Students’ perception towards the problem based learning tutorial session in a system-based hybrid curriculum

BackgroundProblem-based learning (PBL) involves discussions among students who resolve loosely-structured problems to facilitate learning. In the PBL curriculum, faculty tutors are employed as facilitators for small groups of students. Because of lack of time and staff shortage, the effectiveness of tutorless PBL has been discussed as an alternate option.MethodsSessions in which tutored and tutorless PBL groups are mixed were presented by 1st-year medical students, who experienced both tutored and tutorless groups alternately in the two sessions of a year. To examine the effectiveness of tutored and tutorless PBL, written examination scores (WES) and self-contentment scores (SCS) were statistically analysed.ResultsWES averages did not significantly differ between the tutored and tutorless groups; however, a significantly greater variation was observed in WES in the tutorless group. SCS averages tended to be higher in the tutored PBL than in tutorless PBL groups.ConclusionsStudents in these tutorless PBL groups performed well in their written examinations, whereas those in the tutored PBL groups, achieved this and reported better self-contentment with their learning experience. Tutorless PBL sessions were considered to be comparable to tutored PBL sessions at least in the early stages.

Objective:Collaborative Problem Solving Empirical Progressions from the Assessment and Teaching of 21st Century Skills (ATC21S) framework were used to determine the level of collaborative problem solving skills (CPS) in first, second and third year MBBS students at Ziauddin College of Medicine during Problem-Based Learning (PBL) sessions. Variations based on gender and roles were studied.Methods:It is an analytical comparative cross-sectional study in which seven PBL groups were selected per year by non-probability convenient sampling. Data was collected using the Collaborative Problem Solving Five Strands Empirical Progressions by the primary investigator through observation of the students during PBL sessions. Duration of study was six months.Results:We found that in our students, development of social dimension skills is facilitated to a greater extent than the development of cognitive dimension skills through the process of PBL. These skills are generally better developed in the leader compared to the scribe and members in a group. They are also more developed in females compared to males. Modification in them is also observed as the year's progress.Conclusion:Although PBLs facilitate development of CPS skills' progression however in our curriculum, PBLs mainly focus on social skills development and have less emphasis on cognitive skill development. Thus, hybrid instructional strategies with components from TBL and mentorship are recommended for better development of CPS skills.

BackgroundTo develop the skills needed in health care teams, training communication and teamwork skills are important in medical education. Small group collaborative learning is one of the methods utilized in such trainings, and peer evaluation is suggested to be useful in reinforcing the effectiveness of group learning activities. In Mie University Faculty of Medicine, group work consisting of book review sessions of liberal arts education in the first grade and problem-based learning (PBL) sessions in preclinical years were conducted using the same peer evaluation system that included three domains: degree of prior learning, contribution to group discussion, and cooperative attitude. This study was conducted to determine the relationships among behaviors during group work and the academic achievement of medical students.MethodsWith the data from a cohort of medical students in three consecutive academic years (n = 340), peer evaluation scores in groupworks of book review sessions, those in PBL sessions and paper test scores of preclinical years were analyzed. The correlations were analyzed with Spearman’s correlation coefficient, and the respective scores were compared by using the Wilcoxon signed-ranked test.ResultsSignificant correlations were observed among the evaluation scores of respective domains in group work and paper test scores. The degree of prior learning had the strongest relationship among the three domains (rs = 0.355, p < 0.001 between book review sessions and PBL; rs = 0.338, p < 0.001 between book review sessions and paper test score; rs = 0.551, p < 0.001 between PBL and paper test score). Peer evaluation scores of respective domains were found to be significantly higher in PBL.ConclusionMedical students maintained their groupwork behaviors to some extent from early school to preclinical years. Those behaviors were positively related to their academic achievement in the later years of the medical education curriculum. Our study highlighted the importance of the early introduction of group work. The results will be useful to motivate medical students to put more effort into group work.

