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Dr. Soumya Swaroop Sahoo 
Junior Resident 
Dept. of Community Medicine
Introduction 
Differences between traditional learning and 
Problem Based Learning (PBL) 
PBL Characteristics 
Steps of PBL 
Advantages and disadvantages of PBL 
Examples 
Indian scenario 
Conclusion
“ You can not teach a man anything, you 
can only help him find it within himself 
” 
- Galileo 
‘Spoon feeding in the 
long run teaches us 
nothing but the shape 
of the spoon’ 
- E M Forster
1913 Sir William Osler (concerning the education of 
medical students) “ too great a reliance on lectures and on 
students’ capability of memorising a growing number of 
items of knowledge.” 
1960’s PBL introduced in Canadian medical school 
1970’s most of US and worldwide medical schools 
adopted PBL 
1990’s PBL introduced into medical schools in UK by 
Manchester, Glasgow and Liverpool universities.
PBL was pioneered in 
the medical school 
program at McMaster 
University in Hamilton, 
Ontario, Canada in the 
late 1960s by Howard 
Barrows and his 
colleagues.
McMaster architect of PBL 
who pioneered the concept 
of using simulated patients to 
train medical students. 
Professor of medicine at 
McMaster from 1971 to 
1980, Barrows created 
educational tools and 
learning methods that have 
defined modern medical 
training. 
His research encompassed 
the problem solving skills of 
physicians and PBL as a 
structured teaching/learning 
method. 
HOWARD BARROWS 
1928-2011
The intent is to challenge the learner with problems 
found in practice both as a stimulus for learning and 
focus for organizing what has been learned for later 
recall and application to future work. 
Howard Barrows 
“…a process of acquiring understanding, knowledge, skills 
and attitudes in the context of an unfamiliar situation, 
and applying such learning to that situation.” 
C. E. Engel, University of Newcastle
Grades did not predict success 
Many students could not apply knowledge 
Diagnosis 
Problem solving 
Education is a continuous process and requires 
life-long learners 
PBL adopted to better prepare people for handling 
real life situations
Institutions 
Medical Schools 
Pharmacy Schools 
Veterinary Schools 
Business Schools 
Community Colleges 
Disciplines 
Health Care and Nursing 
Engineering 
Geography 
Cell Biology 
Law
Problem based learning
(118 courses at 103 institutions across 35 countries) 
Linkoping University 
Roskilde University
Problem-based 
learning (PBL) is a 
student-centered 
pedagogy in which 
students learn about 
a subject through the 
experience of 
problem solving.
Problem-Based 
Learning really is just 
what its name 
implies…allowing 
students to learn 
through solving real-world 
problems.
We are preparing our students 
for jobs that don't exist, using 
technologies that have not been 
invented, to solve problems that 
we haven't even considered yet. 
Moreover PBL meets 
the demand of 
modern job 
requirements 
Richard Riley (1999) 
Communication skills 
Teamwork 
Analysis
From focus on teaching 
To focus on learning 
Investigation of real world problems 
Engages students as stakeholders 
Utilizes cooperative learning 
Instructor becomes coach
Told what we 
need to know 
Memorize it Problem assigned to 
illustrate how to use it 
Problem 
assigned 
Identify what we 
need to know 
Learn and apply it to 
solve the problem 
Traditional Learning 
Problem based learning
New- 
Innovative 
Curricula 
Traditional 
Medical 
Curricula 
 Continuum 
 
Student-centered Teacher-centered 
Problem-based Information gathering 
Integrated Discipline-based 
Community-based Hospital based 
Elective Standard 
Systematic Apprenticeship-based 
S 
P 
I 
C 
E 
S 
SPICES
>> learning is driven by 
challenging 
& open-ended problems. 
>> students work 
in collaborative groups. 
>> teachers take on the role 
as "facilitators" of learning.
>> learning is driven by 
challenging 
& open-ended problems. 
>> students work 
in collaborative groups. 
>> teachers take on the role 
as "facilitators" of learning.
>> learning is driven by 
challenging 
& open-ended problems. 
>> students work 
in collaborative groups. 
>> teachers take on the role 
as "facilitators" of learning.
Existing 
Content 
Lecturer Student 
Problem 
Facilitator 
Problem 
Solver 
PBL 
Learn new 
knowledge
FACILITATOR STUDENTS THE PROBLEM 
SOLVING THE 
PROBLEM
Barrows identified six core features of PBL: 
Learning is student-centred. 
