Problem based learning

[beeyoonee]

can anyone tell me how problem based learning works and how they like it?

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[Hoberto]

Well, I am not in it, but we got a lecture about it and talked to some students at WVSOM during interviews....

At WVSOM, the PBL groups get a 'case', say an elderly man with back pain. Then the students try to figure out what to do. Order a physical, CAT scans whatever, and why? So, they might find out that this person has really high cholesterol and would then decide to learn more about cholesterol and atherosclerosis. They use the case of a starting point for studying all sorts of topics and are guided somewhat by a faculty member.

I'm not sure this is a good description.

Anyway, the students we talked to really liked it mostly for the extra time they had. Where the traditional students are spending all day in class the PBL people meet for a few hours 2 or 3 times a week. Of course, all that extra time is supposed to be used to reseach and study, but it sounded like they were still more free than the other non-PBL students.

One VERY interesting thing mentioned by a faculty member while we were there is that the PBL class scored poorly compared to the regular class on the first board exam. This, alone, has made me really question PBL. At first I thought it sounded good since most of my engineering classes are problem based and I have done much better in these classes than in lecture/problem set type eng classes. If the scores aren't comparable to regular didactic classes I'm not sure it's a good option.

Now, I've heard that at OU the PBL students actually outscore the regular lecture students. So, maybe the benefit of PBL depends on the school.

Maybe someone who is currently in PBL will respond. I'd be interested in hearing what different students from other schools think.

 

[jgl1980]

Well, I am not in it, but we got a lecture about it and talked to some students at WVSOM during interviews....

At WVSOM, the PBL groups get a 'case', say an elderly man with back pain. Then the students try to figure out what to do. Order a physical, CAT scans whatever, and why? So, they might find out that this person has really high cholesterol and would then decide to learn more about cholesterol and atherosclerosis. They use the case of a starting point for studying all sorts of topics and are guided somewhat by a faculty member.

I'm not sure this is a good description.

Anyway, the students we talked to really liked it mostly for the extra time they had. Where the traditional students are spending all day in class the PBL people meet for a few hours 2 or 3 times a week. Of course, all that extra time is supposed to be used to reseach and study, but it sounded like they were still more free than the other non-PBL students.

One VERY interesting thing mentioned by a faculty member while we were there is that the PBL class scored poorly compared to the regular class on the first board exam. This, alone, has made me really question PBL. At first I thought it sounded good since most of my engineering classes are problem based and I have done much better in these classes than in lecture/problem set type eng classes. If the scores aren't comparable to regular didactic classes I'm not sure it's a good option.

Now, I've heard that at OU the PBL students actually outscore the regular lecture students. So, maybe the benefit of PBL depends on the school.

Maybe someone who is currently in PBL will respond. I'd be interested in hearing what different students from other schools think.

Would you happen to know the class averages of both the SBL and PBL classes. I am very interested in finding out how much poorly the PBL Class did compared to the SBL class.

 

[Hoberto]

No we weren't given actual numbers...he just said that they did very poorly in comparison and that he was very disappointed in them. We were told that they are changing the program though hoping to have better scores. I'm not sure how they are changing it, though.

 

[FutureDocDO]

Would you happen to know the class averages of both the SBL and PBL classes. I am very interested in finding out how much poorly the PBL Class did compared to the SBL class.

Last year our overall passage rate for first time takers was 87.5% - SBL did better with over 92% passage rate, the PBL passage rate was only 71.4% but most that failed indicated they did not prepare well.

 

[Darth Asclepius]

My school is lecture-based, with some small group PBL stuff thrown in. I hate it when we have to do it. You spend several hours working on a small, detailed topic when you could have spent that time learning a lot more. It's important to note that I don't go to lecture, so I see these sessions as a required waste of my time. If it was PBL a couple hours/week vs. required lecture all day every day, I guess I would choose PBL. I'm just not a fan of anything required. We have a "practice of medicine" course that has small group sessions where we practice interviewing each other and will practice physical exam skills. That's a good use of time. I think it also depends a lot on how PBL is done and how you like to learn. I just feel like they're holding our hands, working through cases.

