2ObjectivesBy the end of this presentation the participants will be able to:Recognize the importance of the principles behind running SGL sessionsIdentify the unique circumstances and techniques used in SGL and techniques to improve group interactionDescribe some of the strengths and difficulties with SGLManage some of the challenges facing the facilitator during SGL sessionsTo determine the ways of providing feedback to students
3Tell me and I will forget Show me and I may rememberInvolve me and I will surely learn
5What is problem based learning? In problem based learning (PBL) students:use “triggers” from the problem case or scenario to define their own learning objectives.Subsequently:they do independent, self directed study before returning to the group to discuss and refine their acquired knowledge.Thus, PBL is not about problem solving per se,but rather it uses appropriate problems to increaseknowledge and understanding.
6So, group learning facilitates the acquisition of knowledgecommunication skillsTeamwork problem solvingindependent responsibility for learningsharing informationand respect for others.
7What happens in a PBL tutorial? A typical PBL tutorial consists of a group of students (usually eight to 10) and a tutor, who facilitates the sessionStudents elect a chair for each PBL scenario and a “scribe” to record the discussion usingsuitable flip charts or a whiteboardThe roles are rotated for each scenario
8At the start of the session either the student chair reads out the scenario orall students study the material
10Benefits of SGL Enable learners to take part in: Discussion Active participationFeedback and reflectionConsolidate learningClarify understandingExplore ideas and concepts.
11Retention of information NeedsSGL is more demanding of staff, rooms, resources and time than lectures;However, well-designed SGL has clear benefits for student learning in terms of:Retention of information&Critical thinking
13Objectives of Early Clinical and Professional Development Module The student knows the features of good doctor.The student knows his responsibilities as future doctor.The student knows the communication skills and ethics required for history and clinical examination.The student knows the communication skills and ethics required for difficult situations
14Designing and implementing a curriculum module using PBL supported by other teaching methods
15Writing PBL scenariosPBL is successful only if the scenarios are of high quality.In most undergraduate PBL curriculums the faculty identifies learning objectives in advance.The scenario should lead students to a particular area of study to achieve those learning objectives
16How to create effective PBL scenarios Learning objectives likely to be defined by the students afterstudying the scenario and should be consistent with the faculty learning objectivesProblems should be appropriate to the stage of the curriculum and the level of the students’ understandingScenarios should have sufficient intrinsic interest for the students or relevance to future practiceBasic science should be presented in the context of a clinical scenario to encourage integration of knowledge
17How to create effective PBL scenarios (continue) Scenarios should contain cues to stimulate discussion and encourage students to seek explanations for the issues presentedThe problem should be sufficiently open, so that discussion is not restricted in the processScenarios should promote participation by the students in seeking information from various learning resources
18Staff development Introducing PBL into a course makes: new demands on tutors,requiring them to function as facilitators for small group learning rather than acting as providers of information.Staff development is essential and should focus on enabling the PBL tutors to:acquire skills in facilitation and in management of group dynamics (including dysfunctional groups).acquire basic expertise about the subject.
19Tutors should be also given information about the institution’s educational strategy and curriculum programmers.so that,they can help students to understand the learning objectives of individual modules in the context of the curriculum as a wholeMethods of assessment and evaluation should be described and time should be available to discuss anxieties.
20An Effective Small Group Teacher Guides the discussion rather than steal the showInvolves the students in the discussion rather than giving the answerCalls on individual students if no one volunteers informationIf one student always talks, asks him to wait while others talkAdd humorInterject personal experiences, when appropriate
21An Effective Small Group Teacher(continue) Manages timeIs punctualStarts on timeDOESN’T go over the scheduled timeWatches students’ time if they are spending too long on a given subject
223 Keys to Motivating Students to Learn EnthusiasmShow your careEncouragement
23Assessment of PBLAssessment of students’ activities in their PBL groups is advisable.Tutors should give feedback or use formative or summative assessment procedures as dictated by the faculty assessment schedule.It is also helpful to consider assessment ofthe group as a wholeFeedback should be constructive rather than punitive
24Importance of Feedback Feedback drives learningGive feedback on non-technical skills as well as technical skills and knowledgeStudents need to know how they are perceivedWe need to help students learn how to accurately self-assess
25Individual’s assessment schedule based on: Student’s attendanceadherence to the processcommunication skillsrespect for othersand individual contributions.award of a group mark added to each individual’s assessment schedule encourages students to achieve the generic goals associated with PBL.
