Rate PBL vs Traditional Lecture

[1olddoc]

Just want to see feedback on PBL vs Traditional Lecute Methods of Learning Medicine.
Curious about Long Term Understanding/ Retention of Material, etc.

Please Reply with School in Which You attend. Thanks

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[Qafas]

I'm interested in this as well. I've never done any formal PBL, but don't think I'ld want to either. Perhaps I'm misinformed about PBL, but I just don't think it covers the basics as well as traditional lecturing does. Would love to hear from people with first hand knowledge.

 

[Wrigleyville]

At Northwestern, we have PBL on top of lectures. It's not an either-or proposition. PBL is a way of integrating the material and showing how the basic sciences that you're learning translate into the clinical setting. In PBL you're responsible for teaching your fellow classmates material (the 6-7 students in each class basically run it themselves-- the physician is there to just facilitate the discussion somewhat, and hand out materials, etc). Studies have shown that people retain about 90% of information that they teach to other people, as opposed to about 10% of information that they hear at a lecture.

At Northwestern the lectures are integrated -- instead of having cell bio, biochemistry, genetics, anatomy, histology etc (the basic science classes) as seperate courses, they're taught as one integrated course, called structure-function. When we do the liver, for instance, we'll go over its anatomy, biochemisry, physiology, histology, etc. The same goes for the other organ systems.

We have about 2 hours of lecture a day, with labs/ethics/PBL for about another two hours or so, and then a smattering of things in the afternoon. The curriculum is what might be described as "adult-based learning" -- in return for fewer lectures, you're expected to spend time learning on your own outside of class. Most of the people in my class have had time off after graduating from college. It is assumed that, as mature people, the students will learn the material because they want to learn it, not because it's something that the professors are spewing out and it'll be on the test.

 

[DW]

wow, that was one of the most insightful posts i've seen on this site

 

[carrigallen]

Originally posted by DW
wow, that was one of the most insightful posts i've seen on this site

likewise!

 

[1olddoc]

Thanks for your insight. Best Regards

 

[raining4days]

I third DW.

 

[Entei]

Alright, I gotta speak up for the dark side.

I, for one, really love lectures. I think I would absolutely hate being in a system where PBL comprised a large part of my learning. I like being presented with what I need to know and then learning that information instead of wasting time trying to figure out what material is important. I think that if I had to constantly look up information on my own and determine on my own what was relevant, all while having a facilitator watch me struggle, I would go nuts.

There is something to be said for having experts teach you the material that you have to learn. Yes, some of them make much better scientists than teachers, but I have also encountered ones that are fabulous at both. I, personally, would rather rely on an expert in the field to present the information to me than my classmates who are learning this material for the first time along with me. I think small groups and PBL can be valuable additions to a traditional curriculum, but I also think that they work better when the students already have some solid foundation of knowledge.

Now, these are just my personal opinions on PBL vs. traditional lectures. Obviously, there are many people out there who strongly prefer a PBL environment. I don't think that one system is better than another, except where individual preferences come into play. If you think you'd like PBL, go for it. If you'd prefer lectures, that's fine too. I think that you ultimately learn just as much in either system.

 

[souljah1]

Originally posted by Entei
I think that if I had to constantly look up information on my own and determine on my own what was relevant, all while having a facilitator watch me struggle, I would go nuts.

There is something to be said for having experts teach you the material that you have to learn. Yes, some of them make much better scientists than teachers, but I have also encountered ones that are fabulous at both. I, personally, would rather rely on an expert in the field to present the information to me than my classmates who are learning this material for the first time along with me. I think small groups and PBL can be valuable additions to a traditional curriculum, but I also think that they work better when the students already have some solid foundation of knowledge.

Now, these are just my personal opinions on PBL vs. traditional lectures. Obviously, there are many people out there who strongly prefer a PBL environment. I don't think that one system is better than another, except where individual preferences come into play. If you think you'd like PBL, go for it. If you'd prefer lectures, that's fine too. I think that you ultimately learn just as much in either system.

Ent,

Good points. I would like to add, though, that PBL sessions are 'overseen' by 'experts' who keep the dialogue from becoming tangential and also make sure the learning objectives are covered. I like having to look things up on my own and figure out what is relevant. I think they are skills that a physician must learn eventually, so why not learn them in medical school?

Our curriculum is a mix of lecture and small group/pbl. 2 hours (sometimes three) of lectures a day and the rest is small group where we discuss cases, path lab, etc. I really like this mode of learning b/c I get each successive block shows me how much things are coming together, etc. Rarely do I have to spend time memorizing any minor details. It all seems very clinically relevant. The only thing that irks me about our curriculum is the order in which we were taught some things, i.e. not getting immunology/micro until the beginning of second year, but getting taught renal, hematology, etc in your first year. Having immuno would have been great when we were discussing all those nephritides that involve Ig and complement. All in all, I REALLY like the organ-based approach and REALLY REALLY like case-based learning. Our clinical vignettes stay in my mind quite a bit longer than random textbook facts. But I do have to agree, a good lecturer can be absolutely amazing, and even more amazing when they are only two hours/day.

