PBL vs. traditional curriculum?

mln said:

Any ideas or opinions on pros and cons of each?

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I've heard from some med and dental students that PBL is a pain because you end up learning a bunch of nit-picky stuff that will not help you on the boards.

However, while it might not help you on the boards, it might help you become a better doc, maybe.

Depends on your learning style too. Personally I think PBL is silly since you have 2 years to get hands-on experience anyway.

Thank you for strating this thread. I started having thoughts about these two different styles of learning. I set on in one of PBL classes (in a small group setting, Is PBL always small group setting?) after interview and I liked it in terms of more interactions between students and the teacher.
But I thought PBL might be more confusing. It's a little bit hard to explain but it's less organized comparing to a traditional "good" lecture. Anyhow, PBL is really different from traditional style. But it looked like that the core materials are covered again during lectures.

I also think even lecture style can have lots of details not required to know for USMLE. I heard/read some students complain about too much detail info from famous researchers teaching med school classes. So, regarding learning too much unnecessary stuff, PBL and traditional are even.

Personally, I might enjoy PBL better becasue I learn very well when it's related to a story/episode/case. However, I'm not sure how much I can remember if hundreds of cases are presented in a couple of weeks.

Any other thought?
I think some experiened med students posts will help to determin which style is better for me. Thanks in advance.

It boils down to that one needs standard curriculum as well as problem-based learning. The standard gives a structured environment to learn the basics and the guts of the subject matter while the problem-based part gives the opportunity to put things into practice and see how they are used in a clincal setting. The pros and cons boil down to contrasting idealism vs. pragmatism.. where the clinical process boils down to idealism progressed to a usable solution.

There was a recent thread in which I gave my opinion on PBL. Rather than rewriting everything I said then, you can read it here.

Here's my analogy. Say you're painting a portrait.

In a traditional curriculum, you draw a rough sketch, then a finer sketch, then shading and color.

In a PBL curriculm, you begin by drawing a very detailed eye, and then a very detailed nose, and so on. Obviously, you need to know where to put each part, so you need to make a very rough sketch of a head as an outline.

mln said:

Any ideas or opinions on pros and cons of each?

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It depends on your learning style. Some people like PBL, which involves a small discussion group and discussion of a case through a "whole body" patient approach. PBL is good for those who want to apply their basic science knowledge clinically as soon as possible (why wait until your 3rd year clerkships they say). I think you learn clinical diseases well with this approach, but not enough to cover all the fine details and specifics for the boards (USMLE, etc)

Other people like the traditional lecture style where you learn about organ systems and their associated diseases. This is more of a categorization/dissection approach. You build the big picture from slowly learning from your building blocks (anatomy, physiology, biochem, pathology, microbiology, etc). I think this style is geared more toward the boards because you learn the fine details and specifics well. However, it usually falls on your own shoulders to apply the knowlegde clinically.

From my anecdotal experience, the people who had PBL at their med schools did mediocre on the USMLE Step 1. In contrast, the traditional lecture style schools did much better on USMLE Step 1.

Bottomline: You will have to decide which learning style is best for you.

Do any of the schools that brag about high USMLE scores have PBL curricula?

TheMightyAngus said:

Do any of the schools that brag about high USMLE scores have PBL curricula?

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Not that I know of. But I graduated med school a few years ago and have been out of the loop for awhile.

Back when I was applying to med school (many eons ago), some of the schools I interviewed at had PBL curriculums. Drexel (formerly called "MCP/Hahnemann") and Univ of Hawaii had PBL curriculums. These school had a number of failures on USMLE Step 1. That turned me off. In contrast, there were schools with traditional curriculums, like Columbia and NYMC, which had no failures on USMLE Step 1.

I ended up going to a traditional curriculum med school in the end...and I believe it helped me do well on my USMLE Step 1 and 2...which in the end, helped me get the residency of my choice

Although, traditional curriculums can be long and painful (you can easily get lost in the details and ask yourself many times where's the clinical relevance), in the long run I think they are better for boards prep.

TheMightyAngus said:

Do any of the schools that brag about high USMLE scores have PBL curricula?

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northwestern has a PBL curriculum and seems to do pretty well on the USMLE on average.

vn2004 said:

northwestern has a PBL curriculum and seems to do pretty well on the USMLE on average.

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it's hard to find the USMLE averages for each school, they don't publish that information, i don't think. but i was a little worried about whether the PBL stuff would adversely affect USMLE scores, so knowing that the scores at northwestern tend to be good was a relief.

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Zoom-Zoom said:

I've heard from some med and dental students that PBL is a pain because you end up learning a bunch of nit-picky stuff that will not help you on the boards.