26Treat your weakest student as you treat your best student Expect them to succeed
27PBL tutorial processStep 1—Identify and clarify unfamiliar terms presented in the scenario; scribe lists those that remain unexplained after discussionStep 2—Define the problem or problems to be discussed; students may have different views on the issues, but all should be considered scribe records a list of agreed problemsStep 3—“Brainstorming” session to discuss the problem(s), suggesting possible explanations on basis of prior knowledge; students draw on each other’s knowledge and identify areas of incomplete knowledge; scribe records all discussion
28Step 4—Review steps 2 and 3 and arrange explanations into tentative solutions (analysis); scribe organizes the explanations and restructures if necessaryStep 5—Formulate learning objectives; group reaches consensus on the learning objectives; tutor ensures learning objectives are focused, achievable, comprehensive, and appropriateStep 6—Private study (all students gather information related to each learning objective).Step 7—Group shares results of private study (students identify their learning resources and share their results; tutor checks learning and may assess the group
36Problems associated with leading effective small groups The teacher gives a lecture rather than guiding the group.The teacher talks too muchStudents cannot be encouraged to talk except with difficult situations, they will not talk to each other, but will only respond to questions from the tutorStudents do not prepare for the sessionsOne student dominates the discussionThe students want to be given the solutions to problems rather than discuss them.
37Kinds of students inside the group and how the tutor dealing with each of them
38The persistent talkerSummaries their main points and divert the discussion to others;Interrupt with a yes/no question and ask someone else to comment
39Quiet people Shy and timid: They may speak quietly or cannot find the words to say what they mean.You can help them by allowing time for them to respondAsking ‘easy’ questionsProtecting them from mockery or teasingAcknowledging their contribution
40Negative attitudeThese people may like to talk but have a negative attitude that can affect others.Superior : They appear to know everythingFlatter a little by indicating how others can learn from their experienceAsk for specific examplesAsk the group to comment
41Negative attitudeClown : ridicules discussion by joking or making irritating remarksAsk them for a serious contributionAcknowledge any valid contributionBe direct and say that although this was amusing, the group must move on to complete its task.
42Advantages and disadvantages of PBL Student centred PBL—It fosters active learning, improved understanding, and retention and development of lifelong learning skillsGeneric competencies—PBL allows students to develop generic skills and attitudes desirable in theirfuture practice
43Integration—PBL facilitates an integrated core curriculum Motivation—PBL is fun for students and tutors, and the process requires all students to be engaged in the learning process“Deep” learning—PBL fosters deep learning (students interact with learning materials, relate concepts to everyday activities, and improve theirunderstanding)Constructivist approach—Students activate prior knowledge and build on existing conceptual knowledge frameworks.
44Disadvantages of PBLTutors who can’t “teach”—Tutors enjoy passing on their own knowledge andunderstanding so may find PBL facilitationdifficult and frustratingHuman resources—More staff have to take part in the tutoring process
45Other resources—Large numbers of students need access to the same library and computer resources simultaneouslyInformation overload
46Design of case scenario for 2nd year medical students Salma a 25 years old pregnant lady in her 5 months gestation, came to the PHCC complaining of dyspnea during her regular house work, specially when floor sweeping.She gave history of attacks of dyspnea during sleep which forced her to rise from bed and go to a nearby window for some fresh air. The doctor inquired about a previous joint problems which was not present, but she gave history of abnormal hand movement during childhood, she was clumsy and dropping things which was cleared by itself without any diagnosis or treatments. The doctor referred her to the consultant physician in Tikrit Teaching Hospital. The consultant physician admitted her in the hospital for further investigations as ECG, CXR, Echocardiography.Consultation was done to a gynecologist which revealed pregnancy with no complication. During hospitalization orthopnea continued inspite of intesive medical treatment. He introduced the information which were gained from this patient to his program in the computer.The consultant physician decided to refer her to cardiac surgeon for emergency surgery to Baghdad Medical City. The consultant physician phoned the cardiac surgeon who was his friend and knew from him that they are going to do an urgent valvotomy.
47Learning ObjectivesBy the end of this week, the student should be able to:Describe the structure of cardiac valves and its locationsIdentify the characteristics of normal valvular functions.Describe the pathogenesis of valvular damage in valvular heart disease (V.H.D).Indicate the abnormalities in ECG in (V.H.D).Describe the bacteriological features causing valvular diseases.Identify pathophysiology of the heart in valvular diseaes.Describe the cardiac chambersDescribe the histopathological features of the cardiac valves.Describe the histopathological features of endocardiumAppraise the use of computers as a resource for data analysis
48Further readingDavis MH, Harden RM. AMEE medical education guide number15: problem-based learning: a practical guide. Med Teacher1999;21:Norman GR, Schmidt HG. Effectiveness of problem-based learning curricula: theory, practice and paper darts. Med Educ 2000;34:721-8.Albanese M. Problem based learning: why curricula are likely to show little effect on knowledge and clinical skills. Med Educ 2000;34: