Pbl?

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Thanks...I had followed that thread off and on...

What I'm looking for is exactly how it is run. What does the faculty do? Is there even much of a faculty presence at these schools? How is material tested? Are there learning objectives, etc?

It loooks/sounds VERY disorganized...but I'm interested in learning more about it.

I keep getting told how group study is absolutely ESSENTIAL to being successful in Med School, but I'm trying to figure out why/how. I live an hour from school, so group study is quite difficult for me....and I'm doing fine, though one course gave me fits this fall.
 
PBL can be done in a variety of ways. The key lies in the name: Problem Based Learning. It is really learning through application of knowledge. It is often done through group work. I suggest googling PBL for some excellent background info.

PBL is implemented in a variety of ways at different med schools. I would suggest asking the closest school if you could sit in on a class if you're close enough to one that does it.

The PBL session I observed at LECOM-B was excellent. The students meet and find the gaps in their knowledge while going over a clinical case. They then go home and fill in these gaps before the next meeting. The faculty facilitator is there to basically make sure you don't miss something important. He chimed in a few times.

I've heard it is done MUCH differently at other schools and many people don't like it. I feel most of the LECOM-B students are happy with the PBL there.

I did PBL in my organic chemistry class in undergrad and loved it.
 
It sounds like you want details, so I'll take a stab with two caveats: first, it's impossible to get a true sense of how PBL works w/o actually sitting in on a session, and second, PBL seems to be executed differently at different schools - I can only speak to the way it is done at LECOM-B.

OK, in a nutshell: You're in a group w/ 7 other students and a facilitator (either a PhD in a basic science or MD/DO). Several roles are assigned to students - a scribe to keep notes on the board, a student to role play patient, and a student to play doctor.

You are given a page w/ a chief complaint - let's say left sided chest pain. The group starts off with putting a broad differential up on the board. This part has gotten much better in second year - it could take a while in first year since all anybody is thinking is "MI". Once the group has discussed all the possibilities we can think of, the "doctor" interviews the "patient".

This gives you a chance to get a little more practice with your history taking skills. Once we have the history, we revisit the differential and rule things in or out and discuss why. For example, let's say the pt was a 20 yo female with a history of PUD. MI might get moved down on our list of possibilities, and GI might get moved up.

We then move on to the physical exam and the facilitator might question us about our expected findings - do you expect extra heart sounds? What do particular unexpected heart sounds mean? Perhaps there will be a physical finding we have never heard of, a "succession splash", for instance. We will look it up in our physical exam book and discuss what it means. If something comes up that stumps the group, we may put that topic up on the board as a "Learning Issue" - something the group will do extra research on after the session.

Based on the info we've gotten from the history and PE, we then move on to labs, again with the facilitator asking questions as needed to guide the group to discuss pertinent issues. Maybe there was a positive fecal occult blood test - what should we expect to see on the CBC - normal or low MCV? Maybe the patient has been vomiting and unable to keep fluids down - what should the ABG show? Does that fit w/ the pt.'s respirations? Depending on the case, we will have anywhere between 10 and 25 pages of labs and clinical progress notes in a case.

Usually a case will take 2 or 3 days to finish, so after each day, we will go read about our learning issues, look up articles related to the case, and hopefully come back much more prepared to address the case. For each successive day of a case, a student is chosen to present the case to the group, so we get a lot of practice in writing up and presenting SOAP notes.

The real learning and critical thinking happens in the discussion between students and, with a good facilitator, in the thought-provoking questions they pose to the group. Contrary to what some people think, there is not a lot of basic science learning that happens during PBL - for the most part that happens outside class. PBL is an opportunity to make connections between the basic science material you are reading and the case you are working on.

Once we have finished the case, we choose topics we will be tested on from the learning issues that came up in the case. Although there is a lot of overlap, each group picks slightly different topics to be tested on, and takes their own unique test at the end of the block. We all get questions about the cases, so it pays to pay attention in PBL - even if you don't pick a particular drug as a learning issue, if it was in a case, it's fair game. By the time we finish a case, we are expected to be able to explain all the details in it.