 

[(nicedream)]

The class is broken up into groups of 8 and you meet with this group along with a faculty member "facilitator" twice a week. At these meetings you move through clinical cases - starting off with a sheet of paper saying "John Doe presents to your office complaining of swelling in his legs and feet" for example and progressing through a complete history and physical, lab test results, imaging studies etc. As a group you delve into the basic sciences in this clinical context to move through the cases and establish "learning issues" which you study at home from the textbooks. After a group of 8 cases each group has an individualized exam based on their selected learning issues that pertained to the cases. There is no hand-holding, the faculty are encouraged to remain quiet unless their guidance is needed. Oftentimes the clinicians offer clinical pearls of wisdom and the PhDs offer great basic science insight related to clinical topics.
The PBL class at LECOM in Erie has traditionally had a pass rate well exceeding that of the lecture-based class. Here in FL we are entirely PBL.

 

[Hoberto]

After a group of 8 cases each group has an individualized exam based on their selected learning issues that pertained to the cases. There is no hand-holding, the faculty are encouraged to remain quiet unless their guidance is needed. Oftentimes the clinicians offer clinical pearls of wisdom and the PhDs offer great basic science insight related to clinical topics.
The PBL class at LECOM in Erie has traditionally had a pass rate well exceeding that of the lecture-based class. Here in FL we are entirely PBL.

What I am worried about is how do you know that the "selected learning issues" are what's going to be on the licensing exam(s) without guidance? I would worry that the group might spend too much or too little time on a particular topic. It seems that the learning issues should be based on required topics and information that will ensure high pass rates and scores. If the students are using a Kaplan guide or something to help create some kind of outline maybe that would be more effective. It would be cool to select topics to investigate that are of personal interest to the group but, since ultimately one's license depends on an exam it would be best to teach to that exam.

I'm not sure that I am clear...

 

[USArmyDoc]

I think this was mentioned above, but what is wrong with having SBL and then some PBL thrown in. I would think that would be most effective. You could learn all necessary information through lectures and reading then apply it to your PBL group. I am not to familiar with all of this so I could be totally off base.

 

[Hoberto]

I think this was mentioned above, but what is wrong with having SBL and then some PBL thrown in. I would think that would be most effective. You could learn all necessary information through lectures and reading then apply it to your PBL group. I am not to familiar with all of this so I could be totally off base.

I think this would be the best option.

 

[(nicedream)]

What I am worried about is how do you know that the "selected learning issues" are what's going to be on the licensing exam(s) without guidance? I would worry that the group might spend too much or too little time on a particular topic. It seems that the learning issues should be based on required topics and information that will ensure high pass rates and scores. If the students are using a Kaplan guide or something to help create some kind of outline maybe that would be more effective. It would be cool to select topics to investigate that are of personal interest to the group but, since ultimately one's license depends on an exam it would be best to teach to that exam.

I'm not sure that I am clear...

There is a master list of possible learning issues prepared by the faculty - we select learning issues from this list. There is also guidance - first year we are encouraged to complete physiology topics, second year focus on pharmacology and pathology etc. In addition, the cases are deliberately designed to tease out the appropriate learning issues.

 

[(nicedream)]

I think this was mentioned above, but what is wrong with having SBL and then some PBL thrown in. I would think that would be most effective. You could learn all necessary information through lectures and reading then apply it to your PBL group. I am not to familiar with all of this so I could be totally off base.

This is basically what occurs, however with reading constituting our learning as opposed to lecture. After each session we read about the germaine topics on our own and come to the next session prepared to utilize the new information we attained. There are also some adjunct lectures when deemed appropriate, and anatomy/histology/embryology/neuroanatomy is taught through lecture.

