Problem based learning

[DrDuber]

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Sorry to be an undergrad posting here, but I have heard some vague information about pbl and I was hoping that a student currently at a school using this method could give me a better idea about what it entails. The only thing I have ever heard about problem based learning is you are handed some problems and told see you in a few weeks.

Any information would be very much appreciated.

Thanks.

 

[Anka]

It varies heavily from school to school. Some schools are taught primarily via PBL. Others have a lot of lectures and the PBLs are supplemental. In general, the idea is that you get a couple of cases and work as a team to figure out what you're going to do. For example, you might have a 62 year old male who has had leg pain that's been getting worse for a few years. You meet up as a group and decide on a basic differential and what additional information you need (e.g., let's say you happen to know that there is vascular claudication and pseudoclaudication... you might assign one person to research the vascular causes and one person to look at the neurologic causes.) You meet back up whenever your next session is and share what you all researched. Then you make some more decisions.

In fact, what tends to happen is one person (usually someone with previous "field experience" or extensive volunteering at the nursing home) will dominate the discussion, often being frankly misinformed. Then some gunner will "take a leadership position". A few other people trying to do well will then spout off something they happen to know about (for example, "TB could cause chronic leg pain").

Honestly, PBL is the blind leading the blind for the most part. Stick to a curriculum in which an expert, rather than your classmate, will be teaching you. Or at least where you can skip class to read your favorite books.

Best,
Anka

 

[Hayden2102]

I think the ideal (for me, at least, because everyone's learning style is different) is integrated systems-based didactic teaching with PBL/CBL on the side.

 

[rpkall]

^ I agree with Anka.

PBL is overrated.

If you're motivated in your basic science years, willing to ask questions of your profs and your classmates when you don't know something, you'll develop the "intellectual curiosity" you need in order to start thinking critically at the bedside.

Just keep thinking to yourself when you go through your basic science years, "Why is this relevant? How would a patient present if this was his/her issue? What would confuse me about this? Does this look like something *else* that could be mistaken for it?"

Blah, blah.

You can do that anywhere, at any med school. Utilize study groups and all your online resources, and be curious. Whether you're at Harvard or a state school, St. Georges or KCOM, I really think if people approach it like that they'll get more out of it...

 

[smq123]

I think the ideal (for me, at least, because everyone's learning style is different) is integrated systems-based didactic teaching with PBL/CBL on the side.

See, you'd think it would be ideal for most people, but I don't think it is. Integrating PBL into your curriculum is supposed to "reinforce" concepts, but really - how is it "reinforcing" concepts if my classmates feed me erroneous/misinterpreted information? Or if our PBL small group moderator is NOT an MD, but a PhD? (Hey - it happens sometimes.) Or if our PBL group (which was randomly chosen) is made up of the shyest people on the planet who never open their mouths unless absolutely forced to? (I've seen that one happen a couple of times.)

Thankfully, my med school only has 2 PBL sessions in the first year. That was 2 too many, but still, not too terrible.

 

[smq123]

Sorry to be an undergrad posting here, but I have heard some vague information about pbl and I was hoping that a student currently at a school using this method could give me a better idea about what it entails. The only thing I have ever heard about problem based learning is you are handed some problems and told see you in a few weeks.

Any information would be very much appreciated.

Thanks.

PBL gets talked up a lot. A lot of pre-meds think that "team-based" approaches will make you a better "team-player" during your 3rd and 4th years. A lot of pre-meds are also attracted to the idea that you're in class for less time with a PBL curriculum. Finally, I've heard a lot of pre-meds on SDN say stuff like "Well, I hated going to lecture as an undergrad, so I'm sure that I'll hate going to lecture in med school."

Honestly, I'd rather learn about HIV from an actual infectious disease doctor, Cushing's from an actual endocrinologist, and scleroderma from an actual rheumatologist - and not learn it from my classmates who gleaned information from MedLine or UpToDate. (Or, more likely, Wikipedia.)

There are some people on SDN who do go to PBL-only schools, and absolutely love it. It's definitely not for everyone, though.

