Problem Based Learning - Yea or Nay

Red_Marauder

When I started college, PBL was being introduced, or had recently been introduced, to various Irish health sciences courses based on a number of successful trials in Scottish institutions.
I have to say I found it extremely useful. It allowed us to apply all of the tedious theory about anatomy and biochemistry and parasitology and ethics with a really practical application, which after all, is meant to be the whole point of a health sciences education imo.

But 6 years on, PBL is still only a tiny part of my own course, and I know the case is similiar in other institutions.
Why are entire health science courses not taught through PBL (Dental Science in TCD is the only full time PBL course as far as I'm aware - or used to be)
Surely it is the best method we have for teaching undergraduates the basic theoretical skills they will need to apply throughout their professional careers.

Carsinian Thau

I wholeheartedly disagree.

PBL is far far inferior to didactic teaching courses. It allows for gaps in knowledge to develop and when it moves into project work, it punishes hard working students while rewarding those who are prepared to sit back and do nothing.

I think as a process that it is simply too flawed and only exists to give those in charge less to do. I would go so far as to advise any prospective student to put a PBL course at the end of their list.

Just take a quick read around here. You will be able to find a few posts from student lamenting PBL and cursing its pitiful existance.

Don Keypunch

Carsinian Thau wrote: »

for gaps in knowledge to develop and when it moves into project work, it punishes hard working students while rewarding those who are prepared to sit back and do nothing.

.

Elaborate

Carsinian Thau

Don Keypunch wrote: »

Elaborate

Not until you say "please".

PhysiologyRocks

I'm not a big fan.

For the little extras, I'm sure the FOFOY approach is just lovely.

I neither want to be a self-taught doctor, nor the patient of one.

Carsinian Thau

PhysiologyRocks wrote: »

I neither want to be a self-taught doctor, nor the patient of one.

I should have mentioned this earlier too.

Justified or not, I would have doubts over the competency of those who had to fend for themselves. When it comes to people's lives and health, no-one has the right to take unnecessary risks. And I believe FOFOY learning constitutes just that.

ORLY?

Carsinian Thau wrote: »

Just take a quick read around here. You will be able to find a few posts from student lamenting PBL and cursing its pitiful existance.

Yes, but I don't think any come from those who are pursuing a course where PBL is not just done as an aside. I can see how when it's not being fully embraced that people would think that it's not great.

I'm in UL and it's mainly PBL, which is accompanied by lectures and anatomy tutorials.

It definitely takes getting used to, but now that I'm used to it I find it far superior to lectures alone. I find that I get much more work done in a week and much more information assimilated than I did in my 1st degree through lectures, which would of been of similar intensity to medicine.

ORLY?

Carsinian Thau wrote: »

I should have mentioned this earlier too.

Justified or not, I would have doubts over the competency of those who had to fend for themselves. When it comes to people's lives and health, no-one has the right to take unnecessary risks. And I believe FOFOY learning constitutes just that.

I don't quite get this. Just because the information is given to someone in lectures, doesn't mean they are going to study the information, hell they might not even go to the lectures. Someone could attend thousands of lectures and never look at the material after. At least PBL report back gives some indication as to whether students are studying and learning the information as they go along.

Also, what is the story during clinical rotations? Is it not up to students to research whatever they see in the hospital? Is this not self directed?

Even after qualification, whatever anybody says about whatever med school they went too I don't believe that it's possible for a med student to know everything about everything they will come across. Things will come along that you need to investigate and learn more about - FOFOY learning as you call it.

Red_Marauder

Carsinian Thau wrote: »

I wholeheartedly disagree.

PBL is far far inferior to didactic teaching courses. It allows for gaps in knowledge to develop

I can think of occasions when it was the opposite.

Like I said, most of my course was not done through PBL. We studied renal physiology in second year - but histology, embryology and gross anatomy of the kidney in first year.
By the time I got around to studying reproductive health in clinical years, I had totally forgotten everything about physiology and anatomy of the reproductive systems we had studied in earlier years... much of our lecture time involved rehashing the whole thing again.