 

[juiceman311]

We use PBL in my undergrad for biomedical engineering. I hated it at first since there's little structure..."here's an extremely open-ended problem, you have 4 weeks to propose a solution with a computer simulation of how your model will work and a physical prototype that works". Was frustrating at first, but gets interesting, plus it actually makes you think, and you go through several potential solutions to a problem that won't work (hence, the "learning" part of problem based learning). Plus in the real world, you'll be presented with open-ended problems that you need to find solutions for, so it gets you ready for what the real world will be like...

 

[USArmyDoc]

I see PBL as a very good way to learn to become a physician. However, for the boards, I am not sure how well it prepares you. I would still think that lecture and PBL should be combined together.

 

[NRAI2001]

Do schools who follow the PBL format start problems right from the beginning or are they taught some background info on the topics and then given problems? It would seem very difficult to figure anything out if you were just thrown in without any prior knowledge?

 

[(nicedream)]

Do schools who follow the PBL format start problems right from the beginning or are they taught some background info on the topics and then given problems? It would seem very difficult to figure anything out if you were just thrown in without any prior knowledge?

At our school the first semester is lecture for anatomy, histology, embryology, and neuroanatomy and PBL is started concurrently, but only once a week as compared with twice a week starting in the 2nd semester.
The beginning moves more slowly than it does later on, but again - the point is not diagnosing the patients and moving on to the next case. The difficulties and learning experiences are the very basis of the curriculum - the group encounters something new and unfamiliar, and so learns about it before moving on.
Basically, instead of being given a ppt. on a topic and told to read pp. 320-397, you are given a clinical situation which leads you to the same destination in a more involving and clinical way.

 

[CHxyz]

I am a first year at LECOM-B (hi nicedream you are from LECOM-B too right?). I have just went through the 10 week anatomy (final test this monday) and I am just thrilled to have it over with. We had PBL once a week and I have to admit, at the beginning I was a bit intimidated. I am not familiar with what's going on and what tests to order. As we go through the sessions, I got more familiar and comfortable. The first couple of PBL cases were centered around anatomy so we can apply what we learn in class to cases. I was surprised at how much I learned and coupld apply them starting in the second case. I also learn more about how to apply what we learn in a clinical situation.
There are a few students in my group that's concerned about PBL not covering the needed knowledge for the board. However, the way I see is, PBL is not just learning what the group learning issues are. PBL also have another component, which is the individual learning issues and those are not necessary similiar with the group learning issues. For example, if you think you need to study on TCA cycle and your group just wanted to concentrate on anatomy of the kidney, that doesn't mean you can't learn on your own the TCA cycle. Sure you need to learn the anatomy of the kidney for your exams, but you can also learn about the TCA cycle at the same time. In my opinion, in order to be successful in PBL, you need to be self motivating. I think that's what one of the goals of PBL is, is to teach the students to be more self movtivated in learning. When you become a doctor, there's no one there to tell you what you need to learn or review, you need to do that on your own and PBL trains you to have that habbit.
So finally, if you are wondering if PBL is right for you, ask yourself this, do you need someone to tell you what to read or can you handle reading/researching on your own? If you need someone to tell you what to study, then PBL is definitely not for you. If you dont see yourself forcing yourself to study even if there's no assigned work, then PBL is not for you either. Don't get me wrong, PBL is a great program (especially here at LECOM-B, since this school is built specifically for that), but you need to have the right mentality to succeed in it. Its the same in every school. The school will only provide you with the direction and materials, it is how you make use of it. You are in a professional school now, you can't expect the school to spoon feed you every step of the way (lecture or PBL). When I started my master's program a while back, I was in that state of mind where I need someone to teach me. But my thesis professior insisted that i learn on my own, so I am used to doing my own studying and researching and find myself doing better with this method. Therefore, I choose PBL. Right now with anatomy over, I think I'll enjoy it more.
Oh one last thing. I heard from one of the deans of my school (Dr. Krueger) telling us that one of his students from the PBL program in LECOM-Erie got the highest national board exam score and there's like a 90+% passing rate for the first broad exam for the PBL class up in Erie. They wouldn't built a school based on a program that's not going to work right? I think it all depend on the school and how the PBL program is set up. Again, as I mentioned earlier, its all about self motivation for PBL. Learning things on your own even if they are not in the group learning issue. If you can't see yourself doing that and needs someone to tell you what to study (again, lecture based doesn't necessary cover all that's on the broad exam, it is up to you to cover those too), then PBL is probably not for you.