 

[jed2023]

Originally posted by flindophile


I think the ideal program would emphasize a PBL organ-based approach and supplement this with a series of tradional courses in a few of the subjects (e.g. biochem, micro, general path) that do not lend themselves to the PBL-organ approach.

Another course that is not well suited for PBL is pharmacology. Learning drugs according to their classes (in the context of traditional lectures) seems far more efficient to me than learning them in a piece-meal fashion with specific case presentations. For example, let's say that you have a PBL case with a guy that is suffering from organo-phosphate poisoning (maybe he was in the Tokyo subway incident with sarin poisoning). Okay, maybe you discuss atropine and pralidoxime as antidotes, but it's unlikely that you are going to cover all the cholinergic drugs, agonists and antagonists, in an integrated, cohesive fashion. But in a traditional course you would.

Originally posted by flindophile


U of New Mexico did a study of PBL vs lecture when they first started PBL. As I recall, they ran two parallel programs (one PBL and the other traditional) and compared USMLE scores on step I and II. It turned out that traditional trained students outperformed PBL students on Step I (the difference was not statistically significant) but PBL students did better on Step II (statistically significant).

This just doesn't seem very convincing to me. I think a better comparison might be to nationally compare schools that are high on the traditional end versus schools that are almost entirely PBL. Of course, you would have to adjust for a lot of factors, too.
As an anecdotal aside, the schools that I know that have average USMLE step 1 scores hovering around 230 (Columbia, Wash U, John's Hopkins, and a few others) tend mostly to be lecture based schools.

 

[Adcadet]

at my school (U of MN) we're heavily lecture-based, and we do first year material by subject (anatomy, histology, micro/immu, neurosci, genetics, etc) but second year it's organ-system based (cardiovascular/respiratory, GI, etc). What I want to point out is that if you find lectures to be mostly passive listening and low-yield, having lectures online can be really helpful. I find I learn material best by listening to the lectures on my computer, and hitting pause frequently to think about what the lecturer is staying, (look up stuff, do a sample problem, etc, basically to prove to myself what the lecturer is saying). This helps me be an active learner and makes lectures much more effective for me.

 

[DW]

Originally posted by jed2023
As an anecdotal aside, the schools that I know that have average USMLE step 1 scores hovering around 230 (Columbia, Wash U, John's Hopkins, and a few others) tend mostly to be lecture based schools.

Well, something I wonder that might partly contribute to this is also the type of students that go to these schools. if you look at their acceptance criteria, i believe these schools are 1) Wash U, 2) Columbia, and 3) JHU in average accepted MCAT scores. they're strong test takers to begin with, but thats just a small part of it I'm sure.......

the curriculum at UCSF souljah described sounds kinda like our mixed curriculum at Cornell, except we organize our blocks around subjects (biochem/histo/cell in one, anatomy/phys in another, etc) as opposed to organ systems. I really like it insofar. It is a personal preference thing like Entei said....While she loves lecture, I am generally bored senseless by an extended amount of lecturing, and enjoy the clinical context that augments the dry, intellectually devoid memorization of what we're covering in basic sciences. I at least dont find seeking out whats important very hard in our curriculum, since it is usually very clear whats important and whats not in our lectures, small group discussions, labs, and pbls.

I'm sure there is some trade off in USMLE preparation, but I can live with that given the successes of prior classes. If I had to list my primary complaint about our curriculum so far, it might be grading. The averages in our first few tests have been ~90 (note: the grapevine says our class is supposedly a lot more intense academically than the class of 2006), so it seems like the subjectively evaluated parts of the curriculum (pbl, journal club, etc) are going to factor pretty substantially into differentiating honors from passing (at least in this block we're in). I think its a rare instance for someone to get a "harmful" pbl evaluation, and I also dont care so much since I am plenty OK with p=md, but I do think for those who are shooting for honors its kinda lame. que sera, sera.

traditional versus pbl comes down to personal preference in a lot of ways, and any way you dice it you cant skip around the mountain of basic material your first two years. And had I went to columbia I'd probably be skipping a lot of class anyways

 

[Adcadet]

Originally posted by flindophile
This sounds like an EXCELLENT approach because it uses the best mode of delivery for each subject.

In addition, I think putting lectures online is an important step toward improving lecture quality. When lectures are put online, the content and delivery becomes public and available for audit. Thus, a program can insure that lectures meet a quality standard before they are made available.

Hats off to UMN!

Well, it's still a lecture approach. I think the main strength of PBL is 1)that it teaches you to find material for yourself, and 2)as a consequence of the former, you are a more active learner. My method doesn't really capture #1, other than that I occasionally look stuff up online or in a text book.

Another thing we're doing is to abstract key words from each lecture to create a curriculum database. I'm not completely familiar with it, partially because it's just now being made, but among other things it will allow one (school administrator, course director, lecturer, student, etc) to see what topics are covered in which course and lecture. Furthermore, materials from those lectures will be available - power point slides, handouts, and full lectures. And as Flindophile pointed out, all this allows for easy "audits," and should let the administration of the U of MN mold their curriculum much more finely to improve quality.

Now, these lectures are NOT public - they're only available to people in the med school. But, in theory, everybody should have access to them.