Why do I hate PBL (Problem Based Learning) Curriculum??

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woi89

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If you’re a recent medical student, you will know this curriculum so well..
Since 2007, most of Indonesia medical schools had PBL as main curriculum and style of study…
My school had used PBL curriculum in 2004, so..there are 5 batches who used this
curriculum since 2004…

well,…..if you don’t know about PBL, this is the head…
PBL (Problem Based Learning) is a way of medical learning based Problems.
PBL emphasizes medical student to cope the problem in small group by learning some objectives
So you can solve the problem,eventually….
It makes you such an adult learner because you indepently search the objectives on your own instead of being taught , based on your need of learning…..
sometimes PBL calls KBK (Kurikulum berbasis Kompetensi)in Indonesia

So every week,you will get a case from scenario about your topic in this week..
For instance…in this week,your topic is about neoplasia(cancer)..you will get a scenario talking about a patient who get colorectal carcinoma. You will solve the problem in this scenario as if you were a real doctor. you approach the problems just like a real physician would in clinic…

Sounds impressive,right??.....No, you’re absolutely WRONG…

The Surprise is real physicians actually DON'T spend 2hours in tutorial discussing the cell signalling pathways involved in colorectal cancer…
And the fact is way too much different than the concept of PBL…

And..believe me…this curriculum is not as impressive as something you heard…

Well….It's not that I hate it that much.
What I hate is Its sanctity as the highest bastion of collegial learning, I think, is too much overwhelmed…and then…
Why the hell Indonesia medical schools so freakin’ proud being a PBL school ??!!!!!

So, these are the things I hate about PBL curriculum :

A. The amount of learning time

I think the time is too short…this is the main factor why I hate PBL…

How come they hope us shovelling massive amounts of data into our tender young brains in ONE WEEK ???

In conventional curriculum, you learned parasitology in 20 classes but in PBL you just learned about 3 classes???

last time I learned antibiotics and kortikosteroid just in 50 minutes…wow…you absolutely know how important antibiotics in medicine…and you just learned this in 50 minutes???

My tutor always complain my group why We just learned the topic only in superficial. “ You should learn this topic in its real core, not only in its superficial”..she said…Well it’s easy to say..but she never felt how’s the feeling being a PBL medical student who tried “half-died” to cope the whole aspect…
I mean…

how come you can learn deeply the anatomy,histology,physiology,biochemistry of neuro system in one Week??

Hello..We have real life…We don’t use the whole 24 hours a day only for study…

My school teaches us pharmacy less (or..can I say, Barely???)than before because this curriculum…..I feel like its going to be a huge hole to fill during my clinical phase… No wonder, there are some third year medical student in my school who didn’t know at all what the function of mesenamat acid….

And…ask me about gross anatomy of neuro system..Bite me coz
I completely forgot because I just learned that formally in lecture in 50 minutes and the whole neuro system topic in ONE WEEK..

B. Lecturer

The amount time of Lecturer is too limited…50 pages of medical textbook magically transform to 50 minutes..
How can I insist my brain to get the whole information in 50 minutes??

I hate When my lecture cut out the lecturer in the main core of topic and said..”this is your next job to gain more information about this topic”..
Well…it won’t be problem if one lecture said that, but how about the whole lecture give that task… oh,my…it’s really wasting my time…
It’s getting worse when the lecture didn’t mention any source to cope this topic…then..you will find me drowning in whole old medical textbook or googling until I find the right source…and it’s very wasting my time…

C. Tutorial

is it just one /two people doing the talking while everyone else stares blankly and nods (without knowing what he/she nods for)??

C’mon…is there any of medical student who REALLY heard his friend during tutorial time??

It’s really boring listening a friend giving a clumsy explanation about the topic that a lecture could synthesize in two sentence. And It’s quite annoying when my tutor, who experts with the topic of the scenario, chuckled hearing my explanation. But when our group asked her/him about the topic, didn’t want to give information, because he/she should not give mini lecturer in tutorial, instead of that, asked me to searching this information...(why don’t you just give that information??)

When I finished my tutorial..sometimes I muttered "Man... that tutorial was 2 hours of my life I'll never get back".