PS I am not against lecture based classes, I am just being real here So that people won't get overwhelmed and regret with their choices.

 

[CHxyz]

Multipost, deleted

 

[ambernikel]

For example, if you think you need to study on TCA cycle and your group just wanted to concentrate on anatomy of the kidney, that doesn't mean you can't learn on your own the TCA cycle.

When we did PBL in organic I loved it because I really learned how to do everthing on my own and therefore I really knew and understood what I was doing. I also could teach it to the rest of my group and then we could feed off eachother's knowledge and reinforce our own. However, we did some PBL in my Phys class and I was kind of frustrated because the rest of the group wouldn't believe what I was saying. I knew the answer for the (small) case study right away (just from experience) but no one would believe me. The cool thing was that I then had to prove myself to them and argue against all of their ideas. So I did learn more but also I think I wasted a lot of time back tracking. I could see it being a problem if your group doesn't agree or if they aren't keeping up. If you think you need to go one way but the group out votes you what can you do?
Do find this a common problem?

 

[CHxyz]

Well I have 3 cases so far, so I am not "experienced". However, at the beginning of our first case our group decided on what "majority" is on our group (I think we decided on 6 have to vote to pass, we have 8". So far we don't really have that problem. If some one does not agree to something or is unsure, we just stop and look it up. We have a whole lot of books in front of us (We sort of figure out who brings what) so we just look it up and show to the other person. So far my group's been working well and there are no problem (lucky me). However I did hear horror story about other groups though (like how a few of the people wanted to go through the case really quick and solve it or picking extremely hard learning issues". I think that's up to the group to decide what direction to take the group to, that's how a democratic society work right? (majority rules). Like I said in the previous post, if you feel like a specific issue is important to you, you can still go ahead to learn it. Personal learning issues doesn't have to be the same as group issues, you just won't be tested on it. Again, you will get a mix bag of people. Some may be very knowledgeable in medical stuff and some won't. You just need to work through it, just like the real world. In my opinion, your group is only as strong as the weakest person, so just bring them up to date, you will be reviewing yourself by teaching them. If they don't want to learn, that's their problem, it wouldn't hurt you because you made the effort to study and they don't. If people on your group didn't do well on a test, it won't affect you. I know that sounds cruel, but hey, we are all professionals here and you need to act professionally. Another thing PBL teaches is interpersonal skills. How to work as a team and communicate. I think that's a pretty important social skill that lecture base classes doesn't provide.

 

[(nicedream)]

For example, if you think you need to study on TCA cycle and your group just wanted to concentrate on anatomy of the kidney, that doesn't mean you can't learn on your own the TCA cycle.

When we did PBL in organic I loved it because I really learned how to do everthing on my own and therefore I really knew and understood what I was doing. I also could teach it to the rest of my group and then we could feed off eachother's knowledge and reinforce our own. However, we did some PBL in my Phys class and I was kind of frustrated because the rest of the group wouldn't believe what I was saying. I knew the answer for the (small) case study right away (just from experience) but no one would believe me. The cool thing was that I then had to prove myself to them and argue against all of their ideas. So I did learn more but also I think I wasted a lot of time back tracking. I could see it being a problem if your group doesn't agree or if they aren't keeping up. If you think you need to go one way but the group out votes you what can you do?
Do find this a common problem?