Learning occurs in small student groups. 
Teachers are facilitators or guides. 
Problems are the organizing focus and stimulus for 
learning. 
Problems are the vehicle for the development of 
clinical problem-solving skills. 
New information is acquired through self-directed 
learning.
PBL Characteristics 
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 increase 
knowledge and understanding. 
unlike traditional instruction that culminates in a 
problem after basic instruction on facts and skills, 
PBL begins with a problem, teaching facts and 
skills in a relevant context.
Exciting alternative to traditional classroom 
learning. 
The teacher presents a problem, not lectures 
or assignments or exercises. 
Since students are not handed "content", the 
learning becomes active in the sense that they 
discover and work with content that they 
determine to be necessary to solve the 
problem. 
In PBL, teacher acts as facilitator and mentor, 
rather than a source of "solutions.”
PBL Characteristics 
FACTS IDEAS LEARNING 
ISSUES 
ACTION 
PLAN 
Information 
extracted 
from the 
problem 
scenario. 
Grouped 
according to 
themes, where 
possible. 
Possible 
causes/effects/ 
ideas/solution. 
Based on facts 
identified. 
Accepted 
without 
judgment. 
Evolves over 
time. 
Phrased as 
questions 
When 
answered 
should 
contribute 
towards 
solving the 
problem 
Activities to 
be carried out 
to answer 
gaps in order 
to help solve 
the problem 
e.g. conduct 
research, 
interview
Steps in Problem Based Learning 
1. Identify the problem 
2. Explore pre-existing knowledge 
3. Generate hypotheses and possible 
mechanisms 
4. Identify learning issues 
5. Self study 
6. Re-evaluation and application of new 
knowledge to the problem 
7. Assessment and reflection on learning
Step 1: Define the Problem 
Your task today is to 
solve………………… 
Facilitator present problem to student.
Step 2: Propose solution to solve the problem 
Lets discuss 
about…. 
• Clarify the facts and 
• Define what the problem is. 
• Brainstorm ideas based on 
the prior knowledge. 
• Identify what they need to 
learn to work on the problem 
• What they do not know 
learning issues 
Student discuss problem in a small group
Step 3: Gather and Evaluate Information 
Students will gather information from all sorts of resorces like 
from books and websites 
Then students will need to evaluate the findings. 
Student engage on independent study
Step 4: Synthesize and Form Solutions 
Student come back to group and share
Review 
How to improve this? What are the problems? 
Students review what they have learnt and compile 
final report
P - Problems 
R - Resources 
O - Objectives 
B - Behaviour 
L - Learning 
E - Examples 
M - Motivation 
S -Self directed learning and asessment
Analyse a Problem: 
1. Clarifying terms 
2. Defining the problem 
3. Brainstorming 
4. Structuring & hypothesis 
5. Learning objectives 
6. Searching for information 
7. Synthesis 
Pre-discussion 
Post-discussion
needs more information before it becomes 
clear 
act as triggers 
are interdisciplinary 
only given guidelines to 
approach problem 
several alternative solutions are 
often possible
Problem based learning
Work in a group of six to eight 
Meet for about an hour and a half two or three 
times a week 
Analyse, discuss and generate questions and 
learning tasks from the scenario 
Engage in self-directed learning 
Communicate results back to group
Monitors and evaluates learning/discussion 
Guidance is given in the form of suggestions 
Keeps students involved 
Manages group dynamics 
Keeps process moving 
May intervene if the students are not working 
or if the activity is starting to go in the wrong 
direction. 
Provides authentic assessment
all participants have a role to play 
Tutor 
1.Putting the problem 
in context and help 
prioritizing issues 
2. Encourage all group 
members to participate 
3.Prevent sidetracking 
4.Check understanding 
5.Access performance 
Chair 
1.Lead the group 
through the process 
2.Keep group 
dynamics 
3.Time keeping 
4.Ensure group keeps 
to task in hand 
5. Ensure scribe can 
keep up and make an 
accurate record. 
Scribe 
1.Record points 
agreed upon by group 
members 
2. Help group order 
their thoughts 
3. Participate in 
discussion 
4. Record resources 
to be used by groups 
Group 
members 
1.Follow the steps of 
the process of PBL as it 
has been agreed upon 
2. Participate effectively 
in the discussion 
3. Listen to and respect 
contributions of others 
4. Ask open questions 
to stimulate the 
discussion; 
5. Share information 
within the group.
‘Conventional’ PBL Expected effects 
Teacher-centred Student-centred Motivation  
Rote learning Active learning Retention  
Discipline-based Integrated Applicability  
Competitive Collaborative Interpersonal  
Information gathering Problem-solving Relevance  
Assigned resources Information management Professional  
Examinations Progressive learning Life-long learning 
Problem-solving: arriving at decisions based 
on prior knowledge and reasoning 
Problem-based learning: the process of 
acquiring new knowledge based on 
recognition of a need to learn
Method Learning 
through 
problem 
solving 
Project 
based 
learning 
PBL 
Emphasis Application Integration 
and 
application 
Acquisition 
Integration 
Application
Problem based learning
Problem based learning
PROBLEM: Julia , a 19-year-old woman who presents to a 
local adolescent clinic for the first time with concerns about 
a vaginal discharge and irregular menses. She has been 
sexually active for about two years with several partners. 
She frequently, though not always, has her partner use a 
condom. She is not using any other form of birth control and 
has not previously seen a physician for routine gynecologic 
care or contraceptive advice. Her family does not have 
health insurance. She is concerned about the possibility of 
a sexually transmitted disease and possible pregnancy. 
Results of the initial evaluation reveal that Julia has 
Chlamydia trachomatis, a lower genital tract infection. 
Treatment of her infection is initiated. The clinic reports her 
infection to the public health authorities.
Set up learning objectives: 
Causes of STD and risk factors for it 
Probable predisposing risk factors in the patient 
Describe the regulations and procedures pertaining to 
reportable infectious diseases, including the: 
Role of local public health authorities in tracking the epidemiology 
of reportable diseases 
Role of the local public health authorities in undertaking contact 
tracing procedures 
Primary functions of the Centers for Disease Control and 
Prevention and its role in monitoring reportable diseases in the 
United States 
Describe the different types of health insurance available to 
citizens
Session 1: 
the students are given the script of Julia's first 
office visit to the adolescent clinic. The group 
should begin the process of reviewing the learning 
objectives and related questions. 
Session 2 
Given the describing the results of her initial 
physical examination and summary of the 
laboratory testing and formulate a plan for her 
subsequent treatment and follow up care.
Active learning : learn by doing 
Increases student motivation 
Relevant issues and learning 
(real life problems) 
Greater use of library and other resource 
material 
Less use of memorization/short-term recall 
Increased faculty-student interaction
Students engage in a wide variety of 
learning experiences of which PBL tutorials 
lecture/plenary 
PBL 
tutorial 
topic tutorials 
practicals 
personal study 
computer assisted learning 
library skills 
clinical work 
demonstrations 
are of central importance.
Demanding on staff time 
Teacher’s not acquainted with PBL 
Human resources 
Other resources 
Information overload 
Different type of students- quiet student and 
dominant student 
Dysfunctional group 
Difficult with large classes 
Needs flexibility and adaptability
Although, world is weighing up for PBL and its positive outcomes, it 
could not extend much in Indian higher education. 
In India, after 4 decades, PBL is still in its infancy, and its use is 
limited to particular subject or topics of a few premier institutions. 
In India it is practised only in some private schools, engineering 
colleges, medical colleges and private hospitals. 
Keeping in mind the dearth of resources it would be difficult to 
implement PBL in all streams across various institutions as of now.
A hybrid system incorporates elements of conventional curricula, 
such as lectures and tutorials, in a problem based curriculum. 
overcome some of the shortcomings of a purely PBL curriculum 
some schools such as University of Otago Medical School, New 
Zealand, use a hybrid system in their preclinical curriculum. 
In India, used in CMC Vellore.
Objective: to learn the GI system using case based 
scenario 
topics used for the PBL 
cases were: 
1. Upper gastrointestinal tract: A case of peptic ulcer 
2. Lower gastrointestinal tract: A case of malabsorption 
3. Hepatobiliary system: A case of obstructive jaundice 
Problem Based learning 
Session 1: 
evolve a consensus on the learning objectives to be pursued. 
each student in the group takes responsibility for one or more 
specific learning objectives.
Session 2: 
Given the 2nd part of the case and shared the 
information they had gathered during the study time. 
Session 3: 
students were given the third part of the case 
At the end of session 3, the facilitator assessed each 
student’s participation in the sessions. The group did a 
self-assessment of their performance and that of the 
facilitator, using a similar scale.
Integrated lectures: 
Lectures related to Physiology and Biochemistry consisted of 
Case-based lectures (for example, a case of pancreatitis was 
used to discuss the physiology of pancreatic secretions), 
Overview lectures (such as an overview on secretions in the 
gastrointestinal tract), and 
Enrichment lectures (such as one on the historical evolution of 
knowledge concerning peptic ulcers). 
Clinical visits: 
Group visited clinical wards to see patients in medicine and 
surgery also visited the departments of radiology and 
gastroenterology.
General medicine. Patients with diseases of the 
gastrointestinal tract such as gastrointestinal bleeding, 
malignancy and cirrhosis of the liver. 
General surgery. Preoperative and postoperative 
patients with cholecystitis, appendicitis and colonic 
malignancies. 
Gastroenterology. Students watched gastroscopies 
being performed by gastroenterologists. 
Radiology. Students were shown images of barium 
meals ultrasonograms and computerized tomography 
(CT) images of the GI tract by radiologists, who 
emphasized the anatomical correlations in health and 
disease.
Small group laboratory work 
These sessions consisted of anatomy dissection and practical 
exercises in histology and biochemistry. The practical exercises 
in biochemistry related to investigations for assessment of liver 
function. 
Assessment 
Assessment of performance and skills acquired 
Assessment of self-directed learning skills (the content and the 
process) 
Assessment of knowledge (the content).
PBL in and for the future needs to be as an approach 
to learning that is not just about employability… 
or the “happening” new genre in higher education 
learning. It needs to be seen as an approach to 
learning that really does help learners to engage 
with and live in a complex world. 
Savin-Baden, M. & Major, C.H. (2004)
Nevelle AJ, Norman GR: PBL in the Undergraduate MD Program at 
McMaster University: Three Iterations in Three decades. Acad. Med.2007, 
82:370-374. 
http://www.maastrichtuniversity.nl/web/Faculties/FHML.htm 
Albanese, Mark A. Problem based Learning. [ed.] Tim Swanwick. 
Understanding Medical Education:Evidence, Theory and Practice. London 
: WileyBlackwell,2010, pp. 3752. 
Barrows H. 1994. Practice-Based Learning: Problem-Based Learning 
Applied to Medical Education. Springfield, IL: Southern Illinois University 
School of Medicine. 
Kahn, P. & O’ Rourke, K. (2005). Understanding Enquiry Based Learning 
in T. Barrett, I. Mac Labhrainn & H. Fallon (eds). Handbook of Enquiry and 
Problem based Learning. Galway: Celt 
Bhattacharya N, Shankar N, Khaliq F, Rajesh CS, Tandon OP. Introducing 
problem-based learning in physiology in the conventional Indian medical 
curriculum. Natl Med J India 2005;18:92–5.

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Problem based learning

  • 1. Dr. Soumya Swaroop Sahoo Junior Resident Dept. of Community Medicine
  • 2. Introduction Differences between traditional learning and Problem Based Learning (PBL) PBL Characteristics Steps of PBL Advantages and disadvantages of PBL Examples Indian scenario Conclusion
  • 3. “ You can not teach a man anything, you can only help him find it within himself ” - Galileo ‘Spoon feeding in the long run teaches us nothing but the shape of the spoon’ - E M Forster
  • 4. 1913 Sir William Osler (concerning the education of medical students) “ too great a reliance on lectures and on students’ capability of memorising a growing number of items of knowledge.” 1960’s PBL introduced in Canadian medical school 1970’s most of US and worldwide medical schools adopted PBL 1990’s PBL introduced into medical schools in UK by Manchester, Glasgow and Liverpool universities.
  • 5. PBL was pioneered in the medical school program at McMaster University in Hamilton, Ontario, Canada in the late 1960s by Howard Barrows and his colleagues.
  • 6. McMaster architect of PBL who pioneered the concept of using simulated patients to train medical students. Professor of medicine at McMaster from 1971 to 1980, Barrows created educational tools and learning methods that have defined modern medical training. His research encompassed the problem solving skills of physicians and PBL as a structured teaching/learning method. HOWARD BARROWS 1928-2011
  • 7. The intent is to challenge the learner with problems found in practice both as a stimulus for learning and focus for organizing what has been learned for later recall and application to future work. Howard Barrows “…a process of acquiring understanding, knowledge, skills and attitudes in the context of an unfamiliar situation, and applying such learning to that situation.” C. E. Engel, University of Newcastle
  • 8. Grades did not predict success Many students could not apply knowledge Diagnosis Problem solving Education is a continuous process and requires life-long learners PBL adopted to better prepare people for handling real life situations
  • 9. Institutions Medical Schools Pharmacy Schools Veterinary Schools Business Schools Community Colleges Disciplines Health Care and Nursing Engineering Geography Cell Biology Law
  • 11. (118 courses at 103 institutions across 35 countries) Linkoping University Roskilde University
  • 12. Problem-based learning (PBL) is a student-centered pedagogy in which students learn about a subject through the experience of problem solving.
  • 13. Problem-Based Learning really is just what its name implies…allowing students to learn through solving real-world problems.
  • 14. We are preparing our students for jobs that don't exist, using technologies that have not been invented, to solve problems that we haven't even considered yet. Moreover PBL meets the demand of modern job requirements Richard Riley (1999) Communication skills Teamwork Analysis
  • 15. From focus on teaching To focus on learning Investigation of real world problems Engages students as stakeholders Utilizes cooperative learning Instructor becomes coach
  • 16. Told what we need to know Memorize it Problem assigned to illustrate how to use it Problem assigned Identify what we need to know Learn and apply it to solve the problem Traditional Learning Problem based learning
  • 17. New- Innovative Curricula Traditional Medical Curricula  Continuum  Student-centered Teacher-centered Problem-based Information gathering Integrated Discipline-based Community-based Hospital based Elective Standard Systematic Apprenticeship-based S P I C E S SPICES
  • 18. >> learning is driven by challenging & open-ended problems. >> students work in collaborative groups. >> teachers take on the role as "facilitators" of learning.
  • 19. >> learning is driven by challenging & open-ended problems. >> students work in collaborative groups. >> teachers take on the role as "facilitators" of learning.
  • 20. >> learning is driven by challenging & open-ended problems. >> students work in collaborative groups. >> teachers take on the role as "facilitators" of learning.
  • 21. Existing Content Lecturer Student Problem Facilitator Problem Solver PBL Learn new knowledge
  • 22. FACILITATOR STUDENTS THE PROBLEM SOLVING THE PROBLEM
  • 23. Barrows identified six core features of PBL: Learning is student-centred. Learning occurs in small student groups. Teachers are facilitators or guides. Problems are the organizing focus and stimulus for learning. Problems are the vehicle for the development of clinical problem-solving skills. New information is acquired through self-directed learning.
  • 24. PBL Characteristics 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 increase knowledge and understanding. unlike traditional instruction that culminates in a problem after basic instruction on facts and skills, PBL begins with a problem, teaching facts and skills in a relevant context.
  • 25. Exciting alternative to traditional classroom learning. The teacher presents a problem, not lectures or assignments or exercises. Since students are not handed "content", the learning becomes active in the sense that they discover and work with content that they determine to be necessary to solve the problem. In PBL, teacher acts as facilitator and mentor, rather than a source of "solutions.”
  • 26. PBL Characteristics FACTS IDEAS LEARNING ISSUES ACTION PLAN Information extracted from the problem scenario. Grouped according to themes, where possible. Possible causes/effects/ ideas/solution. Based on facts identified. Accepted without judgment. Evolves over time. Phrased as questions When answered should contribute towards solving the problem Activities to be carried out to answer gaps in order to help solve the problem e.g. conduct research, interview
  • 27. Steps in Problem Based Learning 1. Identify the problem 2. Explore pre-existing knowledge 3. Generate hypotheses and possible mechanisms 4. Identify learning issues 5. Self study 6. Re-evaluation and application of new knowledge to the problem 7. Assessment and reflection on learning
  • 28. Step 1: Define the Problem Your task today is to solve………………… Facilitator present problem to student.