My point is that PBL is a string the ties everything in together. You must learn about medical science from an inter-departmental way which incorporates practical and theoretical information, because that is how things happen in real life practice.
Since I qualified, I have found myself going over my old PBL notes far more often than I have gone over any other one piece of my note collection from my undergrad days.

and when it moves into project work, it punishes hard working students while rewarding those who are prepared to sit back and do nothing.

Can you explain why you think it punishes hard working students?

only exists to give those in charge less to do.

In my experience, certainly at pre-clinical level, our lecturers were contracted to spend the same time they would have spent teaching in a lecture hall involved in PBL work instead - we saw them the same amount.
I don't think it has anything to do with ridding lecturers of teaching obligations.

A Neurotic

I've had half a year of PBL at this stage, and have mixed feelings about it.

On the one hand, I find that researching and actually discussing various aspects of a certain disease/biological process/whatever within the PBL group makes it far easier to recall than simply hearing it in a lecture and/or reading it in a textbook. The ins and outs of MS, organophosphates and haemopoiesis spring to mind far more readily than information learned outside of PBL from last semester. That's obviously a subjective account, but I'd bet that it's the same for most of my classmates.

On the other, it can be a frustrating experience and a waste of time if you're in a bad group. Often people compete for marks by dominating the discussion and, frankly, talking out of their arses for as long as possible. Seeing as it's up to a volunteering student and not the actual tutor to chair the discussion, this is permitted much more than it should be. This wankery is generally what makes PBL hell, for me anyway.

Carsinian Thau

A Neurotic wrote: »

On the other, it can be a frustrating experience and a waste of time if you're in a bad group. Often people compete for marks by dominating the discussion and, frankly, talking out of their arses for as long as possible. Seeing as it's up to a volunteering student and not the actual tutor to chair the discussion, this is permitted much more than it should be. This wankery is generally what makes PBL hell, for me anyway.

This is my major objection to it. And why I feel it can "punish" hard working students.

There's obviously more to it than that but I have to be up early tomorrow (ironically for PBL) so I'll address anything else I said at a later date.

A Neurotic

PhysiologyRocks wrote: »

For the little extras, I'm sure the FOFOY approach is just lovely.

Carsinian Thau wrote: »

And I believe FOFOY learning constitutes just that.

Forgot to include this in my first post: would anyone care to inform me of what FOFOY stands for?

ORLY?

A Neurotic wrote: »

On the other, it can be a frustrating experience and a waste of time if you're in a bad group. Often people compete for marks by dominating the discussion and, frankly, talking out of their arses for as long as possible. Seeing as it's up to a volunteering student and not the actual tutor to chair the discussion, this is permitted much more than it should be. This wankery is generally what makes PBL hell, for me anyway.

Sorry, what do you mean by compete for marks?

I think FOFOY stands for F off and find out yourself.

A Neurotic

Perhaps compete was the wrong word. At the end of each PBL session we're asked to mark ourselves out of 10 based on how we feel we performed. We're given guidelines for marking ourselves, based on knowledge of topic; ability to quote research without checking notes; keeping conversation flowing; not dominating; drawing quieter students into the discussion, etc.

Usually what this equates to, in my experience, is certain students trying to get a word in on every point made, no matter how irrelevant or uninformed their opinions are, in the hopes of justifying a score of 8 or 9 out of 10. It's ridiculous. It completely defies the specific guidelines given to us for marking ourselves, but people seem to feel that if they manage to talk for x minutes they get their 8.5 marks. It's a major pet peeve of mine.

ORLY?

A Neurotic wrote: »

Perhaps compete was the wrong word. At the end of each PBL session we're asked to mark ourselves out of 10 based on how we feel we performed. We're given guidelines for marking ourselves, based on knowledge of topic; ability to quote research without checking notes; keeping conversation flowing; not dominating; drawing quieter students into the discussion, etc.