Hopefully, that gives you a bit more of an idea of what it's like, although as I said before, you really have to experience it to fully get it. It also makes a difference who your facilitator is, ie. if they are a microbiologist, you can expect to be pimped extra hard on micro as you go through the case. If they are a surgeon, they may pimp you on more of the clinical management of the pt. and take the session in a more clinical direction.
 
DragonWell said:
It sounds like you want details, so I'll take a stab with two caveats: first, it's impossible to get a true sense of how PBL works w/o actually sitting in on a session, and second, PBL seems to be executed differently at different schools - I can only speak to the way it is done at LECOM-B.

OK, in a nutshell: You're in a group w/ 7 other students and a facilitator (either a PhD in a basic science or MD/DO). Several roles are assigned to students - a scribe to keep notes on the board, a student to role play patient, and a student to play doctor.

You are given a page w/ a chief complaint - let's say left sided chest pain. The group starts off with putting a broad differential up on the board. This part has gotten much better in second year - it could take a while in first year since all anybody is thinking is "MI". Once the group has discussed all the possibilities we can think of, the "doctor" interviews the "patient".

This gives you a chance to get a little more practice with your history taking skills. Once we have the history, we revisit the differential and rule things in or out and discuss why. For example, let's say the pt was a 20 yo female with a history of PUD. MI might get moved down on our list of possibilities, and GI might get moved up.

We then move on to the physical exam and the facilitator might question us about our expected findings - do you expect extra heart sounds? What do particular unexpected heart sounds mean? Perhaps there will be a physical finding we have never heard of, a "succession splash", for instance. We will look it up in our physical exam book and discuss what it means. If something comes up that stumps the group, we may put that topic up on the board as a "Learning Issue" - something the group will do extra research on after the session.

Based on the info we've gotten from the history and PE, we then move on to labs, again with the facilitator asking questions as needed to guide the group to discuss pertinent issues. Maybe there was a positive fecal occult blood test - what should we expect to see on the CBC - normal or low MCV? Maybe the patient has been vomiting and unable to keep fluids down - what should the ABG show? Does that fit w/ the pt.'s respirations? Depending on the case, we will have anywhere between 10 and 25 pages of labs and clinical progress notes in a case.

Usually a case will take 2 or 3 days to finish, so after each day, we will go read about our learning issues, look up articles related to the case, and hopefully come back much more prepared to address the case. For each successive day of a case, a student is chosen to present the case to the group, so we get a lot of practice in writing up and presenting SOAP notes.

The real learning and critical thinking happens in the discussion between students and, with a good facilitator, in the thought-provoking questions they pose to the group. Contrary to what some people think, there is not a lot of basic science learning that happens during PBL - for the most part that happens outside class. PBL is an opportunity to make connections between the basic science material you are reading and the case you are working on.

Once we have finished the case, we choose topics we will be tested on from the learning issues that came up in the case. Although there is a lot of overlap, each group picks slightly different topics to be tested on, and takes their own unique test at the end of the block. We all get questions about the cases, so it pays to pay attention in PBL - even if you don't pick a particular drug as a learning issue, if it was in a case, it's fair game. By the time we finish a case, we are expected to be able to explain all the details in it.

Hopefully, that gives you a bit more of an idea of what it's like, although as I said before, you really have to experience it to fully get it. It also makes a difference who your facilitator is, ie. if they are a microbiologist, you can expect to be pimped extra hard on micro as you go through the case. If they are a surgeon, they may pimp you on more of the clinical management of the pt. and take the session in a more clinical direction.
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Thank you. That's exactly what I was looking for. It sounds VERY self-directed...I'm not so sure I'd like that aspect of it...but at the same time, it sounds like you have time to read.

What I find most appealing is that you get to work actual cases, etc...We've done a "little" bit of this...but not much.

I have absolutely never been a fan of group work, but this does not seem like true "group project" type thinking. It sounds like if you do your work, you will be fine...and not suffer due to others slacking.

About how long are the tests? That seems like it would be the hardest part.

Is there any direction at all given as far as what chapters, etc....or is it just "here's your problem....figure it out" ?

As I understand it, we will have a mix of tried and true lecture basic sciences work, lecture based systems work, and some integrated PBL type stuff. So far, I like what we've got going on, but I am ready to move into systems. Clinical correlations make studying some of this stuff (biochem and cell bio) much more interesting.
 