Physiology teaching as an essential part of medical education faces tremendous criticism regarding curriculum design, methods of implementation, and application of knowledge in clinical practice. In the traditional method of medical education, physiology is taught in the first year and involves little interdisciplinary interaction. The Manipal College of Medical Sciences, Pokhara, Nepal (affiliated with the Kathmandu Univ.) started in 1994 and adopted an integrated curriculum drawn along the lines of the student-centered, problem-based, integrated, community-based, elective-oriented, and systematic (SPICES) medical curriculum. Here, physiology is taught for the first 2 yr of the 4.5-yr Bachelor of Medicine, Bachelor of Surgery course. Methodology adopted is as follows. For a particular topic, objectives are clearly defined and priority content areas are identified. An overview is given in a didactic lecture class to the entire batch of 100 students. Tutorial classes are conducted thereafter with smaller groups of students (25/batch) divided further into five subgroups of five students each. In these sessions, a problem is presented to the students as a focus for learning or as an example of what has just been taught. Each problem was accompanied with relevant questions to streamline the students' thought processes. A tutor is present throughout the session not as an instructor but as a facilitator of the learning process. A questionnaire sought students' opinion on the usefulness of this approach, relevance of the combination of problem-based learning (PBL) sessions and didactic lectures in understanding a particular topic and relating clinical conditions to basic mechanisms, and improvement of performance on the university final examination. The majority of the students opined that the combination of didactic lectures and PBL sessions was definitely beneficial regarding all the above-mentioned aspects of learning. The university results corroborated their opinion. Thus it may be considered that a judicious mixture of didactic lectures and PBL sessions is beneficial as a teaching module of physiology in medical schools.

Background: Since its establishment in 2005, the national university -Sudan (NUSU) has adopted problem- based learning (PBL) as an educational strategy and a teaching method. The increasing number of student's intake every year and the turnover of staff had affected the way PBL sessions were conducted. Therefore, in 2014 a task-force was formed by the faculty of medicine to address the issue. Objectives: to investigate the status of PBL in the faculty of medicine and propose required measures. Methodology: A task force was formed by the faculty board. It consisted of a medical educationalist, a senior physician, and a physiologist. The group investigated the organization and implementation of PBL. It reviewed the current practice including the timetables, the problem scenarios and the students' attendance records. Results: Most of the problem scenarios had no clear source or objectives. The implementation of PBL sessions depended on part-time tutors. There was no structured program for training of tutors. The students 'attendance for PBL sessions was notably poor. Conclusion: The task force presented their report including a proposal for actions to be taken. Training workshops for tutors were organized and timetables were restructured to properly accommodate PBL as an active learning method. Implementation of PBL requires continuous support for training of academic staff and provision of learning resources for the students. The use of e-learning should be considered as a future measure to increase the learning opportunities for students and as a solution to the issue of large groups teaching.

Background: PBL (problem based learning) is new active learning educational strategy that has been extensively tested and used in recent years. This study aims to compare students' understanding and knowledge retention when taught through PBL and lecture-based classes and compare PAHS students' perceptions of PBL and lectures in medical education. Methods: This is a cross-sectional study of medical students of a PBL based medical school in Nepal, a non-Western low-income country. Ethical approval was given by the institutional research committee of the Patan Academy of Health Sciences. Understanding and knowledge retention was assessed with 50 vignette-based multiple-choice questions, half of which were taught through PBL sessions, and the remaining half were taught in didactic lectures during basic science years of medical school. A separate pre-validated perception questionnaire was used to assess students' preferences regarding PBL and lectures. Results: Out of 107 students, 99 participated in the understanding and knowledge retention questionnaires and 107 completed perception questionnaires. Understanding and knowledge retention of students was found to be the same for topics taught by PBL and lectures, with median scores of 17 and s16, respectively. PBL were mostly preferred for the physiology (59.81%), pathology (51.40%) and pharmacology (53.27%) concepts, and lectures were mostly preferred for the anatomy (78.50%), biochemistry (45.79%), and microbiology (42.99%) topics. Students wanted the same concepts to be taught through both PBL and lectures, especially for anatomy. Conclusions: Understanding and knowledge retention is the same for topics taught by either PBL or lectures during the basic science years of undergraduate medical education. Students prefer PBL for physiology, pathology, and pharmacology-related concepts, conventional didactic lecture for physiology and microbiology, and a combination of lecture and PBL sessions for anatomy.

Carle Illinois College of Medicine.

Purpose:Kyungpook National University School of Medicine has been implementing hybrid problem-based learning (PBL) since 1999. The aim of this study was to investigate the changes in the students’ perceptions and satisfaction levels of hybrid PBL.Methods:The target period of our study was from 1999 to 2014, and target subjects were second-year medical students in Kyungpook National University School of Medicine. The survey was conducted at the end of semester. We had a focused interview with group leaders and some volunteer students.Results:As for the scores regarding students’ overall satisfaction with PBL, there was significant improvement in 2005 compared to 2002, but the scores decreased and no differences between the survey years noted after 2005. The students’ preference ratio for the once a week PBL sessions, tutor presence, synchronization of contents, and arrangement of PBL sessions and related lectures was 60%–80%, 50%–90%, 52%–96%, and 78%–93%, respectively.Conclusion:In order to increase students’ satisfaction with hybrid PBL and to improve the perception of it, firstly, it is necessary to arrange the date and the time of PBL sessions so that students can concentrate on PBL. Secondly, PBL cases should be selected and arranged to be well synchronized with the ongoing lectures. Finally, it is important to create a safe atmosphere so that students can engage actively in PBL sessions.

Monash University Sunway Campus usually conducts Problem-Based Learning (PBL) twice a week for both Year One and Year Two medical students. However, in 2009 PBL session was reduced from a two-day PBL session to a single day. The main objective of this action research paper is to compare and evaluate the single day session and the two-day session in terms of strengths and weaknesses and to propose possible solutions to the school and other campuses to improve the current practice. A qualitative approach, using focus group interviews were used to collect data from the medical students. Questionnaires were distributed to tutors facilitating the PBL sessions. The results showed that the new approach in PBL delivery was favorably accepted both by students and tutors. This approach, which was initiated by the Malaysian campus, was adopted by both campuses in Australia and Malaysia.

Background: Problem-based learning (PBL) is based on adult learning theory which provides a better understanding of the problem through self-directed learning. During didactic lectures, students are receiving the information and they are memorizing it without understanding the practical applications. PBL provides an active learning environment along with the acquisition of other skills. Aims and Objectives: The present study was conducted to assess the effectiveness of PBL over conventional lectures as a teaching–learning method for phase 1 medical students. Furthermore, the perception of students toward PBL was taken. Materials and Methods: PBL sessions were conducted among 100 Phase 1 medical students by dividing them into two groups and assessed by MCQs. Lecture class was taken for the whole students and again assessed by MCQs for the non-PBL topics. A comparison between the aggregate test scores was made using an unpaired t-test. Perception of students toward PBL was collected using a validated questionnaire in Likert scale and expressed as a percentage. Results: Data analysis showed the aggregate mean score of PBL as 27.96 (3.42) and conventional lecture as 22.66 (4.28) with P &lt; 0.001, which was taken as significant. Students showed a positive response toward PBL as an effective learning tool. Conclusion: PBL is an effective teaching–learning method that can be incorporated into the medical curriculum to create medical graduates with self-directed lifelong learning skills.

Context: Basic medical sciences education differs among medicine courses, especially as traditional and integrated problem-based learning (PBL) curricula teach basic sciences in very different ways. The literature shows no clear differences in the performance of students of these different educational philosophies. The Charité Medical University of Berlin (Charité Universit tsmedizin Berlin) teaches both a traditional medical curriculum (TMC) and a PBL reformed medical curriculum (RMC). Both curricula conduct the Progress Test in Medicine (PTM), which examines competence in the basic and clinical sciences from the first to the last semester. Objectives: The aim of this study was to compare the development and retention of knowledge in the basic medical sciences between students on the traditional and reformed undergraduate medical curricula, respectively. Methods: For each student and single PTM, relative frequencies of correct answers were computed for basic sciences items only and for the whole curriculum. Frequencies were averaged and grouped by semester and curriculum. Analyses of variance (ANOVAs) were performed at all measurement points with a Bonferroni-corrected p-value at the level of p &lt; 0.005. Eta-squared (η2) was used to classify effect size. Results: In the first three semesters, RMC students slightly outperform TMC students in the basic sciences, although TMC students receive more systematic teaching. After this, TMC students develop a peak of knowledge in basic sciences and overtake RMC students. The knowledge of TMC students then decreases over time, but despite this, they perform better in the final semester. Students on the RMC show constant progress throughout their undergraduate studies. Overall, the development of medical knowledge is consistent in both curricula. There is no significant difference in this outcome between the traditional and PBL courses. Conclusions: Progress testing as a longitudinal method allows us to better understand the development of knowledge during formal undergraduate education. The main difference between traditional and problem-based medical education seems to be provoked by the high-stakes national examination undertaken in the traditional course (the Physikum).