 

[Hayden2102]

See, you'd think it would be ideal for most people, but I don't think it is. Integrating PBL into your curriculum is supposed to "reinforce" concepts, but really - how is it "reinforcing" concepts if my classmates feed me erroneous/misinterpreted information? Or if our PBL small group moderator is NOT an MD, but a PhD? (Hey - it happens sometimes.) Or if our PBL group (which was randomly chosen) is made up of the shyest people on the planet who never open their mouths unless absolutely forced to? (I've seen that one happen a couple of times.)

Thankfully, my med school only has 2 PBL sessions in the first year. That was 2 too many, but still, not too terrible.

Well, for starters, I didn't say most people, I said for me.

As I said, I like it on the side, which means if for some reason your group sucks, it's not going to destroy your semester.

 

[smq123]

As I said, I like it on the side, which means if for some reason your group sucks, it's not going to destroy your semester.

That's true, fortunately. I think what I was trying to say (obviously I didn't say it too well!) was that that's how my school did it, and I found it useless. As far as I can recall, the "learning issues" we dug up were not even mentioned in the actual lecture on the subject. Which means that we were so far off base it isn't even funny.

Is it popular in Australia? I think that PBL started in Canada, but trickled into the US. What about other countries?

 

[Hayden2102]

Yeah it totally depends on how your school handles it. If it is handled well, it definitely helps. Learning objectives are the key. That's something my school does well. Every week we get a list of learning objectives, so we know that if something isn't covered in lectures/CBL then we can go over it in SDL (self-directed learning).

It's becoming a part of every school in Australia. There is only one school that does it as its sole part of learning, and only has 3-4 lectures a week. That's Newcastle, the first to introduce CBL into Aus, and it got a really great reputation for doing so.

I didn't realise it started in Canada, but the CBL movement in Australia was supposedly based on "extensive testing in the US", whatever that means. Their idea also was that it is harder to learn CBL, but "situated learning" is more effective in the long run.

You can understand their motivation, they kill many birds with one stone:
1. Situated learning
2. (Somewhat forced) Teamwork
3. Self-directed, independent, take-the-responsibility-yourself learning
4. Early establishment of evidence-based medicine

What do you think?

 

[doctorp82]

Our school does 1 case/week PBL style learning, with system based didactics/lectures as well. We're responsible for two learning objectives/reports on a topic of the case each week.

 

[rachmoninov3]

As a nervous Mzero starting at a heavily PBL c some lectures school, let me say 2 things:

1. The PBL simulations my school gave at second look day really impressed me b/c they remind me of H&P's. Since this is how I've learned medicine from a nursing perspective (reading the charts), it made sense to continue it formally.

2. At this point, I'd go to ANY school that gives me love! Luckilly enough it's instate, and I only have to move 75 miles!

 

[GWmdwannabe]

I find that your enjoyment (and what you get from) PBL is highly individualized. I learn well by teaching and explaining things to others, so I find that they help quite a bit - as long as they're used to reinforce topics I've already been taught, as opposed to learning things de novo.

 

[zephyrhills123]

It depends on who is in your group. Like someone else said, I've got know it alls in my group who dominate every conversation and aren't good at listening to other people's opinions on a case.

Each session (there are 2 of them a week) is for an hour long only, and we have tasks at the end of each page of the case report (new information/test results on each page) that we must answer before going on to the next page. It keeps us more on track than I think we normally would. At the end of the week, our professor has one randomly chosen group report back on how they came to their conclusion on what was happening with the patient (with focus on anatomy since this is the class).

I suppose it helps you to learn how to work with people you may dislike, because not everyone you work with is going to be your best friend and approach things the same way you do. It's still irritating, though.

 

[Miami_med]

We do a couple of weeks before Christmas and a couple of weeks after classes but before the boards. This seems like just about enough, and I enjoyed my sessions. It can be a good supplement, though it might not be. I'd be VERY hesitant to go to a school that did it in place of lectures.

 

[Anka]

PBL gets talked up a lot. A lot of pre-meds think that "team-based" approaches will make you a better "team-player" during your 3rd and 4th years.

I just wanted to build on SMQ's point a little, since this team based approach appears to be the new med school fad. You'll hear someone talking about some new strategy to get med students working in groups during the preclinical years ("team based learning" or PBL or whatever the poison of the day is), with the idea that this will somehow make you better when you get to the clinics (since you are more used to "working as a team".) Realize that the problem people have adjusting to teams on the wards isn't adjusting to working with a team, but adjusting to a very heirarchical team with you at the bottom of the heirarchy.