I'm a 2nd year in a PBL program and I haven't encountered that at all. There's not really anything to agree or disagree about. We work through the cases methodically - write up a differential, perform H&P, edit differential, order tests etc etc. The only disagreements sometimes come up in selecting learning issues and we do 6/8 must agree on a given issue. That way, if 2 people are dissapointed their issue did not get picked, they can read it on their own anyway, it just won't be on the test.

 

[DORoe]

For example, if you think you need to study on TCA cycle and your group just wanted to concentrate on anatomy of the kidney, that doesn't mean you can't learn on your own the TCA cycle.

When we did PBL in organic I loved it because I really learned how to do everthing on my own and therefore I really knew and understood what I was doing. I also could teach it to the rest of my group and then we could feed off eachother's knowledge and reinforce our own. However, we did some PBL in my Phys class and I was kind of frustrated because the rest of the group wouldn't believe what I was saying. I knew the answer for the (small) case study right away (just from experience) but no one would believe me. The cool thing was that I then had to prove myself to them and argue against all of their ideas. So I did learn more but also I think I wasted a lot of time back tracking. I could see it being a problem if your group doesn't agree or if they aren't keeping up. If you think you need to go one way but the group out votes you what can you do?
Do find this a common problem?

I'm a second year at OUCOM in a PBL track and I think that the arguments are the most productive learning experiences in problem-based learning. I liked being challenged about my understanding of a subject. If you are able to really argue your point well it means that you have a good understanding of the subject matter at hand. Arguments and teaching are what make the PBL great.

Also to address what people said about boards and PBL.... Of course you don't go over everything in group that you need for boards in group. The PBL requires that you do a lot of work and learning on your own. The way I figure it I can spend 8 hours a day sitting in class listening to some person talking at me about this stuff or I can spend the same eight hours learning these things on my own. Studying on my own allows me to go as deep or as shallow as I think necessary to facilitate my understanding of a subject. For example, I need to read a lot about immuno because I don't have as good of an understanding about it, but I don't need to spend that much time on physio because I'm better at that already. So I can dictate what I spend my time on and what I don't. I couldn't imagine learning medicine any other way.

 

[OSUdoc08]

I think this was mentioned above, but what is wrong with having SBL and then some PBL thrown in. I would think that would be most effective. You could learn all necessary information through lectures and reading then apply it to your PBL group. I am not to familiar with all of this so I could be totally off base.

Our school has primarily lecture-style learning, with a small group systems-based learning course, called clinical problem solving, for 2 2-hour sessions a week. We work-up cases on patients in these sessions.

Obviously, there won't be certain learning issues covered in this class. It would be incomplete to just have PBL, but it also helps us learn how to solve cases on our own and as a small group of students, which is essential.

 

[njaqua]

What I am worried about is how do you know that the "selected learning issues" are what's going to be on the licensing exam(s) without guidance? I would worry that the group might spend too much or too little time on a particular topic. It seems that the learning issues should be based on required topics and information that will ensure high pass rates and scores. If the students are using a Kaplan guide or something to help create some kind of outline maybe that would be more effective. It would be cool to select topics to investigate that are of personal interest to the group but, since ultimately one's license depends on an exam it would be best to teach to that exam.

I'm not sure that I am clear...

To address the licensing exam issue, I did a pubmed search and a quick survey of the articles suggests that PBL students do just as well on the USMLE if not better than other/standard students.
I can't seem to link it from here, but i searched for "PBL" and "USMLE".

 

[jjsmalls]

What I am worried about is how do you know that the "selected learning issues" are what's going to be on the licensing exam(s) without guidance? I would worry that the group might spend too much or too little time on a particular topic. It seems that the learning issues should be based on required topics and information that will ensure high pass rates and scores. If the students are using a Kaplan guide or something to help create some kind of outline maybe that would be more effective. It would be cool to select topics to investigate that are of personal interest to the group but, since ultimately one's license depends on an exam it would be best to teach to that exam.

I'm not sure that I am clear...