Usually what this equates to, in my experience, is certain students trying to get a word in on every point made, no matter how irrelevant or uninformed their opinions are, in the hopes of justifying a score of 8 or 9 out of 10. It's ridiculous. It completely defies the specific guidelines given to us for marking ourselves, but people seem to feel that if they manage to talk for x minutes they get their 8.5 marks. It's a major pet peeve of mine.

Feck sake, that sounds like a bit of a waste, people always know where they really lie without having to fill out self assesments. Where do you study?

A Neurotic

Trinity. I should point out that my personal feelings on PBL are not representative of those of the student body as a whole and that my views may be biased based on particularly bad groups/tutors/whathaveyou :P

ORLY?

A Neurotic wrote: »

Trinity. I should point out that my personal feelings on PBL are not representative of those of the student body as a whole and that my views may be biased based on particularly bad groups/tutors/whathaveyou :P

How much of a role does PBL play there?

A Neurotic

Two-hour sessions, twice a week, for first year only. I'm not entirely sure, but as far as I know they all add up to something like 5% of the semester in each module. I could be very wrong there, but I've heard that figure thrown around.

Oh, and we also have Behavioural Science tutorials once fortnightly that sadly also take the PBL format.

Red_Marauder

A Neurotic wrote: »

Seeing as it's up to a volunteering student and not the actual tutor to chair the discussion, this is permitted much more than it should be.

In my experience it is the tutor who chairs the discussion and keeps the whole affair on the rails, asks questions, and so on - I'm not sure I would agree with students doing that.

I think it was you who also mentioned self-marking. We didn't do that ourselves, and often had exams after the PBL cases based on what we had learned. We also handed up assignments.

I think when we say PBL, it's clear that methods vary from institution to institution quite a bit.

Vorsprung

What you learn in Medical School is a mere basis, and emphasis on the mere, upon which you learn to be a doctor. No matter how much you think you've learn at college, or what way you've learnt it you may be sure that your first principles go out the moment you first have to deal with a sick patient on your first night on call. The real learning starts as an intern.

Miss Lockhart

I also learned through PBL for much, but not all, of my degree and I loved it for the same reasons Red_Marauder mentioned - getting to put it all together and seeing the point in learning seemingly irrelevant, obscure material. However, although we learned through PBL, and were examined following some PBL cases, we were still examined normally at the end of semester 1 and 2, just like any traditional course.

Interestingly, my friend is currently completing a phd in the area of education and is studying PBL methodologies at third level as part of her work. Her work is only half way through though, so not published or anything yet.

She has studied the outcomes of two groups of first years following the same 3rd Level course - one taught by PBL, the other not - with both groups examined in the traditional manner of end of semester written and oral examinations.

So far the results show that the top marks for the non-PBL group were marginally higher but that the lowest mark for the non-PBL group was also much lower - in fact nobody failed at all in the PBL group.

Additionally, when both groups were re-examined on 1st Year material while in 2nd Year the non-PBL group did quite poorly, especially when compared with the PBL group whose results were almost as good as they had been on the original exam. Basically, the PBL group seemed to remember the material much better one year on.

Obviously there's a lot more work to do on the project but this is how it's shaping up so far.

Red_Marauder

I'm going to try read up on some PBL studies like that because it is interesting.

I had an Anatomy Professor in first year who I thought I would try to sweeten a bit when I started to foresee a bit of a sticky situation with my gross anatomy exam.
To say he took the FOFOY approach would be an understatement. He point blank refused to answer any of my questions until I showed him the lengths I had gone to in order to get my answers.
The reasons for this - and I respect him for it now - is that we never really appreciate what we don't work for.

I don't remember a lot of what was rattled off to me in lecture theatres, and what I learned by heart in turn. However, it's the topics I rented books on, questions I trawled through dusty old journals for, and pretty much anything that made me personally engage with a topic, that I remember the most. This, I think is a huge part of PBL.

There is also a lot to be said for working in small group collaborative situations.
The informal nature of learning through PBL abolishes self-conscience. I recall asking the types of questions a two-year old might ask during those PBL sessions, whereas I would never have asked such questions in a lecture theatre or in front of an academic for fear of it being seen as too elementary. In fact, the most important questions usually are elementary.