Best,
Anka

 

[Husky85]

This will explain everything:

http://www.youtube.com/watch?v=ZJeXDhI7L5g&mode=related&search=

😉

 

[UCLAstudent]

PBL is not all that it's cracked up to be. Almost everything I learned during the basic science years came from lecture, not PBL.

 

[Pinkertinkle]

PBL is one very inefficient way to learn. It's just a result of everyone jumping on the harvard bandwagon.

 

[plastikosmd]

after years of lecture, grade school, HS, college..etc PBL is attractive. sure it is fun to sit around and talk...and talk...and talk.."Wow it doesnt even feel like class." Personally i found it annoying...and harder to skip out of and get real studying done. a lesson in think tanks and group dynamics that did nothing to prepare me for residency (not that lectures..etc do either.) however, the lecture portions at least did more to prepare me for the USMLE. it's different for everyone.

 

[Gut Shot]

Any information would be very much appreciated.

Sure. PBL sucks.

Consider this. Day one of medical school. You sit down at a table with seven strangers and a faculty member. The faculty member says "Okay guys, a 45 year old caucasian male comes to the ER with abdominal pain. Any ideas?"

Blank stares.

Welcome to the PBL Terrordrome, bitch.

 

[GreenShirt]

PBL is similar to the approach used on the TV show "House". The residents meet in a room with a chalkboard and throw out ideas regarding a patient's case. Dr. House (aka the moderator) is not there to give them answers, but to guide them towards a diagnosis. The residents go out and try to figure the case and keep reconvening until they get it right.

The benefit, IMO: Why sit in lecture for 8hrs a day having someone read the material you'll have to sit and learn on your own later anyway, when you can have more of your own study time and use the few hours of class time you actually have to apply the material you've learned to a clinical context.

Sure it's a little intimidating to have someone say "You have a 34 yo patient with abdominal pain. What do you do?" on the first day, but when you enter clinicals, you'll be glad that someone taught you how to approach a case and have the ability to locate information on your own.

 

[smq123]

after years of lecture, grade school, HS, college..etc PBL is attractive. sure it is fun to sit around and talk...and talk...and talk.."Wow it doesnt even feel like class." Personally i found it annoying...and harder to skip out of and get real studying done. a lesson in think tanks and group dynamics that did nothing to prepare me for residency (not that lectures..etc do either.) however, the lecture portions at least did more to prepare me for the USMLE. it's different for everyone.

Your PBL group talked a lot?! Boy, you sure were lucky. It's worse when no one has anything to say and you can practically hear the crickets in the background.

Consider this. Day one of medical school. You sit down at a table with seven strangers and a faculty member. The faculty member says "Okay guys, a 45 year old caucasian male comes to the ER with abdominal pain. Any ideas?"

Maybe that was the problem with PBL at my school. There were 12 people in a group, and trying to find 12 learning issues for an MS1 level topic is hard. For instance, one of our cases was about a woman in her 40s, with 3 kids, and presenting with RUQ pain. My learning issue was...Crohn's disease. I was relatively lucky, though - someone else had epididymitis.

I hated coming up with "learning issues" for PBL. I think it's the worst way in the world to teach students how to develop a good differential dx.

The faculty member says "Okay guys, a 45 year old caucasian male comes to the ER with abdominal pain. Any ideas?"

Blank stares.

Welcome to the PBL Terrordrome, bitch.

This is my favorite description of PBL, EVER! 👍

 

[smq123]

The benefit, IMO: Why sit in lecture for 8hrs a day having someone read the material you'll have to sit and learn on your own later anyway, when you can have more of your own study time and use the few hours of class time you actually have to apply the material you've learned to a clinical context.

There is some benefit to lectures, though - why learn about diseases from your classmates, when you could learn them from a lecturer who actually takes care of people with these diseases?

Like I said earlier - I found it much more interesting to learn about gallstones from a gastroenterologist, than to learn it from one of my classmates. Learning about HIV from an infectious disease doctor was really useful in that I was able to talk to him after class, and arrange to work with him in his outpatient HIV clinic. You don't get that in PBL.

