1. Making PBL work David Taylor Liverpooldcmt@liv.ac.uk

2. What do we know? There has been a huge amount of research on how people learn There has been a huge amount of research on how people learn And on how they become members of a profession And on how they become members of a profession

3. “Traditional teachers” Make statements/convey information Make statements/convey information Expect prompt, “correct” answers Expect prompt, “correct” answers Focus on what they do (“I gave a good lecture”) Focus on what they do (“I gave a good lecture”) Emphasise short term outcomes Emphasise short term outcomes

4. We prefer... Asking questions that invite thinking, problem solving and self-assessment Asking questions that invite thinking, problem solving and self-assessment Help you learn how to learn Help you learn how to learn Focus on what you do Focus on what you do Emphasise long-term outcomes Emphasise long-term outcomes

5. Change This may well be different from what you are used to This may well be different from what you are used to And it may be different from what you expect And it may be different from what you expect And there will be times when you feel uncomfortable And there will be times when you feel uncomfortable but but

6. It works! It really does It really does Jason, H. Advances in physiological education 2007; 31: 312-317 Jason, H. Advances in physiological education 2007; 31: 312-317 Taylor D, Miflin B. Problem-based learning: Where are we now? Medical Teacher 2008;30(8):742 - 63. Taylor D, Miflin B. Problem-based learning: Where are we now? Medical Teacher 2008;30(8):742 - 63. But lots more..... But lots more.....

8. DualityMultiplicityRelativism Things are either right or wrong Can compare and contrast, starting to expect to see evidence. Can grasp concepts, recognize contexts, and importantly synthesize information to use in other contexts. Peers are not a reliable source of information Peers are OK – to give a variety of perspectives Peers are legitimate source of information if they have checked the evidence “Teacher knows everything” “Teacher knows best”“Teacher might know”

9. But first If you have a worry or a problem before you meet your personal tutor If you have a worry or a problem before you meet your personal tutor dcmt@liv.ac.uk dcmt@liv.ac.uk dcmt@liv.ac.uk 07803 963 899 (SMS or voice!) 07803 963 899 (SMS or voice!) 01704 873304 (night-time) 01704 873304 (night-time)

10. Routine New case scenario every two weeks New case scenario every two weeks Three PBL meetings every two weeks Three PBL meetings every two weeks Each session lasts 2 hours Each session lasts 2 hours Facilitated by a PBL tutor Facilitated by a PBL tutor Each of whom is an expert in their own field Each of whom is an expert in their own field And is trained as a PBL facilitator And is trained as a PBL facilitator Monday, Monday, Friday (or similar) Monday, Monday, Friday (or similar) Compulsory, punctual attendance Compulsory, punctual attendance

12. PBL groups do it together

13. Say what you know not that you know

14. Are we doing it right?

15. Liverpool PBL sessions: L ook for phenomena requiring explanation L ook for phenomena requiring explanation I nvestigate prior knowledge and experience I nvestigate prior knowledge and experience V olunteer shared learning objectives V olunteer shared learning objectives E xplain the essence of the case scenario E xplain the essence of the case scenario R eflect and evaluate R eflect and evaluate … pool … pool Maudsley G... Maudsley G... British Medical Journal 1999; 318: 657-661. British Medical Journal 1999; 318: 657-661.

16. Look for phenomena requiring explanation How? How? Spend considerable time brainstorming Spend considerable time brainstorming Keep to brainstorming ‘rules’ Keep to brainstorming ‘rules’ (if you think it say it (BRIEFLY) ; do not judge, apologize for, discuss, justify suggestions; write all suggestions down verbatim even if they appear to be overlap; do go back through the trigger material after a short break thinking about something else) (if you think it say it (BRIEFLY) ; do not judge, apologize for, discuss, justify suggestions; write all suggestions down verbatim even if they appear to be overlap; do go back through the trigger material after a short break thinking about something else)

17. Look for phenomena requiring explanation Why? Why? to be creative and open-minded about what might be important in a clinical situation, before getting too focused to be creative and open-minded about what might be important in a clinical situation, before getting too focused to learn from other people’s suggestions to learn from other people’s suggestions to think about issues from lots of different angles to think about issues from lots of different angles

18. Look for phenomena requiring explanation How? How? Spend considerable time brainstorming Spend considerable time brainstorming Keep to brainstorming ‘rules’ Keep to brainstorming ‘rules’ …so that you work together and do not miss key features to research, act upon, etc. …so that you work together and do not miss key features to research, act upon, etc.

