MD Schools Without CBL

[Piskaupf]

Never in my life have I seen a regression in the world of academia as egregious as group CBL (which is saying a lot bc academia today is replete with problems). It’s intuitively the most inane form of teaching, riddled with problems and weaknesses.

I won’t get into the problems bc I’m sure everyone is experienced with it. Sadly, these sessions at my school are mandatory.

1. Why do so many med schools try so hard to propagate it in the curriculum? When I was interviewing, every school was bragging about how CBLs were interwoven in the curriculum making me think it was a strength.

2. Are there any med schools that do not have it?

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[OnePunchBiopsy]

1. Why do so many med schools try so hard to propagate it in the curriculum? When I was interviewing, every school was bragging about how CBLs were interwoven in the curriculum making me think it was a strength.

CBL (or PBL) is an unfortunate buzzword conveying the notion that medical schools have an up-to-date curriculum. Pre-meds eat it up. What sounds better as a pre-med? Powerpoint didactics or CBL?

I've seen CBL done very well, and I do admit, it works when the lecturer knows how to teach. The issue is when the lecturer is bad, then CBL is even worse.

I'm sorry it's mandatory for you. IMO, no didactic (hands off) lectures should ever be mandatory. They should be recorded/live streamed and available at home.

2. Are there any med schools that do not have it?

I think every school has it to some degree. I would avoid schools that have it for every organ block, especially if attendance is mandatory. I liken it to buying a gym membership where they force you to go everyday, and the only exercise they let you do is crossfit. Want to do bench press? Want to do cardio outside from home? Nope, get back to doing those fake pull-ups you're paying us for the privilege of doing.

 

[hallowmann]

My preclinical curriculum was primarily PBL. It was actually quite good honestly, but it was done well, in small groups and comprised the majority of the curriculum.

Adding it on like some sort of mandatory requirement supplement, seems stupid, redundant, and pointless. I've seen the curricula where this is how it was done and it definitely seemed like a step back.

 

[ciestar]

I think because the LCME said so

 

[Obnoxious Dad]

Never in my life have I seen a regression in the world of academia as egregious as group CBL (which is saying a lot bc academia today is replete with problems). It’s intuitively the most inane form of teaching, riddled with problems and weaknesses.

I won’t get into the problems bc I’m sure everyone is experienced with it. Sadly, these sessions at my school are mandatory.

1. Why do so many med schools try so hard to propagate it in the curriculum? When I was interviewing, every school was bragging about how CBLs were interwoven in the curriculum making me think it was a strength.

2. Are there any med schools that do not have it?

The purpose of PBL/TBL/CBL is to justify keeping inflated faculties and empires. The schools know that most students would prefer to stay home, wear pajamas all day, study outlines and watch streaming video.

 

[Emmet2301]

As a lay person I've always been curious how CBL/PBL can teach the minute things you might miss with such teaching, but would learn in the non-CBL methods.

 

[Osteosaur]

It's funny. When attending interviews it seemed like the best thing in the world.

Now? It's mostly it's 30 minutes of medical students trying to one up each other arguing the semantics of what constitutes colicky pain to a patient.

Just wretched.

 

[hallowmann]

As a lay person I've always been curious how CBL/PBL can teach the minute things you might miss with such teaching, but would learn in the non-CBL methods.

The primary purpose of our PBL sessions was to get our minds accustomed to working through a medical case, what to order, why, the differential, etc. Every once and a while the facilitator would reveal some clinical gem, but that's about it. The main goal was to identify learning points in the source text for each case. We would then read the text on our own, make notes, and our exams would be based on the text. Something like 700+ pages would be covered on one 200 question exam (3 per semester), and they would be based on something like 5-7 cases that we worked through. There was also a portion that was considered required to cover, so some chapters would be required per exam block regardless of what our group "chose".

Everyone wanted to cover all the texts, and some of them a couple of times, so it was never an issue that people didn't want to study certain things. It actually promoted pretty invested in learning, because it was reinforced that we were doing this to cover the material necessary to be good doctors and also to do well on boards. Reading Big Robbins a couple of times made it a bit easier to cover the minutiae. Everyone transitioned to board prep material rather than the source texts by mid-second year.

 

[Emmet2301]

^Thank you very much for the explanation! Very insightful.

Just a quick follow-up: what are the chances that something very minute but relevant would be missed by this learning approach?

 

[7331poas]

PBL only exists because PhDs and brainwashed MDs have invaded medical education.