However, while it might not help you on the boards, it might help you become a better doc, maybe.

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I seriously doubt PBL won't help you for the boards considering that PBL cases are really just extended clinical vignettes. The vast majority of board questions are short clinical vignettes. If you are well trained with clinical vignettes there is NO DOUBT that is an advantage for the USMLE.

Iwy Em Hotep said:

Here's my analogy. Say you're painting a portrait.

In a traditional curriculum, you draw a rough sketch, then a finer sketch, then shading and color.

In a PBL curriculm, you begin by drawing a very detailed eye, and then a very detailed nose, and so on. Obviously, you need to know where to put each part, so you need to make a very rough sketch of a head as an outline.

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You are confusing PBL with organ-based learning. The two have nothing to do with each other. PBL is just two hours a couple times a week going over actual clinical cases, just like a real doctor, only you are doing it on paper. Far from being detailed on a certain topic, it is broad and teaches you how to extrapolate causes by looking at signs and symptom, along with demographic and other patient information that would be useful to initiate treatment.

porokeratosis said:

Not that I know of. But I graduated med school a few years ago and have been out of the loop for awhile.

Back when I was applying to med school (many eons ago), some of the schools I interviewed at had PBL curriculums. Drexel (formerly called "MCP/Hahnemann") and Univ of Hawaii had PBL curriculums. These school had a number of failures on USMLE Step 1. That turned me off. In contrast, there were schools with traditional curriculums, like Columbia and NYMC, which had no failures on USMLE Step 1.

I ended up going to a traditional curriculum med school in the end...and I believe it helped me do well on my USMLE Step 1 and 2...which in the end, helped me get the residency of my choice

Although, traditional curriculums can be long and painful (you can easily get lost in the details and ask yourself many times where's the clinical relevance), in the long run I think they are better for boards prep.

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Well, you should know as a future doc that you can never rely on anecdotal evidence. For instance, Northwestern is a progressive PBL curriculum and the USMLE average there is much higher than at University of Chicago, a traditional, completely lecture based format.

You have to realize that PBL curriculums still have lots of lecture time! Just less and it is more compressed and relavant I believe, to the USMLE. There are a lot of receptors and such you do not need to know, ever, as a doctor, and progressive curriculums take the fat out it seems. There is so much information that drinking properly from the hose coming at you is important, and progressive curriculums help you do this IMO. Otherwise you are just bogged down with too much info no human being could possible remember.

You also have to realize that PBL is just 4 hours per week! That's it! And all it is is going over actual clinical cases in a group learning format. I don't see how this could negatively effect anything. At just 4 hours a week it is not like it is your main source of learning and could possibly cut into too much lecture time, and all it does is enforce the proper thought process you will use as a doctor and on USMLE board questions, which are mostly formatted in very similar clinical vignettes. My guess would be that PBL curriculums actually do better on the boards. I know Northwestern's board scores skyrocketed after they initiated PBL many years back, and now is one of the highest average board scores in the country. If you talk to the administration you will find that they credit their increase in board scores to the initiation of PBL. And that makes sense because PBL cases are just like USMLE cases, only longer and more involved.

ctwickman said:

You are confusing PBL with organ-based learning. The two have nothing to do with each other. PBL is just two hours a couple times a week going over actual clinical cases, just like a real doctor, only you are doing it on paper. Far from being detailed on a certain topic, it is broad and teaches you how to extrapolate causes by looking at signs and symptom, along with demographic and other patient information that would be useful to initiate treatment.

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you go to NU, right? can i safely assume then that you liked your PBL sessions?

^

I personally do not like PBL because I do not like talking in front of people, or presenting information to other people. But I absolutely can see it's uses, especially now in year 2 that I am starting to study for the boards and I see that the USMLE clinical vignettes are just like our PBL cases, only the PBL cases were a lot more detailed so I am well trained to handle USMLE vignettes I feel. Also it is ABSOLUTELY useful for my future, I feel, because in PBL sessions we go over clinical cases and try to solve them. I don't see how this could not possibly be relavant because that is exactly what you do as a doc. All those average lab values and words you have never heard in your entire life will be grilled in your head by the 20th PBL session. I mean basically what we are dealing with is a complete Physician's History and Physical. Seeing that I read two complete history and physicals every week in PBL I think will help me next year when I actually have to write one practically every day in rotations.