I think that PBL, as long as it is run properly and the material is examined accordingly, has the potential to be a huge assett to professional education.

Narkius Maximus

Vorsprung wrote: »

What you learn in Medical School is a mere basis, and emphasis on the mere, upon which you learn to be a doctor. No matter how much you think you've learn at college, or what way you've learnt it you may be sure that your first principles go out the moment you first have to deal with a sick patient on your first night on call. The real learning starts as an intern.

Agree wholeheartedly with this. Until you are hands on, you know nothing. Prepare for a brave new world. It really amazes me how much I chucked in the dark recesses of the brain the minute I put on my intern coat. Forget issues with PBL/ FOFOY?? etc and get out the books and learn, learn, learn. All med students are self taught! We can show you how to do examinations, you may pick up on little tricks, but if you don't do it for yourself, you'll never do it.

PhysiologyRocks

Okay, I understand that PBL vs. Lectures is not even close to being the main aspect of medicine, but I do find that depending on the group, 'let's all learn together' style sessions can make things very difficult.

For example, I may study a particular topic very well and thoroughly prior to a session. Student X may spend 5 minutes on Wikipedia, and misinterpret the topic. Even if I previously knew the material very well, X's poor understanding (combined with his/her vocal nature) could lead to me having to review the topic more than would otherwise be necessary, just to make sure I have it straight. (It's not that I wouldn't revise the topic anyway, it's just that I'd rather not search for info with the aim of making sure it's not true!)

Of course I'll need to take off the training wheels sooner or later. I'll self-teach once I know what I must learn. Still, I'm medically but an infant, and appreciate all the direction I can get in these early stages (2nd year).

I have certain friends with whom I am delighted to study. These are people who will prepare and be able to reference their sources.

I'd rather not be tossed in with a random group, some of whom work, others who don't. A little knowledge is a dangerous thing.

EDIT: My reference to self-teaching earlier was to the early stages of college. I felt that little cracks in understanding of the basic biological/clinical sciences could develop through PBL, and lead to gaps further along.

bythewoods

I'm also in Trinity, in the same cloass as A Neurotic, and I feel pretty much the same as him.

Many of us refer to it as PBHell, it can often seem like a waste of time and a generally crap way to spend 4-6 hours of your week.

Tbh, I think the time spent doing PBL sessions would be better spent on more lectures or perhaps tutorials with our lecturers or whathaveyou.

For the most part, everyone seems to google the topic the night before and spit out Wikipedia facts for 2 hours. It has its positive aspects, in that you get to know the people in your group a bit better and also have any misconseptions clarified, but it's quite waffley and BS-y.

There have been days when I've actually just made up statisitics and used wikipedia as my only resource to get me through it, and days where I've spent hours pouring over textbooks and Medical journals, yet come out with exactly the same mark. (A mark which is consistently lower than those who dominate conversation/ are mature students).

Red_Marauder

In fairness, any tutor who isn't pulling students up on using Wikipedia just isn't doing their job.

Anyone who isn't providing credible and extensive journal and textbook references in the group isn't doing their job either

But that's not a problem with PBL - It's people not fulfilling their duties. It does happen in lecture halls and lab classes too, unfortunately.

ORLY?

Wikipedia? Ah come on, nobody should be looking at wikipedia. There is perhaps a case that PBL is more suited to the grad shcemes while lectures are more appropriate for the standard undergrads. I mean no offence to the standard undergrads but when people have been through the joys and excesses of college before, they've generally had enough of most of that and are only really concerned with the work by the time they're in their mid twenties. The notion of just scrambling something together the night before PBL would be abhorrent here. As soon as the case is worked through people are flocking to the library to get started on the topic of the week.

In any case, I still think that when the clinical years come around, every med student has to have the initiative to the hit the books themselves and to constantly be going over anything they're hazy on and researching all the new stuff that they will be encountering. So it ends up being PBL/Self Directed or whatever you want to call it anyway.