Sure it's a little intimidating to have someone say "You have a 34 yo patient with abdominal pain. What do you do?" on the first day, but when you enter clinicals, you'll be glad that someone taught you how to approach a case and have the ability to locate information on your own.

How did your school do PBL? Because if you feel like PBL taught you how to properly approach a case, maybe I can suggest that to the course directors at my school. The only way I learned how to generate a good differential is from lectures and working in student-run clinics. Seriously.

 

[Gut Shot]

The benefit, IMO: Why sit in lecture for 8hrs a day having someone read the material you'll have to sit and learn on your own later anyway, when you can have more of your own study time and use the few hours of class time you actually have to apply the material you've learned to a clinical context.

Sure it's a little intimidating to have someone say "You have a 34 yo patient with abdominal pain. What do you do?" on the first day, but when you enter clinicals, you'll be glad that someone taught you how to approach a case and have the ability to locate information on your own.

Don't get me wrong, a little clinically-oriented small group is a useful learning adjunct. Given the massive amount of information med students have to assimilate for Step 1 (and beyond) I just favor a more efficient approach. Not everything has to be some big diagnostic mystery.

 

[DrZeke]

I was accepted to a school that has 50% PBL and they have adapted the curriculum from others that have shown to be very successful. I know for a fact that at these schools there is PBL with a FACULTY member in the room guiding you. It's not just a bunch of students trying to show who knows best. Also, at this school part of your grade will depend on your evaluations at the end of 1st and 2nd year from your classmates. There is definitely an entire section about teamwork and that BS, so you best not being a gunner mofo in PBL session cuz it will come back and bite you in the ass...

🙂

 

[evade]

I was accepted to a school that has 50% PBL and they have adapted the curriculum from others that have shown to be very successful. I know for a fact that at these schools there is PBL with a FACULTY member in the room guiding you. It's not just a bunch of students trying to show who knows best. Also, at this school part of your grade will depend on your evaluations at the end of 1st and 2nd year from your classmates. There is definitely an entire section about teamwork and that BS, so you best not being a gunner mofo in PBL session cuz it will come back and bite you in the ass...

🙂

Sometimes, the faculty member "guiding" you only exacerbates the problem! Some of them really want to weigh in on every single thing that's discussed, and talk about their experiences with the subject, blah blah blah. My group had one of these once. He was insufferable.

Simply put: PBL is the most inefficient way imaginable to learn anything. It also won't reduce your total hours in class. Lecture is usually not mandatory, and if you don't feel the need, you don't have to go. PBL, on the other hand, is mandatory, and it's long. To learn an hour's worth of lecture material via PBL usually takes something like 3 hours.

As Gut Shot so truthfully put it, "Welcome to the PBL Terrordrome, bitch."

 

[Critical Mass]

I was accepted to a school that has 50% PBL and they have adapted the curriculum from others that have shown to be very successful.

Let's see some data, please.

Nobody is going to convince me that PBL works for boards because the USMLE requires a minimum set of facts that must simply be memorized. As long as we will be measured against every other student with specific respect to our ability to memorize tedious details, PBL will remain a complete and utter waste of time.

My school has a small sampling of it, but the cases used are recycled from year to year, and the faculty aren't exactly great/supportive of it. It's really just something that they make us to do make the school look progressive.

 

[RaaMD]

PBL is similar to the approach used on the TV show "House". The residents meet in a room with a chalkboard and throw out ideas regarding a patient's case. Dr. House (aka the moderator) is not there to give them answers, but to guide them towards a diagnosis. The residents go out and try to figure the case and keep reconvening until they get it right.

The benefit, IMO: Why sit in lecture for 8hrs a day having someone read the material you'll have to sit and learn on your own later anyway, when you can have more of your own study time and use the few hours of class time you actually have to apply the material you've learned to a clinical context.

Sure it's a little intimidating to have someone say "You have a 34 yo patient with abdominal pain. What do you do?" on the first day, but when you enter clinicals, you'll be glad that someone taught you how to approach a case and have the ability to locate information on your own.

What you fail to point is out is that this show portrays residents who already have a foundation in medicine. Imagine pre-clinical medical students trying to conjure up a differential on various signs and symptoms without this foundation. Blind leading the blind as it has been said before. I think the facilitators assistance can only extend so much since classmates are teaching each other rather than being lectured from an expert. PBL is great once a foundation has been set, but not for learning the boards. Only makes the task of passing Step 1 even more difficult.