  • 29. Step 2: Propose solution to solve the problem Lets discuss about…. • Clarify the facts and • Define what the problem is. • Brainstorm ideas based on the prior knowledge. • Identify what they need to learn to work on the problem • What they do not know learning issues Student discuss problem in a small group
  • 30. Step 3: Gather and Evaluate Information Students will gather information from all sorts of resorces like from books and websites Then students will need to evaluate the findings. Student engage on independent study
  • 31. Step 4: Synthesize and Form Solutions Student come back to group and share
  • 32. Review How to improve this? What are the problems? Students review what they have learnt and compile final report
  • 33. P - Problems R - Resources O - Objectives B - Behaviour L - Learning E - Examples M - Motivation S -Self directed learning and asessment
  • 34. Analyse a Problem: 1. Clarifying terms 2. Defining the problem 3. Brainstorming 4. Structuring & hypothesis 5. Learning objectives 6. Searching for information 7. Synthesis Pre-discussion Post-discussion
  • 35. needs more information before it becomes clear act as triggers are interdisciplinary only given guidelines to approach problem several alternative solutions are often possible
  • 37. Work in a group of six to eight Meet for about an hour and a half two or three times a week Analyse, discuss and generate questions and learning tasks from the scenario Engage in self-directed learning Communicate results back to group
  • 38. Monitors and evaluates learning/discussion Guidance is given in the form of suggestions Keeps students involved Manages group dynamics Keeps process moving May intervene if the students are not working or if the activity is starting to go in the wrong direction. Provides authentic assessment
  • 39. all participants have a role to play Tutor 1.Putting the problem in context and help prioritizing issues 2. Encourage all group members to participate 3.Prevent sidetracking 4.Check understanding 5.Access performance Chair 1.Lead the group through the process 2.Keep group dynamics 3.Time keeping 4.Ensure group keeps to task in hand 5. Ensure scribe can keep up and make an accurate record. Scribe 1.Record points agreed upon by group members 2. Help group order their thoughts 3. Participate in discussion 4. Record resources to be used by groups Group members 1.Follow the steps of the process of PBL as it has been agreed upon 2. Participate effectively in the discussion 3. Listen to and respect contributions of others 4. Ask open questions to stimulate the discussion; 5. Share information within the group.
  • 40. ‘Conventional’ PBL Expected effects Teacher-centred Student-centred Motivation  Rote learning Active learning Retention  Discipline-based Integrated Applicability  Competitive Collaborative Interpersonal  Information gathering Problem-solving Relevance  Assigned resources Information management Professional  Examinations Progressive learning Life-long learning 
  • 41. Problem-solving: arriving at decisions based on prior knowledge and reasoning Problem-based learning: the process of acquiring new knowledge based on recognition of a need to learn
  • 42. Method Learning through problem solving Project based learning PBL Emphasis Application Integration and application Acquisition Integration Application
  • 45. PROBLEM: Julia , a 19-year-old woman who presents to a local adolescent clinic for the first time with concerns about a vaginal discharge and irregular menses. She has been sexually active for about two years with several partners. She frequently, though not always, has her partner use a condom. She is not using any other form of birth control and has not previously seen a physician for routine gynecologic care or contraceptive advice. Her family does not have health insurance. She is concerned about the possibility of a sexually transmitted disease and possible pregnancy. Results of the initial evaluation reveal that Julia has Chlamydia trachomatis, a lower genital tract infection. Treatment of her infection is initiated. The clinic reports her infection to the public health authorities.
  • 46. Set up learning objectives: Causes of STD and risk factors for it Probable predisposing risk factors in the patient Describe the regulations and procedures pertaining to reportable infectious diseases, including the: Role of local public health authorities in tracking the epidemiology of reportable diseases Role of the local public health authorities in undertaking contact tracing procedures Primary functions of the Centers for Disease Control and Prevention and its role in monitoring reportable diseases in the United States Describe the different types of health insurance available to citizens
  • 47. Session 1: the students are given the script of Julia's first office visit to the adolescent clinic. The group should begin the process of reviewing the learning objectives and related questions. Session 2 Given the describing the results of her initial physical examination and summary of the laboratory testing and formulate a plan for her subsequent treatment and follow up care.
  • 48. Active learning : learn by doing Increases student motivation Relevant issues and learning (real life problems) Greater use of library and other resource material Less use of memorization/short-term recall Increased faculty-student interaction
  • 49. Students engage in a wide variety of learning experiences of which PBL tutorials lecture/plenary PBL tutorial topic tutorials practicals personal study computer assisted learning library skills clinical work demonstrations are of central importance.