D. Plennary Discussion

Well..the concept of HUGE class of groups making a discussion about medical case sounds impressive…but the fact is…..well…awful…

What I really hate is when An outstanding-brilliant medical student tried to make him/her impressive by asking a question ( who obviously he/she completely knows about that) to his/her an average medical student….

But actually that’s not the real problem..
The real problem is when there’s no any expert come to the plenary discussion..

I mean…you come to plenary discussion due to want getting the new information or clearing some misunderstanding in tutorial…
But…when you enter the discussion room, there’s no any expert..
Just your classmates giving presentation that material had given in lecturer…
And when you asked your question…..your classmates said..
“ I’m sorry..I can’t answer that question because our group don’t discuss that topic and we don’t have any information about that…”
SO WHAT’S THE POINT?????

And How come they hope us to learn each other while we had same question, same source, same amount of time to cope with this problem???

and there are so many reason why do I hate PBL…

Being PBL medical student...

the worst feeling being a PBL medical student is feeling that all the work I do is valueless because I forget most of what I learn within a week after any given exam. We're given a mountain of information to learn in a ridiculously short period of time ….so we study countless hours a day and all night trying to cram it all in. But then we take the exam, may or may not do well, but either way move on and end up forgetting the previous block and try to remember the mountain of information in next block….

We always argue that it's just Indonesia culture who can adapt the way of PBL...
but I changed my mind when I read some thread in studentdoctor.net/forum
Even US medical students relieved that they don't really like PBL because its inefficiency..
check out that sites...and you will find interesting statement...

However, on the other hand, I have to admit that PBL had made a new academical aura in our school (with the concept of self studying). PBL can be entertaining (usually in inverse proportion to how efficient/on-topic your discussion is). It may serve as some vague approximation of how medicine is practiced in the real world (the way of team to solve the clinical problem). It's a great way to get to know your classmates. And one is less likely to fall asleep than during a lecture (hahaha…think about my high school moment)….

But Sometimes I wonder How it will make difference if medical schools in Indonesia mix the PBL/KBK curriculum with the conventional curriculum…
 
I am a PBL proponent but I am not even going to state why I like it. What I will do is say that every problem that kid has with PBL can be extrapolated to the study of medicine as a whole, regardless of the curriculum.
 
I am a PBL proponent but I am not even going to state why I like it. What I will do is say that every problem that kid has with PBL can be extrapolated to the study of medicine as a whole, regardless of the curriculum.

Agreed. That guy wasn't complaining about PBL, he was complaining about medical school.
 
woi89;7895378Hello..We have real life…We don't use the whole 24 hours a day only for study…[/quote said:
Silly Indonesians. 😀

The amount time of Lecturer is too limited…50 pages of medical textbook magically transform to 50 minutes..
How can I insist my brain to get the whole information in 50 minutes??

Sounds like you have 50 pages of a textbook to read.

is it just one /two people doing the talking while everyone else stares blankly and nods (without knowing what he/she nods for)??

Most of the people in my PBL group don't bother relating the material to the case and will often ramble on about something irrelevant.

C'mon…is there any of medical student who REALLY heard his friend during tutorial time??

Yes.

It's really boring listening a friend giving a clumsy explanation about the topic that a lecture could synthesize in two sentence. And It's quite annoying when my tutor, who experts with the topic of the scenario, chuckled hearing my explanation. But when our group asked her/him about the topic, didn't want to give information, because he/she should not give mini lecturer in tutorial, instead of that, asked me to searching this information...(why don't you just give that information??)

Its not a lecture. Its fairly unprofessional and rude for your director to chuckle.

What I really hate is when An outstanding-brilliant medical student tried to make him/her impressive by asking a question ( who obviously he/she completely knows about that) to his/her an average medical student….

We usually have average students asking dumb questions.

Just your classmates giving presentation that material had given in lecturer…
And when you asked your question…..your classmates said..
" I'm sorry..I can't answer that question because our group don't discuss that topic and we don't have any information about that…"

We generally don't look too kindly in our groups of people regurgitating lecture information. You are supposed to use NIH, google scholar, and journals to find information. I usually use wikipedia and read abstracts to figure out what I'm going to say.

From what I understand you have a very poor implementation of PBL at your university.