I don't blame people for being confused at what PBL actually is because the admin acts like it is the main method of learning. But even at NU which is known for PBL, you will have it MAX 4 hours per week. Even people who can't stand PBL wouldn't trade it for a second for another 2 hours of lecture time, I can gaurantee you that!

ctwickman said:

^

I personally do not like PBL because I do not like talking in front of people, or presenting information to other people. But I absolutely can see it's uses, especially now in year 2 that I am starting to study for the boards and I see that the USMLE clinical vignettes are just like our PBL cases, only the PBL cases were a lot more detailed so I am well trained to handle USMLE vignettes I feel. Also it is ABSOLUTELY useful for my future, I feel, because in PBL sessions we go over clinical cases and try to solve them. I don't see how this could not possibly be relavant because that is exactly what you do as a doc. All those average lab values and words you have never heard in your entire life will be grilled in your head by the 20th PBL session. I mean basically what we are dealing with is a complete Physician's History and Physical. Seeing that I read two complete history and physicals every week in PBL I think will help me next year when I actually have to write one practically every day in rotations.

I don't blame people for being confused at what PBL actually is because the admin acts like it is the main method of learning. But even at NU which is known for PBL, you will have it MAX 4 hours per week. Even people who can't stand PBL wouldn't trade it for a second for another 2 hours of lecture time, I can gaurantee you that!

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i guess what i wanted to ask was not so much whether you liked it but if you thought it was useful and not just a waste of time. i didn't realize it was only about 4 hrs a week though, that's not too bad at all. it sounds like you are at least getting something out of it, which is reassuring. i've read plenty of posts from other current med students who thought it was an absolute waste of time, but i'm sure the way PBL sessions are run differs from school to school.

I don't know the history of the PBL initiative, but I was under the impression that NU does not have a representative PBL curriculum, rather, they have a hybrid. I will likely go to University of Missouri next year, which claims to have a very traditional PBL curriculum, where students have 10 hours of PBL sessions per week, with no more than 10 hours a week of lectures/labs. Is this what a classic PBL curriculum should look like? or is it 4 hours a week? That doesn't seem like enough time.

ahumdinger said:

I don't know the history of the PBL initiative, but I was under the impression that NU does not have a representative PBL curriculum, rather, they have a hybrid. I will likely go to University of Missouri next year, which claims to have a very traditional PBL curriculum, where students have 10 hours of PBL sessions per week, with no more than 10 hours a week of lectures/labs. Is this what a classic PBL curriculum should look like? or is it 4 hours a week? That doesn't seem like enough time.

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Yeah, Mizzou has a traditional PBL curriculum. They saw a dramatic increase in Step scores after moving to the PBL curriculum back in the mid-90s. My wife went to med school there and scored very well on Step 1 and Step 2 (99th and 94th percentile respectively). I know you can't generalize to all students, but the PBL system worked well for her.

ahumdinger said:

I don't know the history of the PBL initiative, but I was under the impression that NU does not have a representative PBL curriculum, rather, they have a hybrid. I will likely go to University of Missouri next year, which claims to have a very traditional PBL curriculum, where students have 10 hours of PBL sessions per week, with no more than 10 hours a week of lectures/labs. Is this what a classic PBL curriculum should look like? or is it 4 hours a week? That doesn't seem like enough time.

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It depends on the particular school for how much they use PBL as a method of learning. From what I've been seeing from schools since I'm still figuring out where I want to apply, a lot of them have PBL in some format, but the amount it is used within the curriculum varies between schools. I've seen some almost completely PBL-based curriculums, some curriculums that have mostly lectures with PBL only a few hours a week, and some that are straight lecture format.

To begin with, I want to second robotsonic -- the thread he posted a link to contains my thoughts on PBL, as well.

ctwickman said:

You are confusing PBL with organ-based learning. The two have nothing to do with each other. PBL is just two hours a couple times a week going over actual clinical cases, just like a real doctor, only you are doing it on paper. Far from being detailed on a certain topic, it is broad and teaches you how to extrapolate causes by looking at signs and symptom, along with demographic and other patient information that would be useful to initiate treatment.

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Maybe this is what YOUR school's version of PBL is. However, some curriculums are pure PBL, which means no lectures. Drexel's PIL program is very close to this, and I know other schools are as well. There is a huge difference. Drexel's IFM program, which is their "non-PBL" program, actually does include PBL and case-based learning. The difference is that most of the information you need to learn is presented in lectures, rather than investigated on your own and by your peers, with faculty advisement.

Drexel was mentioned before. Supposedly the PIL board scores went up after the school added more multiple choice questions to the exams, and maybe made some other changes. This does speak strongly to the ability of small curricular changes to affect board scores, I think. It has also been suggested that PIL may average slightly lower on the boards because the people who choose that program are not as comfortable taking multiple choice/standardized tests in the first place, which is why they choose the program to begin with.

Anyway, again, check robotsonic's link to see what I, and many others, think about PBL