 

[CCLCMer]

Sorry to be an undergrad posting here, but I have heard some vague information about pbl and I was hoping that a student currently at a school using this method could give me a better idea about what it entails. The only thing I have ever heard about problem based learning is you are handed some problems and told see you in a few weeks.

Any information would be very much appreciated.

Thanks.

I can't speak for other schools, but that's not what PBL is like at my school at all. We have three PBL sessions per week, for a total of six hours. We also have four seminars per week, for a total of eight hours. The rest of our time is spent on clinical skills (four hours per week in first year, eight hours per week in second year), issues in medicine (1.5 hours per week) and research seminar (1 hour per week). The PBL cases and seminars are integrated into a theme for the week, and they build on one another. Basically, each week we get a new case on Monday. We go through the case, list the things we don't know and would like to know, tests we'd like to run, etc. By the end, we come up with certain learning objectives that we want to cover. Specific people are assigned to lead the discussion about them, and we come back Wednesday to do that. Individual groups vary a lot as far as how they are run, but we usually have a student leader, a scribe, and a reader as well as the faculty tutor. Some tutors talk a lot, but most don't say much unless we're really going off track. Some are MDs and others are PhDs.

Let's see some data, please.

Nobody is going to convince me that PBL works for boards because the USMLE requires a minimum set of facts that must simply be memorized. As long as we will be measured against every other student with specific respect to our ability to memorize tedious details, PBL will remain a complete and utter waste of time.

Actually, most of the published studies show that PBL students do equally well on the boards compared to students in traditional curriculums. The first CCLCM class had a 100% pass rate on the boards with a 229 class average. (For those who don't know, the national average on Step 1 is about 215.) Here are abstracts from a few papers in medical education journals looking at how PBL students perform on the boards:

http://www.academicmedicine.org/pt/...9nCFH2Y1XnXQ58Gg!1354923979!181195628!8091!-1

http://academicmedicine.org/pt/re/a...bJL5RXX7RnGK2vn4!1354923979!181195628!8091!-1

http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2923.2001.01058.x

 

[postbacker]

Despite the prevalence of anti PBL fervor on SDN, I remain open-minded about it. I would like to see it in action.

Without knowing more about it, I am interested in schools that use a variety of teaching techniques in the curriculum - some lecture, some PBL, small group stuff, theme stuff, etc. CCLCM sounds very interesting to me...

Without pointing at any of the anti PBLers on this thread, and acknowledging that I am a lowly pre-med and don't know what I don't know, I am also struck by the high number of people on SDN who don't attend classes, instead studying alone, downloading powerpoints, etc - something about that just doesn't sound right to me, and I think that some of the anti PBLers are also anti lecture people, too...

 

[plastikosmd]

So the short and sweet for me..there are things that i heard in lecture that i remember today....nothing in PBL has ever contributed to my education...so it was a complete waste of time. Emphasis on the word TIME. Lecture is helpful for the concepts that are difficult to grasp. It isnt that it is rocket science..but some stuff like pharm/neuro etc. is nice to hear a bit about. I didnt need a great deal of help learning to develop a DD, asking pointed questions, figuring out if it was a horse or a zebra and treating the patient in PBL cause the first 2 years of medical school wasnt what it is about. Sure, PBL gives you that touchy-feely good feelin that wow im gonna be a doctor..askin questions...ordering test...etc. All of that is repeated in real clinical scenarios as a 3,4th, intern, resident etc. If PBL were gone..I wouldnt have missed a thing. The first 2 years can be summed up in one word "memorization." For memorization I need time, and maybe you dont. nobody said people who are in PBL wont do well on the USMLE. I did just fine..and had a lot of PBL..60-70%. It just means that I had a good amout of time that i couldnt be studying. Three to six hours of daily studying, or more as you approach exams and USMLE needs to get done...so later nights. If a day of lecture wasnt useful, then that was time gained, skip and study. I think PBL would be more helpful in the 3rd year, if it were added to say clerkships for 1/2 day a week or something. But for the first 2 years it was in the way for me.....

i think it is great to remain open minded, and no doubt PBL can be fun. I never felt like PBL was there to teach me about disease, rather a process in which to approach a problem. That is useful, but it is also gained elsewhere, when your step 1 is rapidly approaching, or your midterms/finals..ask yourself how PBL has helped you prepare. maybe your answer will be/is different...hope so!