In my own PBL group we have a director who is very lenient with stupidity and is of the mentality that there are no stupid questions or stupid topics of discussion. She encourages us to "think" by throwing out a random and bizarre diagnosis and encouraging us to entertain it.

We have to waste 15 minutes discussing why a 40 year old patient's mother might be coming in to the hospital with her before our director announces that she has down syndrome--something that would be obvious immediately in a realistic setting. Then some girl is obsessed with her opinion that because the down syndrome patient is pregnant she had to have been raped despite the patient saying she had "many boyfriends" at her job, which employed other mentally handicapped people. She couldn't deal with not having the last word so we spent 30 minutes on the topic explaining to her that this is not a fact, just her opinion.

This week the people(yes, 2 of them) responsible for presenting the previously existing condition(angina pectoris) didn't cover the mechanism. My group then discussed it as though the problem was a lack of deoxygenated blood to the heart through the systemic circuit. I had casually looked it up prior and asked if it was a lack of oxygenated blood flowing to the heart impeding its function...the entire group shut me down. I figured I didn't have any sleep the night before and might not want to push it and look dumber than usual(I have asked some pretty dumb questions). An hour later they reach the same conclusion. Not understanding the basic mechanism makes PBL useless.

We waste so much time entertaining people's pet theories(one group member refused to believe it was a heart attack despite the history of angina pectoris, his audible systolic murmur, his collapse, mitral valve regurgitation, etc.) Nope, to him the pulmonary edema was the primary cause. The same girl was arguing for "high cholesterol"...I don't think she understood that we were supposed to be discussing the immediate causes of his heart attack an hour prior and not waxing on about his history.

Part of the problem is the diagnosis is usually so obvious after 45 minutes that we just bull**** our way through the next 3 hours.

Do you guys have any gems of stupidity you would like to share?
 
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Thankfully we don't have PBL very often (so it actually is enjoyable when we get to have PBL time) - but our program loves to fill patient histories with red herrings.

I think every PBL patient history I have ever seen has described the patient as having 2 pet cockatiels, just returning to India, and having some rare (but generally silent) genetic disease. I swear, one of these days, it will actually be avian flu or TB, darnit!
 
My wife didn't enjoy PBL. She would have preferred the traditional approach. I think there are pros and cons, but you have to know yourself. If you're someone who can be self-motivated and driven to read and study independently, then PBL can work really well.
 
I go to a 100% PBL school and hated it at first. I ended up deciding to do my own thing near the end of year 1. I listened to Goljan early and brought the SDN-recommended board books (BRS physio, CMMRS, HY Beh Sci etc). I read them instead of the PBL reports. I liked how reading things chapter by chapter in books felt cohesive, whereas PBL jumps around. At first, it wasn't easy. Some board review books don't make sense if you don't have the foundation. You really have to choose the right book. But over time, things started to stick. Meanwhile, I did the minimal work necessary for PBL. I found I could pass a PBL triple jump even though I was studying totally different topics on my own. By second year, it was clear that I was actually ahead of my group even though I think I was spending a lot less time studying than other people too.

By not taking PBL too seriously, I found that I was a lot happier. I no longer worried about missing things. I didn't expect anything from the sessions, so if one day was helpful, then I was really happy, but if not, I was totally fine with it as well. I ended up being friends with some of the people who I initially found really frustrating to work with. Of course, I'm better friends with some of the other classmates who felt the same way about PBL as me.

I think any curriculum will have portions which you think are a waste of time. As a PBL student, I never faced any of the "basic science PhD from hell" experiences. It's really up to you to find a way that works and try to make yourself happy. In retrospect, I would even whole-heartedly recommend PBL to applicants.
 
I liked PBL and put lots of effort into it...but I kind of felt burned once I started studying for Step I. I think it's a good idea, fosters teamwork, more complex problem solving etc., but don't count on it for content.

PBL should be something in addition to a solid lecture series...
 
i found it to be an amazing learning experience when it is done correctly. I am was fairly sure that I could solve any basic problem and gain basic knowledge on my own in any field after PBL. and yes OP you don't like medical school.
 
From what I understand you have a very poor implementation of PBL at your university.

