1. By; Col Abrar Hussain Zaidi
CASE AND PROBLEMS-BASED LEARNING – [CBL] Using specific cases to teach and learn how to deal with clinical problems AN INTRODUCTION
By;
Col Abrar Hussain Zaidi

2. SEQUENCE NOMENCLATURE INTRODUCTION THE SPECTRUM OF STUDIES
CASE SELECTION
THE LEARNING OBJECTIVES [SLO’S]
METHODOLOGY/FORMATS
THE PROCESS/STEPS OF LEARNING
CBL IN AMC

3. NOMENCLATURE PROBLEM BASED LEARNING--PBL CASE BASED LEARNING -- CBL
SUBJECT BASED LEARNING-- SBL
TARGET BASED LEARNING-- TBL

4. NOMENCLATURE PBL - A scientific problem could be of any type
-Term used in broader perspective
CBL - In clinical studies
the problems
are the individual cases /the patients

5. INTRODUCTION studying a given; individual case/problem/subject
CBL – The learning that stems out from;
studying a given;
individual case/problem/subject
and involves clinical process of
Understanding the problem
[investigations and diagnosis] and
Rationalizing the resolution of a
problem [treatment].

6. INTRODUCTION CBL vs conventional learning
The problem is encountered first
in the learning process
[opposite to conventional]

7. INTRODUCTION
The method of problem-based learning (PBL) has been used in different fields of sciences for decades.
In medical education it began at McMaster University in the mid-1970s. [Barrows and Tamblyn (1980):]

8. INTRODUCTION
Problem-based learning (PBL) has been widely adopted in U.S. medical schools and is believed to be highly effective for knowledge acquisition and clinical performance.
1-Colliver JA. Effectiveness of problem-based learning curricula: research and theory. Acad Med2000;75(3):
2-Galey WR. What is the future of problem-based learning in medical education? Adv Physiol Educ 275:12-15, 1998.

9. INTRODUCTION PBL/CBL learning strategy that builds on
linkages between basic science and
clinical knowledge.

10. THE SPECTRUM OF STUDIES
A broad range of
topics in a clinically relevant context.
Define your learning objectives

11. CASE SELECTION Usual Practice Clinical cases are generally organized
around organ systems.
Major, typical, model cases
common clinical problems
of all body systems

12. THE LEARNING OBJECTIVES [SLO’S]
DOMAINS
COAGNITIVE
PSYCHOMOTOR
AFFECTIVE
SU-CATEGORY [LEVEL]
C BASIC KNOWLEDGE
C INTERPRETATION
C SOLVING THE PROBLEM
IMPORTANCE OF DEFINING THE SLO’S--?

13. METHODOLOGY/FORMATS
PBL/CBL method of teaching /learning can be used in many formats
Problem-based lectures
Small-group tutorials
large-group case discussion,
Problem-based laboratories (Kaufman, 1995).
most common -- small groups with a facilitator

14. 05/%
Assessed after
02 wks

16. [AFTER HAVING DEFINED OUR SLOS AND HAVING SELECTED THE CASES ]
Most practical for student teaching
Small-group tutorials

17. THE PROCESS/STEPS OF LEARNING
It is a student-centered approach
Small groups of students
Facilitator
Steps wise discussion
Information gathering
Problem identification
The judicious application of diagnostic tests
Evaluation and interpretation of data
Management decisions or therapy and intervention
Outcomes monitoring

18. THE PROCESS/STEPS OF LEARNING
PBL/CBL method involves the three steps :
Confronting the problem
Engaging in independent study
Returning to the problem-
Discussion
(Wilkerson & Feletti, 1989).

19. THE PROCESS/STEPS OF LEARNING
CBL discussion utilizes
A deductive process that
parallels the steps
used routinely in the evaluation and care of patients in actual clinical practice
(Figure next).

20. THE PROCESS/STEPS OF LEARNING
THE PATIENT
CASE SCENARIO- HISTORY AND PHYSICAL EXAM
THE ON
GOING
DISCUSSION
QUESTIONING
MODERATION
LEARNING
SUMMARY PROBLEMS
DIAGNOSIS AND TREATMENT PLAN
D/D
INTERPRET/EVALUATE THE DATA
INVESTIGATION
LAB/X-RAYS

21. CBL IN AMC -In AMC the CBL started last year[2008]
-We are trying to address it critically and are
in the process of assessing its effectiveness
in our set-up
-Total 36 topics were covered during previous
session /same no to be covered in new class
-The process of improvement is continuous
-Students and teachers feed back is important
for improvement

22. CBL IN AMC PBL/CBL method involves the three steps :
Confronting the problem
Engaging in independent study
Returning to the problem-Discussion
(Wilkerson & Feletti, 1989).

23. CBL IN AMC Case scenario are given to students
Have a full week for own study
Students develop their approach of dealing with the
problem;
Study different aspects of history [pain /mass etc]
Study D/D
Study main aspects of pathology
Rationalize investigations
Re-assess and give one diagnosis
Give a plan of treatment
Small Group discussion -weekly
Moderated and guided by a teacher
Every student has to participate
Individual student grading will be done by teacher

24. CBL IN AMC Limitations/flaws/loopholes
Students may not take the task seriously
No active participation
Remain passive learners with low retention
Every student may not have enough participation
Time may be too less to cover all aspects of topic
Some teachers may convert the discussion into a
kind of lecture
Students grading is not always accurate
Interest and efforts expressed by teachers
Others ?

25. CME credits for the teachers Grading for students
CBL IN AMC
Limitations/flaws/loopholes
How to overcome--?
Reward:
CME credits for the teachers
Grading for students

26. CBL IN AMC Is the system effective in our set up -?
How to objectively assess
Needs an observational study

27. CBL - ?
THANKS