  • 50. Demanding on staff time Teacher’s not acquainted with PBL Human resources Other resources Information overload Different type of students- quiet student and dominant student Dysfunctional group Difficult with large classes Needs flexibility and adaptability
  • 51. Although, world is weighing up for PBL and its positive outcomes, it could not extend much in Indian higher education. In India, after 4 decades, PBL is still in its infancy, and its use is limited to particular subject or topics of a few premier institutions. In India it is practised only in some private schools, engineering colleges, medical colleges and private hospitals. Keeping in mind the dearth of resources it would be difficult to implement PBL in all streams across various institutions as of now.
  • 52. A hybrid system incorporates elements of conventional curricula, such as lectures and tutorials, in a problem based curriculum. overcome some of the shortcomings of a purely PBL curriculum some schools such as University of Otago Medical School, New Zealand, use a hybrid system in their preclinical curriculum. In India, used in CMC Vellore.
  • 53. Objective: to learn the GI system using case based scenario topics used for the PBL cases were: 1. Upper gastrointestinal tract: A case of peptic ulcer 2. Lower gastrointestinal tract: A case of malabsorption 3. Hepatobiliary system: A case of obstructive jaundice Problem Based learning Session 1: evolve a consensus on the learning objectives to be pursued. each student in the group takes responsibility for one or more specific learning objectives.
  • 54. Session 2: Given the 2nd part of the case and shared the information they had gathered during the study time. Session 3: students were given the third part of the case At the end of session 3, the facilitator assessed each student’s participation in the sessions. The group did a self-assessment of their performance and that of the facilitator, using a similar scale.
  • 55. Integrated lectures: Lectures related to Physiology and Biochemistry consisted of Case-based lectures (for example, a case of pancreatitis was used to discuss the physiology of pancreatic secretions), Overview lectures (such as an overview on secretions in the gastrointestinal tract), and Enrichment lectures (such as one on the historical evolution of knowledge concerning peptic ulcers). Clinical visits: Group visited clinical wards to see patients in medicine and surgery also visited the departments of radiology and gastroenterology.
  • 56. General medicine. Patients with diseases of the gastrointestinal tract such as gastrointestinal bleeding, malignancy and cirrhosis of the liver. General surgery. Preoperative and postoperative patients with cholecystitis, appendicitis and colonic malignancies. Gastroenterology. Students watched gastroscopies being performed by gastroenterologists. Radiology. Students were shown images of barium meals ultrasonograms and computerized tomography (CT) images of the GI tract by radiologists, who emphasized the anatomical correlations in health and disease.
  • 57. Small group laboratory work These sessions consisted of anatomy dissection and practical exercises in histology and biochemistry. The practical exercises in biochemistry related to investigations for assessment of liver function. Assessment Assessment of performance and skills acquired Assessment of self-directed learning skills (the content and the process) Assessment of knowledge (the content).
  • 58. PBL in and for the future needs to be as an approach to learning that is not just about employability… or the “happening” new genre in higher education learning. It needs to be seen as an approach to learning that really does help learners to engage with and live in a complex world. Savin-Baden, M. & Major, C.H. (2004)
  • 59. Nevelle AJ, Norman GR: PBL in the Undergraduate MD Program at McMaster University: Three Iterations in Three decades. Acad. Med.2007, 82:370-374. http://www.maastrichtuniversity.nl/web/Faculties/FHML.htm Albanese, Mark A. Problem based Learning. [ed.] Tim Swanwick. Understanding Medical Education:Evidence, Theory and Practice. London : WileyBlackwell,2010, pp. 3752. Barrows H. 1994. Practice-Based Learning: Problem-Based Learning Applied to Medical Education. Springfield, IL: Southern Illinois University School of Medicine. Kahn, P. & O’ Rourke, K. (2005). Understanding Enquiry Based Learning in T. Barrett, I. Mac Labhrainn & H. Fallon (eds). Handbook of Enquiry and Problem based Learning. Galway: Celt Bhattacharya N, Shankar N, Khaliq F, Rajesh CS, Tandon OP. Introducing problem-based learning in physiology in the conventional Indian medical curriculum. Natl Med J India 2005;18:92–5.