In my own PBL group we have a director who is very lenient with stupidity and is of the mentality that there are no stupid questions or stupid topics of discussion. She encourages us to "think" by throwing out a random and bizarre diagnosis and encouraging us to entertain it.

We have to waste 15 minutes discussing why a 40 year old patient's mother might be coming in to the hospital with her before our director announces that she has down syndrome--something that would be obvious immediately in a realistic setting. Then some girl is obsessed with her opinion that because the down syndrome patient is pregnant she had to have been raped despite the patient saying she had "many boyfriends" at her job, which employed other mentally handicapped people. She couldn't deal with not having the last word so we spent 30 minutes on the topic explaining to her that this is not a fact, just her opinion.

This week the people(yes, 2 of them) responsible for presenting the previously existing condition(angina pectoris) didn't cover the mechanism. My group then discussed it as though the problem was a lack of deoxygenated blood to the heart through the systemic circuit. I had casually looked it up prior and asked if it was a lack of oxygenated blood flowing to the heart impeding its function...the entire group shut me down. I figured I didn't have any sleep the night before and might not want to push it and look dumber than usual(I have asked some pretty dumb questions). An hour later they reach the same conclusion. Not understanding the basic mechanism makes PBL useless.

We waste so much time entertaining people's pet theories(one group member refused to believe it was a heart attack despite the history of angina pectoris, his audible systolic murmur, his collapse, mitral valve regurgitation, etc.) Nope, to him the pulmonary edema was the primary cause. The same girl was arguing for "high cholesterol"...I don't think she understood that we were supposed to be discussing the immediate causes of his heart attack an hour prior and not waxing on about his history.

Part of the problem is the diagnosis is usually so obvious after 45 minutes that we just bull**** our way through the next 3 hours.

Do you guys have any gems of stupidity you would like to share?

Yikes! It seems as if patience (of which I have none!) is an indispensable must for PBL students. It would take about a week for all my group members to hate me.
 
I liked PBL and put lots of effort into it...but I kind of felt burned once I started studying for Step I. I think it's a good idea, fosters teamwork, more complex problem solving etc., but don't count on it for content.

PBL should be something in addition to a solid lecture series...

this pretty much sums up my experience.
 
Had a classmate who wanted everything(including a MI) to be an asymptomatic UTI related to diabetes.

I know a guy that quotes House ad nauseum.

Dude, we're first years there's no way they're going to put a case about primary amebic meningoencephalitis. I hate to break it to you.
 
Had a classmate who wanted everything(including a MI) to be an asymptomatic UTI related to diabetes.

I really don't understand these people. Sometimes its so clear...
PBL guy #1: "I think its beta thalassemia major"
PBL guy #2: "you just said that it doesn't manifest symptoms at birth because you still have high fetal hemoglobin. how does that fit? the infant is suffering from anemia at birth"
PBL guy #1: *rambles*

Its as though its ok if some symptoms don't fit because 90% of them do. And the mechanism? Obviously its some bizarre mutant version! :laugh:

Come to think of it PBL actually is fairly enjoyable. Its a nice way to kick up your feet and listen to people say some outrageous things.
 
Its as though its ok if some symptoms don't fit because 90% of them do. And the mechanism? Obviously its some bizarre mutant version! :laugh:

I'll take 90% of the symptoms matching for a diagnosis. Penetrance can be a funny thing.

Bizzare mutant mechanisms are another story.
 
In terms of quality of content, PBL probably won't match your lectures and a textbook will probably present it more clearly.

The good points of PBL is you get to meet your classmates in a non-classroom setting, learn to work in a team setting and have a chance to talk. Cause sitting in a room for 20hrs+ listening to someone else speak can get boring real quick if it's a bad week
 
In terms of quality of content, PBL probably won't match your lectures and a textbook will probably present it more clearly.

The good points of PBL is you get to meet your classmates in a non-classroom setting, learn to work in a team setting and have a chance to talk. Cause sitting in a room for 20hrs+ listening to someone else speak can get boring real quick if it's a bad week

I don't know. I'm always concerned if I'm making enough points to "honor" the class since we have stupid subjective evals for it.

It's not malicious, but you can tell that everyone is trying to get the last word because they don't want to be the "dumb" one in the corner not saying anything.
 
