Wondering what studying a Problem-Based Learning course is like? In this blog, our writer Natalia tells us what PBL courses are like to study.
Just as the name implies, Problem-Based Learning (PBL) is a form of teaching which is centred round a “problem” or scenario. The scenarios can be real or fictional, and usually involve patients and their surrounding environment.
They tend to be quite complex, involving many disciplines – such as the natural and social sciences, epidemiology and statistics, medical law and ethics – which aims to reflect the complexity of real-life situations. Students have to dissect and try to make sense of the scenario while guided by a facilitator.
They form objectives and then research these topics with the help of recommended resources and supporting lectures or workshops. The students meet again to discuss their findings, consolidating what they’ve learnt and identifying any gaps in their knowledge.
PBL definitely suits my style of learning. It encourages people to ask questions and can spark some rather controversial debates. I distinctly remember a scenario of a comatose patient which triggered a rather heated discussion on termination of life support and assisted dying.
Students come from different backgrounds and will inevitably challenge each other, and even though I left that session feeling rather frustrated, it encouraged me to look into the topic more carefully – and
Of course not every session leads to confrontation. A lot of work has to be covered in a short period of time, so good time-management is key. Finally, I’ve learnt a lot from other students’ style of learning and revising which has helped me develop my own revision technique.
The key concept of PBL is self-directed learning. This is meant to reflect the life-long learning that one has to adopt as a doctor. PBL aims to move away from didactic way of teaching and instead encourages you to take ownership of your studying. This can, at times, be rather frustrating, especially at the start when you don’t know how much depth you need to go into a certain topic. This can leave you feeling a bit lost, but ultimately this is part of the learning process.
The feedback session allows you to compare your work with the rest of the group and you can identify which areas you may need to work more on. The only real disadvantage of this is that the quality of the session depends on the quality of work of each group member – if nobody has done any research on a particular topic, then very little can be said and learnt from the feedback session.
If this does happen, the facilitator will highlight this and make sure the topic is covered in the next session. PBL teaches you to work in a team, even when you might not get along with all of the team members, and trains you to communicate your knowledge to others in a clear and logical manner, a vital skills for all doctors.
Mrs Blackburn is a 83 year old widow who lives by herself in a two storey apartment. She was getting out of bed one morning when she felt dizzy and fell. She was found unconscious by her carer about an hour later, who immediately called the ambulance.
The paramedics arrived and took Mrs Blackburn’s vital signs, measured her blood glucose and performed an ECG on their way to the hospital. The doctor on call was informed and ordered an X-ray of her pelvis as well as some other blood tests. Her X-ray showed evidence of an intracapsular fractured neck of femur and the NICE pathway of hip fractures was followed.
Hospital episode statistics data showed that falls were the most common cause of hospital admission in the previous year, with a higher prevalence in females. Once she had recovered from the anaesthesia, her mental capacity was assessed, and consent was taken to share her medical information with her daughter who was a nurse working at the same hospital – she had been finding it increasingly difficult balancing her mother’s care, her two children and her full-time job and wanted the best for her mother.
Before Mrs Blackburn was discharged from hospital a few days later, an OT assessment was performed and several adjustments were made in her house to ensure her safety when she returned home.
This is a short scenario to give you a flavour of what PBL may look like. There will be many unknown terms and different topics will need to be covered. The intended learning objectives will involve the topic of falls in the elderly, the types of hip fractures and the different treatment options.
The role of the members of the multidisciplinary team that are mentioned will need to be investigated, and the group will need to look up terms such as “NICE pathway” or “hospital episode statistics”. The burden on the patient’s carers and the impact on the whole family would need to be considered and certain ethical issues are raised such as the extent to which healthcare professionals can share medical information with others.
Finally, legal terms such as “mental capacity” and “informed consent” will be integral in this case. The PBL group will discuss the topic with any prior knowledge they may have, identify their learning needs and, with the help of the facilitator, come up with learning objectives which they will then go on to research before the next session.
Words: Natalia Kyrtata
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