MJB said:
Thank you. That's exactly what I was looking for. It sounds VERY self-directed...I'm not so sure I'd like that aspect of it...but at the same time, it sounds like you have time to read.

What I find most appealing is that you get to work actual cases, etc...We've done a "little" bit of this...but not much.

I have absolutely never been a fan of group work, but this does not seem like true "group project" type thinking. It sounds like if you do your work, you will be fine...and not suffer due to others slacking.
Click to expand...

Me neither - as a rule I find group study pointless, but this is nothing like a study group. It's very focused and fast paced - by the time two hours is up you've had enough lab values and questions thrown at you that you know what you need to go study - on your own.

About how long are the tests? That seems like it would be the hardest part.
Click to expand...
Test are pretty rough, usually around 180- 200 questions and cover anywhere from 30-50 chapters of material (it was a little lighter 1st year).

Is there any direction at all given as far as what chapters, etc....or is it just "here's your problem....figure it out" ?
Click to expand...

Usually it becomes pretty clear what the major issues in the case are, but the exact chapters to study are decided by the group. If a group is really in left field, they might get an email from a faculty member, but not too often. The idea is to empower students to determine what they need to be learning. Usually there is agreement about what chapters to choose, occasionally discussions get heated...some folks want more chapters, some want less.

As I understand it, we will have a mix of tried and true lecture basic sciences work, lecture based systems work, and some integrated PBL type stuff. So far, I like what we've got going on, but I am ready to move into systems. Clinical correlations make studying some of this stuff (biochem and cell bio) much more interesting.
Click to expand...

Agree, and now that board time is approaching, I find the clinical context really aids in recall as well.

BTW - how's the weather up there ? I'll be in Knoxville in about 18 hours 😎
 
DragonWell,

Thanks so much for your post...I'm very much interested in PBL and LECOM-B in particular.

Kris
 
Copy and paste exactly everything he said for NYCOM (except for the unique test part - we all get the same exam on common learning issues). Everything else is EXACTLY the same at NYCOM's PBL.

DragonWell said:
It sounds like you want details, so I'll take a stab with two caveats: first, it's impossible to get a true sense of how PBL works w/o actually sitting in on a session, and second, PBL seems to be executed differently at different schools - I can only speak to the way it is done at LECOM-B.

OK, in a nutshell: You're in a group w/ 7 other students and a facilitator (either a PhD in a basic science or MD/DO). Several roles are assigned to students - a scribe to keep notes on the board, a student to role play patient, and a student to play doctor.

You are given a page w/ a chief complaint - let's say left sided chest pain. The group starts off with putting a broad differential up on the board. This part has gotten much better in second year - it could take a while in first year since all anybody is thinking is "MI". Once the group has discussed all the possibilities we can think of, the "doctor" interviews the "patient".

This gives you a chance to get a little more practice with your history taking skills. Once we have the history, we revisit the differential and rule things in or out and discuss why. For example, let's say the pt was a 20 yo female with a history of PUD. MI might get moved down on our list of possibilities, and GI might get moved up.

We then move on to the physical exam and the facilitator might question us about our expected findings - do you expect extra heart sounds? What do particular unexpected heart sounds mean? Perhaps there will be a physical finding we have never heard of, a "succession splash", for instance. We will look it up in our physical exam book and discuss what it means. If something comes up that stumps the group, we may put that topic up on the board as a "Learning Issue" - something the group will do extra research on after the session.

Based on the info we've gotten from the history and PE, we then move on to labs, again with the facilitator asking questions as needed to guide the group to discuss pertinent issues. Maybe there was a positive fecal occult blood test - what should we expect to see on the CBC - normal or low MCV? Maybe the patient has been vomiting and unable to keep fluids down - what should the ABG show? Does that fit w/ the pt.'s respirations? Depending on the case, we will have anywhere between 10 and 25 pages of labs and clinical progress notes in a case.

Usually a case will take 2 or 3 days to finish, so after each day, we will go read about our learning issues, look up articles related to the case, and hopefully come back much more prepared to address the case. For each successive day of a case, a student is chosen to present the case to the group, so we get a lot of practice in writing up and presenting SOAP notes.