 

[Critical Mass]

Actually, most of the published studies show that PBL students do equally well on the boards compared to students in traditional curriculums...

http://www.academicmedicine.org/pt/...9nCFH2Y1XnXQ58Gg!1354923979!181195628!8091!-1

http://academicmedicine.org/pt/re/a...bJL5RXX7RnGK2vn4!1354923979!181195628!8091!-1

http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2923.2001.01058.x

Then there are schools spending a lot of time and money on something that is equally well. I couldn't glean much from those articles, but I would have to see a school randomly assign its student body to one of the two different flavors of the curriculum (PBL vs. Traditional) before I would see adequate evidence that PBL works.

Most of my colleagues agree with me in saying that pretty much anything that takes time away from memorizing the required step 1 stuff in the first two years is not time well spent.

 

[smq123]

Without pointing at any of the anti PBLers on this thread, and acknowledging that I am a lowly pre-med and don't know what I don't know, I am also struck by the high number of people on SDN who don't attend classes, instead studying alone, downloading powerpoints, etc - something about that just doesn't sound right to me, and I think that some of the anti PBLers are also anti lecture people, too...

Since some schools record their lectures, people just listen to the lectures at home, in the afternoon. It's nice because you can pause and rewind if you don't hear something the first time.

I actually liked lectures, attended nearly all of them. Some of my classmates (who don't post on SDN) also hated PBL but really liked lectures. A good lecturer (and I was fortunate to have quite a few this year) can make it a truly worthwhile hour, whereas PBL is much more hit-and-miss.

Case-based learning IS useful, even in the first two years. But you don't need to have PBL to learn how to approach a clinical scenario. We had "large-group" case study sessions where a fellow or an attending would help us work through a problem. Those were helpful, in a way that PBL wasn't.

It is good to remain open-minded, but I don't think it's quite fair to criticize other med students for skipping lecture until you've been in their place. Sometimes, when you're so far behind that the current lecture won't make any sense to you, it is better to stay at home and catch up.

 

[Husky85]

Have any of you seen that episode of House during the first season where House is forced to teach a class of med students and does 3 case based learning exercises?

Wouldn't this be a much more effective approach to learning how to make clinical decisions than pbl? Rather than the blind leading the blind, the learned can lead the blind. (this may be a similar approach to how smq's school ran things...if so, could you give us more insight into why you thought one is better than the other, having done both).

 

[greenbean]

the problem at our school in regards to pre clin years was two fold
1) lectures: were often done by at least 50 different faculty per organ system, so for cards we would be taught by 'experts in the field' of every topic in cardiology. it was difficult to get used to so many different styles of teaching(most of whihc sucked and most of which were just some one reading off his ppt slides). most of the lecturers would also complain about how our school did not bother to pay them for teaching and that they were being forced to become 'volunteers' to teach...i mean i was like "curb your enthusiasm a little please" ..

if there were only 5-6 lecturers for an entire organ system block that would be better. and that would require a lecturer to put time ,thought and effort into making material ez to understand and interesting..not just a chore

2)pbl-oh my, those days still make me cringe. i was the "quiet" one who would always be forced to talk. i never liked these pbl sessions b'c
--they really weren't going to affect my grade so it wasn't worht effort into participating
--most ppl would shout over each other, usually saying stuff that was blatantly wrong, which preceptor never bothered to point out
--i never learned from any one in pbl. if i knew it, it was bc i read about it, i asked a prof about, but never b'c joe or mike said it in pbl and it "stuck" in my mind
--it took away valuable studying time. i usually never went to lecture either so i had to drag my butt out of the house to go to these dumb things
--some sessions required that we make handouts and present to each other, whihc was also another joy(that was internet sarcasm), ppl would spend so much time on these, printing them on glossy paper or cardstock or in color, it was embarrassing.