I don't know. I'm always concerned if I'm making enough points to "honor" the class since we have stupid subjective evals for it.

It's not malicious, but you can tell that everyone is trying to get the last word because they don't want to be the "dumb" one in the corner not saying anything.

I concur. I feel like I always have to contribute something during PBL. Been "somewhat shy", I end up saying the most outrageous things (even thogh they make sense sometimes)and end up feeling way worse than I started. The things I say are not necessarily wrong but they come out differently than I planned. I am soft spoken and kind of small, so when I try to talk sometimes, everything I say gets disregarded and it makes me feel so bad and doubtful, then I stammer. I have had good pBL groups (about two so far) where I'm very comfortable and able to speak out loud without feeling stupid.

The people that ramble a lot (even the smart ones) say wrong things all the time but the difference is that, they are very confident. They ramble more to save face and move on.

I hope that I learn how to work the PBL process before third year
 
Hate PBL. Why?
1. I have to wake up early to make it to the 8AM session just to do the presentation and listen to my classmates.
2. I don't listen to my classmates presentation anyway.. why? Because they could be wrong.. they often are. What do you expect? The blind leading the blind.. good luck with that..
3. There is a case wrap-up after each PBL session by an MD.
So, why do we need PBL again?

PBL is total BS.
 
We had some PBL sessions in my school. looking back at them now that I have a lot of experience under my belt, I wonder just how we came up with half the stuff we had on our differential lists...
 
They created PBL based on the case learning method business students use. Yep, if you've ever met any of the genius MBAs who have done so well with the economy by learning about important topics like "synergy", remember, PBL got them where they are. We can only hope medical students gain the same level of competence. 😎
 
I am a PBL proponent but I am not even going to state why I like it. What I will do is say that every problem that kid has with PBL can be extrapolated to the study of medicine as a whole, regardless of the curriculum.

Word. I don't like PBL... and to be honest... I don't like lecture too much either. Either way... you have to learn it... and it's gonna suck.
 
To me, PBL is one of those things that sounds very good in theory but doesn't pan out that well in real life. It is arguably the worst invention in medical education.
 
I go to a 100% PBL school and hated it at first. I ended up deciding to do my own thing near the end of year 1. I listened to Goljan early and brought the SDN-recommended board books (BRS physio, CMMRS, HY Beh Sci etc). I read them instead of the PBL reports. I liked how reading things chapter by chapter in books felt cohesive, whereas PBL jumps around. At first, it wasn't easy. Some board review books don't make sense if you don't have the foundation. You really have to choose the right book. But over time, things started to stick. Meanwhile, I did the minimal work necessary for PBL. I found I could pass a PBL triple jump even though I was studying totally different topics on my own. By second year, it was clear that I was actually ahead of my group even though I think I was spending a lot less time studying than other people too.

By not taking PBL too seriously, I found that I was a lot happier. I no longer worried about missing things. I didn't expect anything from the sessions, so if one day was helpful, then I was really happy, but if not, I was totally fine with it as well. I ended up being friends with some of the people who I initially found really frustrating to work with. Of course, I'm better friends with some of the other classmates who felt the same way about PBL as me.

I think any curriculum will have portions which you think are a waste of time. As a PBL student, I never faced any of the "basic science PhD from hell" experiences. It's really up to you to find a way that works and try to make yourself happy. In retrospect, I would even whole-heartedly recommend PBL to applicants.

What school is 100% pbl?
 
My school has a systems based curriculum, and in each system we have PBL. Of all the courses in the first two years, in only one of them did I feel that PBL was well-implemented.

The cases were very well written, the questions walked that thin line between providing enough guidance so that we weren't fishing around aimlessly but not so much that it gave us the answer, the facilitator did a good job of guiding the discussion (and cutting people off when they were entertaining clearly ridiculous ideas) without turning it into a mini lecture, and I had a very good group of classmates. The course coordinator also specified that nobody was allowed to use Powerpoints or handout of any kind, and should be discouraged from reading their answers from their own notes. He wanted us to draw any diagrams and charts by hand on the overhead while explaining them and/or asking our classmates questions.