 

[Dwan]

Never in my life have I seen a regression in the world of academia as egregious as group CBL (which is saying a lot bc academia today is replete with problems). It’s intuitively the most inane form of teaching, riddled with problems and weaknesses.

I won’t get into the problems bc I’m sure everyone is experienced with it. Sadly, these sessions at my school are mandatory.

1. Why do so many med schools try so hard to propagate it in the curriculum? When I was interviewing, every school was bragging about how CBLs were interwoven in the curriculum making me think it was a strength.

2. Are there any med schools that do not have it?

We started to complain about why we paid so much for tuition for 95% what could be better taught by well-known video lecturers while at home, so they added this stuff. Just like we started to complain why the step 2 CS exists when everyone just passes it anyways, so they raised the fail rate. Easy solutions.

 

[ooh a bean]

Mandatory CBL/PBL/TBL/Flipped Classroom is another stupid hurdle for medical students to jump over. All I can think about during these sessions is how many anki cards or practice questions I could've gotten done if I wasn't sitting there having to waste so much time.

 

[slowthai]

We started to complain about why we paid so much for tuition for 95% what could be better taught by well-known video lecturers while at home, so they added this stuff. Just like we started to complain why the step 2 CS exists when everyone just passes it anyways, so they raised the fail rate. Easy solutions.

I hate so much how entities like med school admins and the NBME are just insufferable autocrats. All manner of PBL (Pathetically Backward Learning) is trashtastic btw.

 

[hallowmann]

^Thank you very much for the explanation! Very insightful.

Just a quick follow-up: what are the chances that something very minute but relevant would be missed by this learning approach?

Thats no different than any curriculum. Little things that were missed were usually covered in board prep. Your goal in preclinical isn't to learn and memorize e everything, it's to get a good grasp of the basis of medicine and most of the broader conditions.

If you don't use the knowledge regularly, you're going to forget it. I honestly can't tell you how much info I've forgotten over the last 7 yrs.

 

[TelemarketingEnigma]

I'm gonna regret saying this in this thread, but PBL is one of my favorite parts of our curriculum. It sounds like every school does it differently though, and i can imagine some formats being awful. It's also definitely heavily dependent on your groupmates and your facilitators, but ours have been on average pretty good. I've found that the topics we cover in PBL stick way better than things from lectures, because we've spent the time putting it into context. I wouldn't want PBL all day every day, but I'm glad that we have at least some of it.

 

[Goro]

Case-Based Learning and its Application in Medical and Health-Care Fields: A Review of Worldwide Literature

Case-based learning (CBL) is a newer modality of teaching healthcare. In order to evaluate how CBL is currently used, a literature search and review was completed.A literature search was completed using an OVID© database using PubMed as the data ...

www.ncbi.nlm.nih.gov

We don't use PBL at my school because it's manpower intensive, but we do know that passive learning is not as good as active learning, hence the trend to TBL/flipped curriculum.

There is convincing data that TBLs help you retain knowledge. Now, how that affects Board scores remains to be seen.
PBL seems to be one of those love it or hate it types of things...no middle ground.

The purpose of PBL/TBL/CBL is to justify keeping inflated faculties and empires. The schools know that most students would prefer to stay home, wear pajamas all day, study outlines and watch streaming video.

Ah, yes, nothing like hearing from someone who knows nothing about how students learn, or how med schools work. At nearly all MD schools, those inflated faculty" are bringing more money in grant indirects than the student sare bring in via tuition. 95% of my students are indeed at home in their jammies, and that's OK by me. My goal is that adult learners learn. And they still need to come in for my labs.

 

[7331poas]

I am 100% convinced that these "research papers" are heavily heavily doctored. If they went around the country and actually polled students they would find that support is overwhelmingly negative.

I don't know how one can believe these papers when actual experience is overwhelmingly opposite.

 

[premed_mamba]

Can confirm that TBL/PBL/CBL Whatever you want to call it is the worst thing ever invented since pop up ads and asbestos

We had a FIVE hour session this past Monday and no kidding I would rather stab myself in the neck with a knife than to do that again.

 

[DO2015CA]

We started to complain about why we paid so much for tuition for 95% what could be better taught by well-known video lecturers while at home, so they added this stuff. Just like we started to complain why the step 2 CS exists when everyone just passes it anyways, so they raised the fail rate. Easy solutions.

Yes. Keep our mouths shut and bide our time. Unfortunately medicine is a hierarchy. Just follow the dang instructions and move closer to your career. Just remember, they can always hurt you more.