Cultivating communication through PBL with ICT

ABSTRACTProblem: Good teaching requires spontaneous, immediate, and appropriate action in response to various situations. It is even more crucial in problem-based learning (PBL) tutorials, as the tutors, while directing students toward the identification and attainment of learning objectives, must stimulate them to contribute to the process and provide them with constructive feedback. PBL tutors in medicine lack opportunities to receive feedback from their peers on their teaching strategies. Moreover, as tutorials provide little or no time to stop and think, more could be learned by reflecting on the experience than from the experience itself. We designed and evaluated a faculty development approach to developing PBL tutors that combined self-reflection and peer feedback processes, both powerful techniques for improving performance in education. Intervention: We developed an observation instrument for PBL facilitation to be used both by tutors to self-observe and reflect on own teaching strategies and by peers to observe and provide feedback to tutors. Twenty PBL sessions were video-recorded. Tutors completed the instrument immediately after their PBL session and again while watching their video-recorded session (self-observation). A group of three observers completed the instrument while watching each recorded session and provided feedback to each tutor (peer observation and feedback). We investigated tutors' perceptions of the feasibility and acceptability of the approach and gathered data on its effectiveness in enhancing tutors' facilitation skills. Context: The preclinical medical curriculum at the University of Geneva is essentially taught by PBL. A new program of faculty development based on self-observation and peer feedback was offered to voluntary tutors and evaluated. Outcome: Our results suggest that self-observation and peer feedback, supported by an instrument, can be effective in enhancing tutors' facilitation skills. Reflection on self-observation raised teachers' awareness of the effectiveness of the strategies they used to foster student learning. This motivated a need to change their teaching practice. However, for the changes to become operative, peer feedback was required, providing the cues and strategies needed to improve the facilitation skills. Lessons Learned: Peer coaching was considered feasible and useful to improve tutors' facilitation skills. Evaluating the program made it possible to assess tutors' needs and the reasons underlying their difficulties, and this in turn provided the basis for advanced workshops. Nonetheless, aspects related to logistics and the time constraints of such an individualized approach, as well as the cultural appropriation of peer coaching, might be obstacles that need to be addressed.

A major change embraced during a recent review of the Bachelor of Veterinary Science (BVSc.) curriculum of University of Peradeniya, Sri Lanka, was implementation of student-centred learning. Thus, a series of courses; ‘Integrated Veterinary Sciences’, delivered using Problem-based Learning (PBL), were introduced. As PBL is novel to the curriculum, this study was aimed to evaluate veterinary undergraduates’ perception on such a PBL-driven course which has been evaluated for the first time in Sri Lanka. PBL sessions were conducted with volunteers of all four academic year groups. Responses were assessed, using a questionnaire, on the opportunity for improving critical thinking, discussions, facilitator guidance, e-learning and overall satisfaction of using PBL. Over 85% of students across all groups agreed that the PBL had been effective: the highest level of agreement was on the potential to improve critical thinking. There were statistically significant differences between year groups for satisfaction with facilitators’ guidance and overall satisfaction; which may reflect differences in either content or facilitators’ experience between year groups. PBL was well-received as a method for use in the veterinary curriculum, Sri Lanka, suggesting the possibility of its widespread use for vertical and horizontal integration. Teacher training and improving facilities would ensure the success.

Objectives:The aim is to provide students in the preclinical with ultrasound image interpretation skills. Research question: Are students in smaller groups with access to a combination of lectures and hands-on patient contact most likely to have better ultrasound image interpretation skills, than students in larger groups with only interactive didactic lectures?Methodology:First-year students at the preclinical Program of the College of Medicine, participated in two 2-h introductory interactive ultrasound sessions. The study comprised two cohorts: 2012/2013 students, who were offered large group teaching (LGT) sessions (control group), and 2013/2014 students, who received the intervention in small group learning problem-based learning (PBL) sessions (experimental group). The overall learning objectives were identical for both groups. The success of the module was evaluated using pre- and post-tests as well as students’ feedback.Results:The students in the experimental group showed significantly higher scores in interpretations of images than those in the control group. The experimental group showed achievement of learning outcomes along with higher levels of satisfaction with the module compared to the latter.Conclusion:Posttest knowledge of the basics of ultrasound improved significantly over the pretest in the experimental group. In addition, students’ overall satisfaction of the ultrasound module was shown to be higher for the PBL compared to the LGT groups. Small groups in an interactive and PBL setting along with opportunities for hands-on practice and simultaneous visualization of findings on a high definition screen should enhance preclinical student learning of the basics of ultrasound. Despite the potential of ultrasound as a clinical, teaching and learning tool for students in the preclinical years, standardized recommendations have yet to be created regarding its integration into the curricula within academic institutions and clinical medicine. The interactive and PBL is here to stay at the college of medicine. Further research would be carried out to see if this trend persists in the upcoming vertical system-based curriculum of the college of medicine.