--i would just get rid of pbl altogether,have a good lecture format,and weekly review session for about 1-2 hrs in a quiz type style

 

[megadon]

The problem with PBL is that it wastes your time. Instead of someone telling you in 15 minutes what you need to know, you spend an hour reading it, and another 30 minutes teaching your group. Why it works on House, they already are supposed to know this stuff. That's WORKING, we're LEARNING. Thank goodness my school has identified the least important (and not basic science) class and made it PBL. My view of PBL is it also a faculty member's dream, instead of spending four hours lecturing you, they can spend five minutes reading your post of objectives, tell you they are wrong, and get back to painting their toes, playing minesweeper, seeing patients, whatever.

 

[LifetimeDoc]

I'm open to a little bit of PBL and all other types of learning if it enriches my medical education. You'll find many on SDN who wish to minimize the amount of work in medical school and do just enough to get by. I'd rather take advantage of this time to learn all that I can, rather than the minimal amount required.

 

[BlackSails]

Sure. PBL sucks.

Consider this. Day one of medical school. You sit down at a table with seven strangers and a faculty member. The faculty member says "Okay guys, a 45 year old caucasian male comes to the ER with abdominal pain. Any ideas?"

Turf to surgery!

 

[BlackSails]

My orgo class next year will be PBL based. In the regular section, the prof is doing normal lecture format, but in the honors section, he is doing PBL liked he used to at Princeton, where it is claimed that PBL results in better organic chemists. Basically, instead of lecture and recitation, we have groups of 4, he tells us to figure something out, and then we use the textbook and the group to do so. It doesnt sound so bad, but the total amount of stuff you need to know in orgo is less than in medicine.

 

[postbacker]

If the licensing step exam scores were converted to "pass / fail" without the publication of individual absolute scores (thus they could not be used in residency placements), PBL would be more widely accepted (or at least more tolerated).

Many of the same people who oppose PBL also think that the lectures are time wasters. Many of these people describe how they spend as little time as possible in lecture, minimizing their time in the presence of other students, professors, etc. There is something wrong with that attitude, I don't care what anybody says...take the Step scores away from the residency directors, and I think that people would be more receptive to alternative medical education techniques.

 

[Husky85]

I'm open to a little bit of PBL and all other types of learning if it enriches my medical education. You'll find many on SDN who wish to minimize the amount of work in medical school and do just enough to get by. I'd rather take advantage of this time to learn all that I can, rather than the minimal amount required.

You say this now, while you are all bright eyed and bushy-tailed about medicine. Once you get your hands wet a little bit you may change your mind and swear against pbl, saying the same things as those you criticize here for being lazy (I'm in the same boat, having only had pbl for a handful of undergrad classes). Just give it a few months until you've had some pbl on the med school level and then formulate an opinion. 😎

 

[BlondeCookie]

In fact, what tends to happen is one person (usually someone with previous "field experience" or extensive volunteering at the nursing home) will dominate the discussion, often being frankly misinformed. Then some gunner will "take a leadership position". A few other people trying to do well will then spout off something they happen to know about (for example, "TB could cause chronic leg pain").

OMG! This is exactly how my PBL group is! We have this one guy who totally dominates all discussions in the group. He does not shut up. Literally, we might have one person reading the case out loud and then Mr. Big Shot interrupts and says whatever he is thinking at the moment. It might be about something he saw at the hospital or a lecture that is similar to the topic. It might be totally irrelevant about how the case sucks or is really cool. It's totally disruptive. I tend to stay out of the PBL arguments, but Mr Big Shot loves to act rude and condescending to a couple of other students in the group to assert his dominance. PBL was made for people like him at the expense of everyone else. I'm giving the big thumbs down to PBL learning. 👎

 

[deleted77919]

I'm open to a little bit of PBL and all other types of learning if it enriches my medical education. You'll find many on SDN who wish to minimize the amount of work in medical school and do just enough to get by. I'd rather take advantage of this time to learn all that I can, rather than the minimal amount required.

hahaha . . . Most of the people I know in medical school who do "just enough to get by" study for 9 hours per day, every day instead of 14 hours per day. People don't say "PBL is a waste of time, it's taking away from my drinking time!" People say "Well, guess I wasted those 4 hours today, guess that'll be comming out of my scheduled sleeping time for tonight."

 

[deleted77919]

If the licensing step exam scores were converted to "pass / fail" without the publication of individual absolute scores (thus they could not be used in residency placements), PBL would be more widely accepted (or at least more tolerated).