The real learning and critical thinking happens in the discussion between students and, with a good facilitator, in the thought-provoking questions they pose to the group. Contrary to what some people think, there is not a lot of basic science learning that happens during PBL - for the most part that happens outside class. PBL is an opportunity to make connections between the basic science material you are reading and the case you are working on.

Once we have finished the case, we choose topics we will be tested on from the learning issues that came up in the case. Although there is a lot of overlap, each group picks slightly different topics to be tested on, and takes their own unique test at the end of the block. We all get questions about the cases, so it pays to pay attention in PBL - even if you don't pick a particular drug as a learning issue, if it was in a case, it's fair game. By the time we finish a case, we are expected to be able to explain all the details in it.

Hopefully, that gives you a bit more of an idea of what it's like, although as I said before, you really have to experience it to fully get it. It also makes a difference who your facilitator is, ie. if they are a microbiologist, you can expect to be pimped extra hard on micro as you go through the case. If they are a surgeon, they may pimp you on more of the clinical management of the pt. and take the session in a more clinical direction.
Click to expand...
 
I have a question - PBL seems nice, but how do you learn your basic sciences? Are you tested on that at all? Do you learn subjects such as biochemistry and are you tested on it?
 
Lokhtar said:
I have a question - PBL seems nice, but how do you learn your basic sciences? Are you tested on that at all? Do you learn subjects such as biochemistry and are you tested on it?
Click to expand...

Basic sciences are what you learn in PBL and what you are tested on. As you go through a case you read and are tested on the basic sciences behind that particular case. We typically have about 3 tests per semester in PBL. The following is a list of subjects and the titles of each chapter that we were tested on for one of our tests last semester:


Microbiology
Upper Respiratory Tract Infections
Infections of the Compromised Host
Urinary Tract Infections
Fever of Unknown Origin
Obstetric and Perinatal Infections

Histology
Lymphatic System
Blood
Cardiovascular System

Pharmacology

Chloramphenicol, Tetracyclines, Macrolides, Clindamycin, & Streptogramins
Beta-Lactam Antibiotics & Other Inhibitors of Cell Wall Synthesis
Nonsteroidal Anti-Inflammatory Drugs
Antifungal Agents
Antiviral Chemotherapy & Prophylaxis
Cancer Chemotherapy
Drugs Used in Heart Failure
Diuretic Agents
Agents Used in Cardiac Arrhythmias
Corticosteroids & Antagonists
Pancreatic Hormones & Antidiabetic Drugs

Immunology
Failure of the Bodys Defenses

Physiology
Physical Principles of Gas Exchange; Diffusion of Oxygen and Carbon Dioxide
Resistance of the Body to Infection: I. Leukocytes, Granulocytes, the Monocyte-Macrophage System, and Inflammation
Hemostasis and Blood Coagulation
Nervous Regulation of the Circulation, and Rapid Control of Arterial Pressure
Dominant Role of the Kidney in Long Term Regulation of Arterial Pressure and in Hypertension
Cardiac Output, Venous Return, and Their Regulation
Cardiac Failure
The Body Fluid Compartments: Extracellular and Intracellular Fluids; Interstitial Fluid and Edema
Heart Muscle; The Heart as a Pump and Function of Heart Valves
Rhythmical Excitation of the Heart
Cardiac Arrhythmias and Their Electrocardiographic Interpretation
Heart Valves and Heart Sounds; Dynamics of Valvular and Congenital Heart Defects
Insulin, Glucagon, and Diabetes Mellitus
Pregnancy and Lactation
Pituitary Hormones and Their Control by the Hypothalamus
Adrenocortical Hormones

Pathology
Immunological Deficiency Syndromes
Diseases of White Blood Cells, Lymph Nodes, Spleen and Thymus
Red Blood Cell and Bleeding Disorders
The Heart
Adrenal Glands

Biochemistry
The Molecular Biology of Cancer
The Biochemistry of the Erythrocyte and Other Blood Cells
Blood Plasma proteins, Coagulation and Fibrinolysis

In addition to those 44 chapters, we were also tested on the Anatomy, Histology, and Embryology of the thorax. Also, we had quite a number of "case questions" where any kind of treatment, procedure, result, finding, etc. from the cases are also testable material. But the bulk of it, as you can see, is basic science, just like any other school.
 
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