We know their way of learning is antiquated and inefficient. But they are the powers that be. Once the technology era physicians take over things will change as for electronic education material

 

[ooh a bean]

I am 100% convinced that these "research papers" are heavily heavily doctored. If they went around the country and actually polled students they would find that support is overwhelmingly negative.

I don't know how one can believe these students when actual experience is overwhelmingly opposite.

One of the deans at our school presented "research" to us in support of TBL/PBL/CBL flipped classroom crap and almost all of it was done in foreign countries at the middle school and high school level.

 

[slowthai]

One of the deans at our school presented "research" to us in support of TBL/PBL/CBL flipped classroom crap and almost all of it was done in foreign countries at the middle school and high school level.

That stuff makes me wanna flip tables, lol. Like don't push fake BS stupidity to support your backwards learning ideology, like get that outta here

 

[TelemarketingEnigma]

The thing about PBL is that you get out of it what you put into it. The general sense I get from my classmates is that most people in my cohort are neutral to positive about PBL (complaints tend to stem more from having to get out of bed and show up to class, not the sessions themselves), but the strongest negative opinions I've heard also came from people who clearly weren't putting in the effort to actually learn from it.

we have plenty of sessions that are totally useless as well, so it's not all sunshine and daisies, but it's definitely not as bad as the sentiments in this thread

In general though, everyone learns differently - some people hate lecture, some hate pbl, some hate anki, some hate everything (everybody's gotta hate something, or they're delusional). Despite the SDN/reddit/med school hivemind, there are multiple ways to teach effectively, and multiple end goals besides STEP 1 score

 

[blockrudder1]

If I've learned the material well before CBL, it can be a productive time.

 

[Goro]

Paging @Med Ed!

I am 100% convinced that these "research papers" are heavily heavily doctored. If they went around the country and actually polled students they would find that support is overwhelmingly negative.

I don't know how one can believe these papers when actual experience is overwhelmingly opposite.

The papers weren't done to gauge popularity, but learning outcomes. And the idea was that we teach evidence-based medicine, so why not apply that to medical education.

Look, I'm not defending the idea of PBL and CBL per se, just why it was adopted. I'm not a fan of TBL, or at least the way my school has adopted it. I like lecturing students, and TBL is a deterrent to those who use lectures as their first pass. I'm all for happy students. I'm still waiting for evidence that TBL boost Board scores.

And LOL "let's change the curriculum so we can hire more Faculty"...said no medical school dean or Dep't Chair, ever.

 

[Med Ed]

Never in my life have I seen a regression in the world of academia as egregious as group CBL (which is saying a lot bc academia today is replete with problems). It’s intuitively the most inane form of teaching, riddled with problems and weaknesses.

"CBL" has no specific definition, other than being some type of teaching activity organized around at least one case. You'll have to be more specific.

 

[GoSpursGo]

Clearly lots of people have strong opinions on this topic, but let's please keep the discussion civil.

 

[Ho0v-man]

I think you could have given me 50 different ways to learn the stuff in preclinical and all I would say is that my stupid school found 50 stupid ways to fail at teaching me. I had a lecture-based curriculum for the first 2 years and it felt like a slap-stick dumpster fire the whole way through. I’m not sure there really is a perfect way to do this bc at the end of the day it’s just gonna be brutal no matter what. If the information isn’t scarring it’s way into your brain with the hot knife of your own hatred for existence, then you’re doing it wrong.

I didn’t even really gain any appreciation for my schools curriculum until dedicated but even then I complained. I only realized that they actually did a decent job half way through third year.

 

[Piskaupf]

I think you could have given me 50 different ways to learn the stuff in preclinical and all I would say is that my stupid school found 50 stupid ways to fail at teaching me. I had a lecture-based curriculum for the first 2 years and it felt like a slap-stick dumpster fire the whole way through. I’m not sure there really is a perfect way to do this bc at the end of the day it’s just gonna be brutal no matter what. If the information isn’t scarring it’s way into your brain with the hot knife of your own hatred for existence, then you’re doing it wrong.

I didn’t even really gain any appreciation for my schools curriculum until dedicated but even then I complained. I only realized that they actually did a decent job half way through third year.

Sorry but this has nothing to do with what im saying. You not liking lecture is entirely different

 

[Sephirakra]

Sorry but this has nothing to do with what im saying. You not liking lecture is entirely different

Yeah, his not liking lecture is nothing like your not liking CBL.

