Problem based VS. traditional programs

PBL isn't perfect, but at least it isn't as boring as lecture. I think alot of what people get out of it depends on the group dynamic. The PBL group i am in get along together really well and everyone seems to contribute and haul their share of the work. The way the session works is that we are given a case, with many learning issues that come up in it's presentation. each member has to take a learning issue and do research and come back the next session to present that topic. after discussion, (and more data given out), the group arrives to a diagnosis.
for example, this week, i have to present on the molecular pathogenesis of cystic fibrosis, while somebody else may talk about C.F. epidemiology. etc. in general, pbl tends to be something that i don't love, but defintely more entertaining than lecture.

is PBL necessary or perfect? definetly not. my friend is in a group that he dislikes, and i know of another who got in serious verbal argument during the group discussion over the differences between incomplete and codominance. people can annoy. but that's life in general. dealing with other people (especially in health care) is something that can not be avoided. might as well learn how to do it now.

does PBL prepare you for boards? its probably not the most efficent way to get the highest score, but case based presentation is typically used in the way the boards test. i don't think any curriculum in particular prepare you for the boards better, i think the best correlation is the reputation of the school.
but correlations only go so far. there are plenty of people who rock the boards from "no-name" schools, and conversely, for "big-name" schools.

as you are trying to decide the best school for you, the things i think you should consider whether or not you'll be happy there. Ranking don't matter as much as people think when they are deciding medical schools. Obviously deciding between a carribean school and harvard is a cinch to make,...but people who think that school ranked #25 is superior to school ranked #31, while not considering more important things like curriculum, geography, cost, pass/fail vs grades, PBL vs. traditional,..etc... need to reevaluate their criteria.


nuclearrabbit

NUFSOM - class 2006

 

hey, what is NUFSOM?

 

northwestern

 

I really like the way pbl is working for me. I am not a lecture girl so it helps to not have to sit in a big lecture hall trying to stay awake. It might not be the most efficient way to learn material but the material really sticks with you when you learn it actively in the context of a clinical situation. The group dynamics and facilitators do play a role but fortunately I have had really great group members and facilitators.

 

If i remember correctly, some stats showed that pbl ppl do relatively worse on step-1 and better on step-2.

 

Dont some schools have hybrid PBL/lecture programs?...a little bit of both worlds......isnt that what Northwestern has?

 

Hopkins has a little of both. Half lectures and half PBL.

 

My school is 100% PBL. Average Step I=229 with 100% passing. Dunno the standard deviation.

 

In my opinion, I think PBL will prepare you well for residency and your career as a physician. After your first 2 years of medical school, approaching patient care IS PROBLEM BASED LEARNING. The boards are now designed to be clinical vignettes, and you have to formulate differential diagnosis and treatments.

The old boards were much different. Being MD-PhD, I had to take the old pencil and paper USMLE Step I and the computerized Step 2 and 3. PBL is a better approach to the new boards.

 

Hey Ophto_MudPhud, are you sure Hopkins has PBL? I think they have small-group discussion, but not PBL...

 

The small groups are the pseudo-version of PBL. Hopkins switched from 8 hour lecture days to this format to implement a little PBL in the curriculum.

 

Ah, I see. I don't mean to be picky, but I think the deans actually don't consider them to be PBL. The small group sessions don't take a case and make you do your own learning based on that. You just get mini-problem sets to do. Some of the students want to change it slightly to add some PBL, though.

 

Incendiary,

Do you like Hopkins? How is your first year coming along? I was glad that they switched from the 8 hour lecture days to the current format. I was the first class to experience this new format.

 

Just sent you a PM.

 

ahh that F threw me off. when i originally applied i got used to the "NUMS" abbreviation they liked ot use.

 

UCSF has a curriculum that is largely a 'hybrid' of small group, problem based learning, and lecture. I really like it a lot so far. The lectures are mainly to give background information about what we focus on in the labs (anatomy, histology, radiology). We also meet up to do 'surface anatomy', where we take our shirts off and draw on each other with erasable markers (girls where sports bras, bathing suits, etc). It is actually really helpful.

We have been breaking up into groups of 10 or so (this is our small group) and interactively reviewing the basic principles of pharmacology and cell biology about every other week.

We have one PBL case per block (about two per quarter) where we go over a case and develop a problem list and a learning list, which gets divided amongst the pbl group (which is a different group than the small group). We then go research the answers to our questions and post them online (we have a pretty amazing online curriculum/forum/self-assessments/etc).

We also belong to another smaller group for a course called foundations of patient care. Six of us, along with a preceptor, go into the hospitals (once a week) and interview a patient. For example, next week me and another classmate have to interview a cardiovascular patient about the chief complaint, past medical history, health related behaviors, family medical history, etc..They have us interviewing patients one week into school.

We have ANOTHER small group that meets starting in October where we practice physical examinations on one another.

All in all, we have about two hours of lecture per day, along with two hours of either lab, small group, or pbl. Then, once a week we have the clinical course as well (2 hours in the afternoon).

All of the subject material is presented to us in block systems. For instance, we have prologue now, then a cardiovascualar block to finish the quarter. Then, after new year's we have pulmonary, renal, cancer, and brain mind and behavior to finish our the first year. I think it is pretty sweet to learn about both the basic science and pathology of organ systems. Having things integrated like that leads to less redundancy and is a lot more efficient.

 

The New Pathway program at HMS has a PBL curriculum that does include some lecture hours. A typical week for the first-year Human Body block (anatomy) is as follows:

Mon/Wed/Fri:
8:30-9:30: Tutorial
9:30-11:00: Lecture
11:00-12:30: Histology or radiology lab

Tue/Thu:
8:30-9:30: Tutorial
9:30-12:30: Anatomy lab

One afternoon (about 4 hours) a week: Patient-Doctor course--interviewing patients.

One afternoon (about 2 hours) a week : A Social Medicine course, which is required.

The daily tutorial is the core of the curriculum, where real clinical cases, taken from the Harvard hospitals or the NEJM, are discussed. Each case lasts about 4 days. The cases are related to the material being covered in lectures. Eight students and one tutor--a Ph.D. or M.D.--are in each tutorial group.

For example, we just finished a case of meningitis. We of course have to know the anatomy of the head well but also have to explore all the clinical details of the case. There are no questions to lead us at all. On the first day, all we're given is a medical report. We have to determine which tests to do, which questions to ask the patient, etc... in order to arrive at a differential diagnosis. On the second day, we are given the test results, etc... and we now have to determine the next step: viral or bacterial? treatments? possible outcomes?... We also have to interpret CT images... Each member of the tutorial is responsible for certain topics and have to "teach" the others on those topics.

These cases make learning so much fun. Not only do we have to read Moore, but we become very familiar with Harrison's and Robbins...

The free afternoons are very nice as well. I use mine to shadow physicians, do clinical research, do basic research, and run a non-profit organization.

The PBL curriculum with no letter grades keep us all interested, sane, and relaxed, and, perhaps more importantly, it gives us some free time to pursue our personal interests.

And I don't think any HMS student is very worried about their performances on the boards due to the curriculum.