2Learning outcomes By the end of the session, participants will have Critically considered what problem based learning is and how it can be used in the classroomConsidered how PBL activities relate to assessmentDesigned a PBL activity for use in their own teaching context
3What is it?PBL is a student-centred approach to learning that encourages students to be self-directed, interdependent and independent as they attempt to solve the set problem.Both a teaching method and an approach to the curriculum
4AimsTo encourage students to develop skills in accessing, interpreting and evaluating informationTo allow students to make connections between their academic work and their own lives
5A problem-based learning environment emulates the workplace and develops self- directed learners. This is preferable to a mimetic learning environment in which students only watch, memorize, and repeat what they have been told.OMMUNDSEN
6BeginningsMedical education at McMaster UniversityLearning through problem solving more effective for crating a body of knowledge usable in the futureProblem solving skills more important than memory skillsThe learning which results from the process of working towards the understanding of, or resolution of, a problemBarrowsand Tamblyn 1980 Problem based learning: an approach to Medical Education
7PBL students engage in a collaborative activity that: makes them think makes them ask questionsactivates prior knowledgetests their understandingelaborates new knowledgereinforces their understanding by speakingprovides motivation for learningmakes them practise a logical, analytical approach to unfamiliar situationsInvolveslearning in contextintegrated learningcollaboration
8The problem is raised at the start of the topic before the students have been taught some of the relevant information
10PBL groups-an approach Facilitator introduces an “ill structured problem”
11The groups List what is known Includes content and knowledge of others’ strengths and capabilitiesWriting out the problem statementListing possible solutionsList actions to be taken: what do we need to be know? What do we need to do
12The Maastricht ‘Seven Step’ PBL process Step 1: Clarify terms and conceptsStep 2: Define the problem(s)Step 3: Analyse the problem(s) - ”Brainstorm”Step 4: List of the analysis and possible solutionsStep 5: Formulate Learning ObjectivesStep 6: Collect additional information focussed on Learning ObjectivesStep 7: Synthesise and present new information
13List actions to be taken ResearchPossible resourcesAssign tasks"How to make a DENT in a problem: Define, Explore, Narrow, Test."
14Examples-BiologyA 28-year-old man appears to have osteoporosis
15Groups brainstorm possible causes: osteoblasts, diet, vitamin D, parathyroid hormone, growth hormone, calcitonin, kidney function,Each group ranks its hypotheses in order of priority and prepares requests for more data. (E.g., for calcium deficiency hypothesis -- "What did he usually eat?")
16Student suggestions may include Low calcium dietImmobilityLow density of vitamin D receptorsCalcitonin deficiencyExcessive PTHChronic acidosis buffered by salts mobilized from bone
17The students could now be told that the man's lumbar spine density is 3.1 standard deviations below the average age-matched healthy female (osteoporosis = 2.5+ SD), his height is 204 cm, his left middle finger is 10 cm, and knee films show open epiphyses. (The students should now be able to figure out that the man may still be growing at age 28).
18A Case of a Confused Person A 58-year-old woman experienced attacks of confusion: she would repeat the same question 30 times even though it was answered for her each time. [New England Journal of Medicine 315: ] This is a good introductory case, as the students are able to generate a wide range of ideas: Alzheimer's Disease, trauma, alcohol abuse, atherosclerosis, arrhythmia, hypotension, cancer, epilepsy, diabetes, hypocalcemia, emphysema, dehydration, hypoglcemia, stroke, etc.
19Students will ask the circumstances of the woman's attacks (e. g Students will ask the circumstances of the woman's attacks (e.g., "Following alcohol consumption?") When the students learn that the attacks occurred in the late afternoon, they will likely focus on diet and blood sugar.
20The student groups can now brainstorm and investigate possible causes of the low blood glucose: glucagon deficiency, insulin poisoning, anorexia nervosa, extreme exercise, etc. They may ask for an x-ray image of her abdomen.The students can be assisted in identifying the anatomy, including an abnormal mass in the pancreas (an insulin-secreting tumour)
21A PBL scenarioRanjit Singh, 46, has just returned from the Indian sub-continent where he visited his brother and family for a period of one month. He lives with his wife, their four children and his parents in a three bedroom terraced house in the Peartree district of Derby. He works as a waiter in a local Indian restaurant. Recently he has started coughing a lot, has little energy, is losing weight and has developed a fever. He visited his GP after he coughed up some blood and developed chest pains. His GP suspects TB and has sent a sputum sample for analysis and Mr Singh for a chest X-ray.
22Learning Objectives for the PBL scenario Basic and clinical sciencesDescribe mechanisms and common causes of cough.Describe types of clinical investigations available for patients with cough. Interpretation of CXR.Outline the microbiology of mycobacterium tuberculosis.Describe the immune response to TB, its use in diagnosis and the tuberculin test.Describe clinical and pathological manifestations of TB.Outline the drug regimes for treating TB, their mode of action, side effects and the problem of drug resistance.
23Learning Objectives for the PBL scenario Community and populationDescribe the epidemiology of TB, the impact of socio-economic factors and its relation to HIV.Discuss the social and family issues associated with TB in the community.
24Learning Objectives for the PBL scenario Patient and DoctorDescribe how communication problems can be dealt with in ethnic minorities.Awareness of perception of TB in Asian communities and problems of stigmatisation.Dealing with issues of confidentiality versus compulsory notification: patient autonomy.Describe how to ensure compliance with complex and long-term drug regimes.Persuade family members to be immunised.
25PBL fulfils the conditions for effective adult learning Relevant contextAdults are self-motivatedAdults learn best in groupsAdults prefer ‘doing’ to being toldActive learning through posing own questions and finding own answers: therefore student centredIntegrated learning: learning in a variety of disciplines simultaneouslyDeep learning for understanding; metacognition; reflection; appropriate feedback; opportunities for practice
26Implications Loss of teacher control-teacher becomes the facilitator ResourcesLoss of contentLearning on-linePerceptionsTrainingCoverage & ‘holes’ in knowledgeExpert v. non-expert tutorsResource-intensiveSignificant start-up and maintenance costsDemanding of staff timeCan be stressful for students and staffNeed strong commitment of faculty
27Methods of assessment Group/individual presentation Case based individual essayCase based clinical care planPortfolioSelf-assessmentPeer assessmentVivaReflective journal (online)Facilitator assessmentReportPatchwork textMind map
29Problem Based Learning Scenario (Environmental Studies) Rolls Royce have revealed that they have a small nuclear reprocessing plant on their premises in a heavily populated area of Derby. It is similar to a plant in Japan where there was a recent accident.
30PBL: role of the facilitator The facilitator must let the students be responsible for their learning.The facilitator must let the students do the work.The facilitator has the role of monitoring and evaluating the discussion. Guidance is given in the form of suggestions.The facilitator has background information concerning the case under discussion.The facilitator may intervene if the students are not working or if the activity is starting to go in the wrong direction.The students may ask the facilitator for advice which can be given according to his or her judgement.
31Task!Design a PBL scenario that you could use in your own teaching
32Summary of Evidence Graduates of PBL Teacher & Student satisfaction More likely to engage in CPDTeacher & Student satisfactionGreater for PBLCostsMore expensive with >100 students
33Savery, J. ‘Overview of Problem-based Learning: definitions and Distinctions’ The Interdisciplinary Journal of Problem- based Learning • volume 1, no. 1 (Spring 2006); 9-20Maggi Savin-Baden & Claire Howell Major(2004).Foundations of Problem-based Learning Open University Press.David Boud and Grahame Feletti Eds 1997.The challenge of Problem Based Learning Kogan Page Open University Press.