 

[Goro]

Sorry but this has nothing to do with what im saying. You not liking lecture is entirely different

Can you elaborate?

 

[Ho0v-man]

Sorry but this has nothing to do with what im saying. You not liking lecture is entirely different

I have a friend from a pbl school who would study with us and we would both wish we had the others curriculum. Looking back, I’m pretty sure it’s just a “grass is always greener” type situation.

I’m just pointing out that most people hate their curriculum, especially while they’re in it. I was just attempting to empathize. Sorry if I offended you.

 

[Piskaupf]

Can you elaborate?

I have a friend from a pbl school who would study with us and we would both wish we had the others curriculum. Looking back, I’m pretty sure it’s just a “grass is always greener” type situation.

I’m just pointing out that most people hate their curriculum, especially while they’re in it. I was just attempting to empathize. Sorry if I offended you.

I have lecture. I also have CBL 2-3 times a week. For some, its a matter of the grass being greener, but this is not my case since I owned both lawns.

No hoovman you weren’t empathizing, you were coming up with a psychological rationalization for my observation that negates my point.

CBL is idiocy.

 

[initialize]

The only thing we do during our PBL sessions is google the symptoms this fake patient has, followed by googling their diagnosis and googling their treatment

 

[GoSpursGo]

I have lecture. I also have CBL 2-3 times a week. For some, its a matter of the grass being greener, but this is not my case since I owned both lawns.

No hoovman you weren’t empathizing, you were coming up with a psychological rationalization for my observation that negates my point.

CBL is idiocy.

Just because you’ve been “owned both lawns” doesn’t exclude the possibility that CBL is beneficial for some. I think it’s fairly well established that deferent learners absorb material better in different ways.

 

[Goro]

The only thing we do during our PBL sessions is google the symptoms this fake patient has, followed by googling their diagnosis and googling their treatment

Yet that will be more conducive to you retaining the info as opposed to the Professor simply telling you those details.

 

[GoSpursGo]

Yet that will be more conducive to you retaining the info as opposed to the Professor simply telling you those details.

I suspect this post is going to get some blowback, and it may not be true for everyone (for those of you that truly have a photographic memory, kudos to you). But as someone who bellyached over my own PBL classes in med school, as a fellow I can say that I absolutely retain material better when I look up the primary literature and have to present that to my peers.

Again, I don't have a dog in this fight, but I think it is overly simplistic to declare that one or the other method is universally superior. Honestly, I think I do best when I have material presented in multiple different ways.

 

[Sephirakra]

Yet that will be more conducive to you retaining the info as opposed to the Professor simply telling you those details.

I mean, isn't that also part of rotations and residency, just with Uptodate, PubMed, etc.?

 

[Neopolymath]

Once you realize that most factors ruining medicine and medical education are extrinsic to the actual people involved with patient care, you can be at peace. Let it go. Actual medicine is still the greatest job in the world. Do not let hack clinician failures who became faculty out of necessity, PhDs, and administrators dictate your happiness.

All of us know deep down that this type of stuff is just a pathetic ploy to remain relevant and justify payroll, but screw letting them win or giving them satisfaction by arguing or drawing any type of attention to it. Just get through it and move on. When you have the opportunity in the future, help the next generation out in the ways that you can. Otherwise, don't waste your energy on these losers.

 

[Med Ed]

But as someone who bellyached over my own PBL classes in med school, as a fellow I can say that I absolutely retain material better when I look up the primary literature and have to present that to my peers.

That was my experience. Having to teach something makes you an expert rather quickly.

Ultimately medical school is a highly unnatural process. Our brains are content getting by on very little, and the amount of forced learning/memorization is extremely painful even under the best of circumstances. We try to make things efficient and/or engaging and/or effective but the inescapable truth is that the process is inherently both sadistic and masochistic. Considering that both teachers and students have been complaining about this continuously for thousands of years suggests it's merely another element of the human condition.

Again, I don't have a dog in this fight, but I think it is overly simplistic to declare that one or the other method is universally superior. Honestly, I think I do best when I have material presented in multiple different ways.

If you look at most medical school curricula nowadays there is a blend of passive and active teaching modalities. Most places have come around to the idea that there is no one-size-fits-all approach. There is, however, always a vocal minority that hates everything.

 

[7331poas]

If you look at most medical school curricula nowadays there is a blend of passive and active teaching modalities. Most places have come around to the idea that there is no one-size-fits-all approach. There is, however, always a vocal minority that hates everything.