What do you propose they use to determine who gets into what residency then? LOR's only? Just grades (which with essentially just two grades, H and P is fairly low resolution, and how in the world do you compare those across schools?)? Or maybe PD's could just draw names out of a hat?

People may not like that Step I is the end all be all of the preclinical years but I have yet to see a better viable alternative. You've got to differentiate people some how.

 

[beegeforty4]

what's the big deal???

who doesn't love peanut butter and lettuce?

 

[PeepshowJohnny]

Our school is sloppily integrating PBL, so that might have led to my problems with it, but I think there are limitations to the format itself.

Once again, I think the problem is mainly in the students. You've got the guy who wll constantly spout off wrong information that he claims came "right from Access Medicine/the textbook/Uptodate" but is completely off. You've got the guy who goes into ridiculous detail and misses for the forest for the trees. You've got the mumbler who you can't understand and the "prim and proper" guy who is so formal and full of himself you can't stand to listen him. Sure the majority of people are cool in your class, but there's usually one or two in a group that makes it a pain.

 

[DrZeke]

Our school is sloppily integrating PBL, so that might have led to my problems with it, but I think there are limitations to the format itself.

Once again, I think the problem is mainly in the students. You've got the guy who wll constantly spout off wrong information that he claims came "right from Access Medicine/the textbook/Uptodate" but is completely off. You've got the guy who goes into ridiculous detail and misses for the forest for the trees. You've got the mumbler who you can't understand and the "prim and proper" guy who is so formal and full of himself you can't stand to listen him. Sure the majority of people are cool in your class, but there's usually one or two in a group that makes it a pain.

again, the whole grading based on your ability to interact with the group by your fellow classmates, might knock mr big shot off his high horse!

 

[kittalin]

I'm starting a PBL program in the fall. As I understand it, they meet three times a week, one case a week, and lectures are supplemental. Now I have yet to see how much I like it, but hey I didn't get into any other schools

Anyhoo, my very good friend is a year ahead of me in the same program. When I expressed my fear, particularly of relying on info from other people, she said that in all three of her groups (they switch with each unit), that the one that worked the best was when EVERYONE tackled every learning issue. So you study everything yourself, and when you come into discuss, you won't be totally clueless, and Joe Schmo will hopefully contribute something you overlooked. She also said the sooner your group gets over its fear of thinking out loud and sounding like an idiot, the more productive it is. She also said that sometimes your mentor does suck. No way around that...

When I interviewed with the dean of admissions, he said that the school's board scores were awesome, which was somewhat unexpected because the average MCAT for the classes in the past is nothing to be jealous of. He said that traditionally, if Sally Jo scores X on her MCAT then she will score X on the boards, but students from our school broke the mold: lower MCAT scores, excellent board scores. Eh?

What do I know? I'll let you know in four years...

 

[StevenRF]

PBL is the worst thing ever created by man for education.

The problem is it's self fulfilling. Everyone, even the pbl tutors, knows its complete BS. The problem is no one can say it. The students have to go in and put on a show like it's the greatest thing ever to get a good review. Talk to them one on one or with the tutor gone; everyone will it's a complete waste of time. The PBL tutors pretend like they care because it gets them out of any teaching responsabilities since PBL counts as a class, even though they just have to sit there for two hours and refuse to teach anything on the grounds that its a student led discussion while they are just the guides (who usually know nothing on what we are talking about except their specialty). The administration has to keep it. Since harvard made it, it must be amazing. They can put it on their brochures and tramp it around singing cumbiah as a marketing gimmick for how much they truely care about student's feelings. Last but not least is the *****ic Ed.D. they had to hire to run their curriculum. Well he has to justify his job, so putting in crap like PBL gives him something to do.

In reality, its 4 hours of sitting around a stoner table like in the 70's show plus 3 or more hours writing up some bogus learning issue that can usually be found on pub med, up to date, google, as a fully complete and competent article. It many hours a week that are needed to be at home studying on your own actually learning something.

Sorry. I'm bitter.

 

[kittalin]

FYI

Actually, Harvard wasn't the first to do it. At least, when I interviewed at SIU, the dean of admissions told me that they were the first to do it, that PBL was kind of SIU's claim to fame..."so effective that even Harvard adopted it" were his words. But I can't find anything confirming either way...