in small groups and knowing how to sift through information and critically judge the value of that information are key skills that will prepare students well for the rapidly changing world of clinical practice.
To find out more about the University of Worcester’s Three Counties Medical School, visit the website.
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