Teaching learning methods Rakesh Biswas MD, Professor, Department of Medicine, People's College of Medical Sciences, Bhopal, India, Medical education workshop People’s College of Medical Sciences 21st October 2008

Problems in Medical Education: Too much information, too little time, too many students in crowded rooms, and exams that discourage real learning. Advan. Physiol. Edu. 31: 283-287, 2007

How we learn/learnt… When we were medical students… And now…are we still learning or just teaching?

Teaching learning theory in medical education suggests that medical students and physicians will learn best when learning Is in the context of patient care, Answers their questions, Is not directly applicable to their work, Does not take too much time.

“Half of what you are taught as medical students will in 10 years have been shown to be wrong.” And the trouble is none of your teachers know which half.” So the most important thing to learn is “how to learn on your own”. Dr. Sydney Burwell, Dean Harvard Medical School In: Evidence based medicine, Sackett et al, 2000: 31

Top down and bottom up Approaches to teaching learning in Medical education

The old way of learning, was knowing what you should know. BMJ  2003;327:1430-1433

Now the way of learning is knowing what you don't know, not feeling bad about it, and knowing how to find out. BMJ  2003;327:1430-1433 

Uncertainty was discouraged and ignorance avoided Uncertainty was discouraged and ignorance avoided. Now, uncertainty is legitimized and questioning encouraged BMJ  2003;327:1430-1433

Medical education was learning by humiliation, with naming, shaming, and blaming. Now, students are encouraged to question received wisdom. BMJ  2003;327:1430-1433

Active learning means: 1) increasing study activity during exam time 2) learning as a self directed student generated participatory activity 3) Studying must know factual content and topping exams 4) Learning and accepting the content offered by teachers

Teaching/learning methods Mass instruction (Conventional lectures and taught lessons; Film and video presentations; Educational broadcasts; mass practical work Individualized learning (Directed study of texts, study of open-learning materials; mediated self-instruction; PBLs.) Group learning (Class discussions; PBLs, seminars; group tutorials; games and simulations; group projects; etc.

Traditional structured text book learning Background …is a …disorder characterized by increased… Pathophysiology …is an acquired abnormality that involves the… History The clinical manifestations of … are

PEOPLE”S COLLEGE OF MEDICAL SCIENCES DEPARTMENT OF MEDICINE SESSIONAL EXAMINATION Time: 3 Hours Max. Marks: 100 ?     Answer all questions ?     Answer each section in a separate answer book. SECTION – ‘A’ 1) A 37-year-old lady, has come with 3 months history of generalized ill health and a dragging sensation in her left hypochondria. On examination her spleen is massively enlarged. a) What are the possible causes? b) Describe investigations and treatment. (4+3+3) See lecture on CML at www.pitt.edu/~super1/lecture/lec35161/index.htm

Differentials: Myeloproliferative disorders Infections Storage disorders Hemolytic anemia See lecture on CML at www.pitt.edu/~super1/lecture/lec35161/index.htm

In Problem based learning the role of the teacher is: That of an active enthusiast in student learning Active instructor who explains all their student’s queries That of a facilitator who talks only minimally Passive mentor who doesn’t take much interest

Summary: Learning points-

Create your own method

Summary: Medical education can be patient centered Ample content in our day to day practice Formative Assessment needs to be stressed

To teach individual self-directed learning competencies, the following are important: (1) Situate learners to experience "real" problems; (2) encourage learners to reflect on their own performance; (3) Create an educational atmosphere in clinical training situations. (4) Encourage learners to memorize factual content that is not contextual.

Feedback Please let me know your thoughts: Your idea of an ideal teaching learning method What were the positive and negative aspects of this presentation? Would you go about implementing patient centered learning in your curriculum and how? rakesh7biswas@gmail.com