So in other words, a perfect storm. The sessions were always engaging and actually useful. In every other course's PBL session I would fall asleep with my eyes open as people got up and read their Powerpoint slides word for word.
 
That video is funny. In fairness I hate PBL too, but a lot of the time the stuff is interesting. I guess having a time constraint on learning stuff can take the fun out of it!
 
I'm not a huge fan of PBL either, but it beats sitting in lecture from 9 to 5.

...so, what is the best way to teach the preclinical years? any new ideas?
 
I really like the way my school does PBL. Yea we end up only having about 8 hours of small group time and 8 hours of lecture time each week and the rest is self-study(our schedule is just 8-12 am 4 days a week). We're lectured on the most salient topics and in the end our curriculum probably only explicitly gets to around 60-70% of what's tested on the national board in terms of detail. But all the resources to learn all the information are available and if done right most students can get alot out of going over the concepts with the problems explained in detail in an interactive fashion.

I think a big key to this is that it's pure pass/fail with no internal ranking in preclinical and all the tests are short-answer and not really focused on small details. It's alot less stressful and lets you focus on just making sure you know the framework and then you have all the time in the world to study the details around it when researching for the cases. No matter what, you're gonna have to do a ton of reading whether the curriculum's PBL or not, I've found for me this curriculum has been working really well as it's kept me really interested in the material and wanting to read the big textbook for every subject as they're each just randomly brought up as we go through the organ systems rather than taking them as huge classes one by one. I also by nature of encountering the topics randomly in many different contexts end up using several sources(the texts on mdconsult/access medicine, up to date, lecture materials, actual textbooks, review books, etc) and getting everything i learn embedded in a network of knowledge.

I think a potential problem with PBL for some people is that's a different style of learning to some degree. You learn all the subjects simultaneously when you go organ system to organ system and since PBL cases involve patients, they involve disease with a pathologic component that can go over students' heads as they're just trying to figure out the normal cellular and physiological material, not to mention the anatomical/histological structure. You have to be able to deal with all these things simultaneously and learning them together. I found them all related though and I think it saves a lot of time then doing all the subjects separately and taking two years when you can start learning pathology in your first year so everything you learn in the other subjects has context and do it in a smaller amount of time. (My school finishes preclinical in march of second year and we start clinical rotations or our research block depending on student then.)

I can agree it's really not for everyone and you really have to know what you're doing in order to be successful. I did have a really strong physio/biochem background and just am really good with all the math needed for pharm. I'm also taking a graduate pathology class on the side(which i had time to do because of the abundant free time with the PBL) to learn more.
 
See attachment for an article showing the benefits of PBL on USMLE scores.

The issue is that PBL works some places when it's done well... and like anything that's successful, it has spawned immitators that don't quite grasp the concept.

If it's the cornerstone of a curriculum, PBL can be a valuable tool that encourages independent learning. If it's a few hours a week tacked onto a traditional lecture curriculum, it is a distraction.

So why is it shoveled into the curriculum? Because it sounds nice to the educators, the deans and the premeds. Plus there was that study at that PBL school that showed that 100% PBL-> higher board scores, we can generalize that to our 2 hrs of PBL a week, right? 🙄
 
The issue is that PBL works some places when it's done well... and like anything that's successful, it has spawned immitators that don't quite grasp the concept.

If it's the cornerstone of a curriculum, PBL can be a valuable tool that encourages independent learning. If it's a few hours a week tacked onto a traditional lecture curriculum, it is a distraction.

So why is it shoveled into the curriculum? Because it sounds nice to the educators, the deans and the premeds. Plus there was that study at that PBL school that showed that 100% PBL-> higher board scores, we can generalize that to our 2 hrs of PBL a week, right? 🙄

👍 I think you nailed it here.

When implemented as the foundation of a curriculum along with students who are motivated/wired to learn that way it can be beneficial. From what I've seen on here it seems like it tends to get "tacked on" to a traditional curriculum where it no longer serves a way to approach the basic sciences, but as just another activity that takes up valuable time during the week.
 
pBL is done horribly at my school. It's a huge timewaster and I'm glad it's mostly done now. Ugh. First year would have been ten times easier w/o it!
 
Anyone hear anything about Miami's PBL curriculum @ FAU. The students I met seemed pretty happy.
 
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