Actually the vocal majority of students are screaming that curricula should be P/F, non-mandatory attendance.

Its only faculty members who seem to think that this opinion is rare.

Also the idea that "if I am teaching others I will learn it bettter" is a fallacy. That is not what TBL/PBL/CBL does. What it does is it puts 120 people who know absolutely nothing about a topic in the same room and asks them to teach each other.

Sure, I could spend 4 hours of my day going through some TBL/PBL exercise on MI. Or I could just learn about it at home in a quarter of the time and do practice questions. Option two is always always better.

 

[mistafab]

I will say, in defense of pbl/cbl/whatever at your school, that it has somewhat spawned from the LCME accreditation policy of requiring “self-directed learning” and “problem solving” in a med school curriculum. I think the latter two objectives are important, however I did not find the sessions as a student particularly useful in building those traits.

 

[Med Ed]

Actually the vocal majority of students are screaming that curricula should be P/F, non-mandatory attendance.

And they have largely won.

Also the idea that "if I am teaching others I will learn it bettter" is a fallacy. That is not what TBL/PBL/CBL does. What it does is it puts 120 people who know absolutely nothing about a topic in the same room and asks them to teach each other.

PBL is a small group activity. CBL has no singular definition. TBL does require preparation but not peer teaching.

You continue your streak of having strong opinions despite weak knowledge.

 

[Med Ed]

I will say, in defense of pbl/cbl/whatever at your school, that it has somewhat spawned from the LCME accreditation policy of requiring “self-directed learning” and “problem solving” in a med school curriculum. I think the latter two objectives are important, however I did not find the sessions as a student particularly useful in building those traits.

Do you have a better idea?

 

[7331poas]

PBL is a small group activity. CBL has no singular definition. TBL does require preparation but not peer teaching.

You continue your streak of having strong opinions despite weak knowledge.

The terminology is not important. All of these "innovations" are bogus.

If students want to teach others they can do so in private study groups on their own time.

 

[Goro]

The terminology is not important. All of these "innovations" are bogus.

If students want to teach others they can do so in private study groups on their own time.

And the glow of cognitive dissonance glows brighter.

 

[Med Ed]

The terminology is not important.

I rest my case.

 

[Matthew9Thirtyfive]

We have it sporadically at my school. We had one session last block and have like 6 this block. None the first block.

Ours are done well. They are liked by most people in our class and a lot of our class views them as their favorite part of the curriculum. I’m betting if they weren’t mandatory that the majority of the class would go anyway.

 

[Matthew9Thirtyfive]

Actually the vocal majority of students are screaming that curricula should be P/F, non-mandatory attendance.

Its only faculty members who seem to think that this opinion is rare.

Also the idea that "if I am teaching others I will learn it bettter" is a fallacy. That is not what TBL/PBL/CBL does. What it does is it puts 120 people who know absolutely nothing about a topic in the same room and asks them to teach each other.

Sure, I could spend 4 hours of my day going through some TBL/PBL exercise on MI. Or I could just learn about it at home in a quarter of the time and do practice questions. Option two is always always better.

Maybe that’s what they’re like where you are, but that’s not how our school does it.

 

[7331poas]

I’m betting if they weren’t mandatory that the majority of the class would go anyway.

Im betting that your school makes them mandatory because they know that statement isn't true.

 

[WhereMyLiberalsAt]

And they have largely won.

I think we’re in different realities...

Do you have a better idea?

Even if we did have better ideas, it wouldn’t matter. I’d say if we looked at the majority of changes in medical education over the last two decades we’d see changes to things that 1) weren’t an issue to begin with, 2) heavily opposed by medical students.

When students levy a complaint about curriculum (ie TBL) admin/faculty generally respond with a canned answer; this answer is generally quite solid in logic and reaffirms their position... For example, TBLs help students with different “learning styles” or it helps students develop “interpersonal skills and foster your problem solving style in a group setting.”

Cool......

However, those same arguments contradict or undermine other actions/solutions being made in MedEd... The first being

Screw it! I had an argument that I was going to lay out for you... But why? No matter the quality of argument admins always know best.

Next time you and you peeps go to solve a problem ask yourselves this — where do we spend most of our effort: on identifying and responding to specific problems or on resolving underlying causes and finding new ways to improve?

Maybe that’s what they’re like where you are, but that’s not how our school does it.

Bruh you attend a school that is ran by the branch of our government that organizes and runs MASSIVE military exercises... Can you imagine for a second that most medical schools can not organize/communicate as well as our public servants in the US military?