I am in the PBL Pathway at LECOM-Main Campus. As far as whether or not you will learn enough, don't sweat it. We have every book that the Lecture-Discussion Pathway learns from, and are expected to finish each book by the end of the two pre-clinical years (it sounds daunting, but its really only like 300 chapters). You work through the chapters as needed, and as the cases call for them.
The beauty of it, though, is that you change groups after each exam (each exam has about 6-8 cases associated with it). In changing groups, you may be exposed to the same topic two or three times throughout the two years, if other members of your group have never seen it. The repetition is key to the success of PBL. Whereas in LDP, you may have biochemistry in October of your first year, and never see it again until you review for the COMLEX late in your second year.
There is nothing we don't see that LDP does. If anything, we see more. Also, we are exposed to clinical education far earlier. We learned to take histories on patients in the third week of school (with much practice still on-going), but the LDP students won't have this experience until the spring. We learn what tests to call for, how to read results, and how to work through a differential diagnosis.
The biggest advantage is being able to set your own schedule. The workload is pretty even for each pathway. For me, I have limited blocks throughout the day where I am fully focused. If I feel myself straying, I can take a break and go to the gym or relax for a while. If you are stuck in lecture all day, you still have to come home afterwards and try to study for 5 or 6 hours.
Hope this helps!

 

[Hoberto]

I love all the responses! I am 95% sure I am going to OUCOM and am definitely going to apply for the PBL program (well, they use a different acronym..). I was a little worried because I know my engineering PBL courses could get really off-track. Yeah, we learned a lo,t but not necessarily what we were required and needed to learn. It sounds like this is unlikely in med school and that everyone maintains a good focus.

 

[HunterGatherer]

For PBL'ers and those in the know about the PBL program at your college:

1)In your first semester are you doing PBL and basic sciences and then in 2nd semester it is mostly PBL? what classes besides OMM are part of the program after 1st semseter?


2)Is it competitive to get into the PBL program or is it first come first served?

 

[NRAI2001]

For PBL'ers and those in the know about the PBL program at your college:

1)In your first semester are you doing PBL and basic sciences and then in 2nd semester it is mostly PBL? what classes besides OMM are part of the program after 1st semseter?


2)Is it competitive to get into the PBL program or is it first come first served?

So u get to choose if you want to do PBL or LDP? So in the class there are students on different tracks? Could u do PBL, but still attend lecture with the LDP students?

 

[Megalofyia]

For PBL'ers and those in the know about the PBL program at your college:

1)In your first semester are you doing PBL and basic sciences and then in 2nd semester it is mostly PBL? what classes besides OMM are part of the program after 1st semseter?

At WVSOM there is no distinction between basic sciences and first and second year. Second year they end up looking up less basic sciences because they had to put that work in the first year to understand their cases but it is not intentional, or maybe it is, either way it just works out that way. We dont have lectures on any of the basic sciences unless we ask for them or have some sort of resource hour assigned to us.
For first semester we have OMM and POM (problems in osteopatic medicine) and a couple of physical diagnoses things thrown in.
Second semester is more physical diagnoses, OMM, POM, and anatomy.
This is changing next year though because the PBL studenst will be taking anatomy with the SBL students and it will cover more than one semester.

I'm thinking that second year is going to be more reminisent of our first semester in terms of what our schedule looks like with ACLS thrown in.

2)Is it competitive to get into the PBL program or is it first come first served?

I'm not sure about how competative it is.. there is a big element of first come first serve. Any competativeness is bassed on an essay we write that explains why we want PBL. I konw there are some SPLers that wanted to do PBL but didn't get in.

 

[Megalofyia]

Could u do PBL, but still attend lecture with the LDP students?

We have this option open to us but I dont know of very many who take advantage of this. I know that no one does this for all the lectures. It would only be for one lecture once in awhile. There were a couple of lecture I had considered going to but they were during out PBL group time so that nixed that idea. Instead I got their lecture notes to study from.