20. I nvestigate prior knowledge and experience How? How? Spend considerable time activating ‘prior knowledge’ (i.e. what you already know about anything that has been highlighted) Spend considerable time activating ‘prior knowledge’ (i.e. what you already know about anything that has been highlighted) now is the time to discuss the brainstorming suggestions, not during brainstorming now is the time to discuss the brainstorming suggestions, not during brainstorming

21. I nvestigate prior knowledge and experience Why? Why? to make sure that you & the group recognize what you all know & what you need to find out to understand the scenario to make sure that you & the group recognize what you all know & what you need to find out to understand the scenario to show that everyone has something to contribute (and not just from books) whether from school, college, personal experience, etc. to show that everyone has something to contribute (and not just from books) whether from school, college, personal experience, etc. to practise communicating key concepts out loud to practise communicating key concepts out loud

22. I nvestigate prior knowledge and experience How? How? Spend considerable time activating ‘prior knowledge’ (i.e. what you already know about anything that has been highlighted) Spend considerable time activating ‘prior knowledge’ (i.e. what you already know about anything that has been highlighted) …so that you do not keep saying that you know something, yet cannot actually explain it out loud …so that you do not keep saying that you know something, yet cannot actually explain it out loud …so that you realize that you are not the only person who does not know something …so that you realize that you are not the only person who does not know something

24. Volunteer shared learning objectives How? How? From the learning gaps that you have identified, sort out what it is that you as a group should be able to do when you return next time: From the learning gaps that you have identified, sort out what it is that you as a group should be able to do when you return next time: outline x, draw y, discuss the role of x related to y, compare & contrast a, b & c outline x, draw y, discuss the role of x related to y, compare & contrast a, b & c

25. Volunteer shared learning objectives Why? Why? to make sure that the group’s learning tasks are clear (and everyone researches every learning objective) to make sure that the group’s learning tasks are clear (and everyone researches every learning objective)

26. Volunteer shared learning objectives How? How? From the learning gaps that you have identified, sort out what it is that you as a group should be able to do when you return next time From the learning gaps that you have identified, sort out what it is that you as a group should be able to do when you return next time …so that you have a learning plan and know whether you have succeeded in keeping on track by the next session …so that you have a learning plan and know whether you have succeeded in keeping on track by the next session

28. Explain the essence of the case scenario How? How? Come back to the group ready to explain what you now know, still do not know, can illustrate, how you know it, and WHY it is RELEVANT at all to this case scenario… all WITHOUT NOTES Come back to the group ready to explain what you now know, still do not know, can illustrate, how you know it, and WHY it is RELEVANT at all to this case scenario… all WITHOUT NOTES Use evidence, critically appraising yours & other people’s assertions Use evidence, critically appraising yours & other people’s assertions Synthesize what you now know with the scenario Synthesize what you now know with the scenario

29. Explain the essence of the case scenario Why? Why? If you really ‘know’ it (have not just “made notes on it”), you should be able to communicate it and its clinical relevance, and provide evidence/arguments to support/challenge assertions If you really ‘know’ it (have not just “made notes on it”), you should be able to communicate it and its clinical relevance, and provide evidence/arguments to support/challenge assertions The PBL session is for testing out what you know in a safe environment and challenging assumptions The PBL session is for testing out what you know in a safe environment and challenging assumptions

30. Explain the essence of the case scenario How? How? Come back to the group ready to explain what you now know, still do not know, can illustrate, how you know it, and WHY it is RELEVANT at all to this case scenario… all WITHOUT NOTES Come back to the group ready to explain what you now know, still do not know, can illustrate, how you know it, and WHY it is RELEVANT at all to this case scenario… all WITHOUT NOTES Use evidence, critically appraising yours & other people’s assertions Use evidence, critically appraising yours & other people’s assertions Synthesize what you now know with the scenario Synthesize what you now know with the scenario …so that you keep rehearsing what you know in a clinical context (making it easier to recall later on) and keep improving critical thinking …so that you keep rehearsing what you know in a clinical context (making it easier to recall later on) and keep improving critical thinking

32. …and…

33. …and…

34. Reflect and evaluate How? How? Reflect during the session on how you are contributing and adjust accordingly Reflect during the session on how you are contributing and adjust accordingly (…if you have not said a word, why not? …if you have not shut up at all, why? …if you are lost, speak up!) (…if you have not said a word, why not? …if you have not shut up at all, why? …if you are lost, speak up!) Spend time at the end of EVERY session debriefing on how the process went (things that went well, not so well) Spend time at the end of EVERY session debriefing on how the process went (things that went well, not so well)

35. Reflect and evaluate Why? Why? While most of the session focuses on ‘content’, you need to check that the educational process remains on track and prevent complacency While most of the session focuses on ‘content’, you need to check that the educational process remains on track and prevent complacency There may be things about the group dynamics, tutor’s role, etc. that need adjusting There may be things about the group dynamics, tutor’s role, etc. that need adjusting Everyone needs to have his/her ‘say’ and difficult dynamics should be discussed Everyone needs to have his/her ‘say’ and difficult dynamics should be discussed (but the evaluation should focus on different things each time) (but the evaluation should focus on different things each time)

36. Reflect and evaluate How? How? Reflect during the session on how you are contributing and adjust accordingly Reflect during the session on how you are contributing and adjust accordingly Spend time at the end of EVERY session debriefing on how the process went (things that went well, not so well Spend time at the end of EVERY session debriefing on how the process went (things that went well, not so well …so that people have the chance to explain their concerns/behaviour and suggest ways that he/she/the group/the tutor could do better next time …so that people have the chance to explain their concerns/behaviour and suggest ways that he/she/the group/the tutor could do better next time

38. And finally If you have a worry or a problem before you meet your personal tutor If you have a worry or a problem before you meet your personal tutor dcmt@liv.ac.uk dcmt@liv.ac.uk dcmt@liv.ac.uk 07803 963 899 (SMS or voice!) 07803 963 899 (SMS or voice!) 01704 873304 (night-time) 01704 873304 (night-time)