How do you know if PBL is for you?

[Guest byjude]

I've read about the theory and the benefits of problem based learning (and its variations), but I also know that this style of learning suits certain people more than others, just like any other style of learning (classroom, independent learning, etc). It's easy to say something looks enjoyable when others are doing it, than when you do it yourself.

 

So my question is, how do you know if PBL is for you? What character traits make a good PBL learner?

[Guest moo]

Honestly, I don't really like PBL. The only good thing is that it drastically reduces class time (10 hours/week in first year, and this year, the most intensive week we've had was 17 hours/week in lecture). I don't think PBL is conducive to learning. Why? Because you have students presenting topics to each other when they've probably just spent an hour or so looking the topic up on Google. I can't sit there, and listen to my classmate read off the sheet he/she printed out off some website the night before. At least with lecture, I can follow along in the syllabus/precis/notes/slides while the lecturer talks, and because the lecturer is also an expert in the field, I can jot down some notes to clarify things.

[Guest Head Dawg]

Hi moo,

 

I was very interested to read your opinion of PBL. From what you described, however, I wouldn't even call that PBL - at least, not anything like we do at Mac, the so called 'home of PBL' and self-directed learning. One thing I've come to believe is that to really enjoy PBL and get the most out of it, you have to make it the centre and focus of all your learning.

 

PBL is not one student 'presenting topics' to the rest of the group. Where's the discussion? Where's the interaction? By having all the group members involved in discussions, reasoning out difficult concepts of physiology, pathology and treatment, everyone becomes an active part of the learning process. I'm certain, having done traditional lecture style learning for many years, that I also retain knowledge much better this way. I can relate knowledge to specific cases, particular group discussions and hypothetical patient scenarios that we'll remember for a long time.

 

PBL also requires MUCH more preparation than an hour on google. If I prepared that way, my group would be very disappointed in my preparedness and I'd probably spend most of the tutorial feeling lost and useless. I easy spend 3-4 times as much time preparing for PBL as I actually do in it. Discussions can get very detailed, and allow group members to share their specific expertise when called for.

 

Lastly, you referred to expert instruction - I think PBL gives you the best chance to learn from experts. Right now doing a problem on cardiac arrhythmias, we consulted experts in anatomy, cardiology, radiology and our own group tutor. All of these doctors have excellent knowledge, and getting it in groups of 6 with hands-on demonstration allows for complete learning of a concept.

 

As you can probably see, I'm pretty big on PBL - It's just because I really enjoy it. I hope you don't feel like I'm bashing you or your opinions, but I felt like the other side of the story needed to be told.

 

Warmly,

 

HD

[Guest jackiedirks]

I also admit to NOT liking PBL, and also being the type of person to only spend an hour on google researching their topic (well honestly its probably more like 2 hours on emedicine.com, which is almost the same idea...)

 

Saying that, I can certainly appreciate PBL for what it is worth, and what it is trying to teach us. Here in first year there's a lot of basic sciences, physiology, pathology, pharmacology, etc, and in lecture its sometimes difficult to relate this back to a clinical situtation. So PBL does that quite nicely. It is also good at getting us to brainstorm ideas, to look at all aspects of a medical issue (even the social and ethical aspects which sometimes get buried in the science) and to interact with a lot of different personality types.

 

BUT- I am a lecture type person and enjoy learning most of the material this way. Sometimes I get frustrated with the pace of the sessions, and their ability to get off the point. I guess I'm glad that we have the four hours of PBL a week- and glad we have no more than that.

[Guest moo]

I was kind of exaggerating with my opinion. For example, sometimes we'll have radiographs that we need to interpret which one member will have to take to a radiologist. We do have interactions and discussions of the cases; it's just not my style of learning. Because our school doesn't test us on PBL, a lot of my classmates and I find it difficult to spend more than an hour the night before looking up the topics (unless you are extremely interested in the topic).

 

But you are at Mac, so you guys probably get way more PBL than we do. The maximum amount of hours spent in PBL is four hours/week depending on the block.

 

There are good points of PBL. I enjoy meeting new people from my class to whom I normally wouldn't talk. Someone always brings in food so it makes the atmosphere more enjoyable. Once, we even went out for breakfast, courtesy of our leader. Another time, my friend went out to this dessert bar at night. So it's not all bad.

 

I think most people in my class have gotten tired of PBL by the end of the second year and find it more of a pain than anything. But there are some who really still enjoy PBL. To each his own I guess.

[Guest fox]

I love PBL, for the most part, but it totally depends on your group. Our PBL starts with a case that no one has looked at and we bounce ideas around, try to come up with answers etc., decide what we don't know and what we have to research, and then meet back the next time and discuss it. However, if someone in the group doesn't give others the chance to talk, or looks at the case beforehand and states they know everything about it, then it defeats the purpose of PBL. I learn so much more in PBL than in lecture. It also depends on your facilitator.... For our cardiology block I had an amazing facilitator and learned SO much. For our triple I block my facilitator was not so great and I wanted to pull my hair out the time went so slowly because she'd keep taking over and going off topic.

As for if PBL is for you or not, as far as I know, all schools have some PBL (I think it's a requirement now), but whether you want to go somewhere that's almost all PBL (like Mac), or only supplementary (like U of A) depends on how you like learning. For example, if you attend class and learn a lot, or if never go to class may be a factor. It also depends on how motivated you are. I prob wouldn't survive at Mac because I wouldn't have incentive to work every night on my own.

[Guest byjude]

Thanks for the opinions. It's great to hear some advice from the inside rather than just speculating.

 

I'm sure others will benefit from this discussion as well, but I'm personally curious to help decide whether I should apply to Mac next year or not. By the sound of it, I feel like I would hate PBL, but some of my peers have told me I would be well suited for it, so I'm confused.

 

What if your preferred method of learning is independent? I like lectures for their axiomatic style of teaching - here are the basic principles, now go apply them, but they bore me to death and I don't get a lot out of sitting and listening to someone else talk (since I'm much more of a visual learner than an auditory one). I like discussing the things I learn, and examining them from various angles, which is the strength of PBL, but I much prefer learning the principles and then applying them, rather than seeing an example and deducing the principles from it. Would this make me a poor PBL learner?

[Guest moo]

byjude, I consider myself an independent learner and don't really like to sit through more than 2 hours of lecture a day. I thought I would like PBL, but now that I've been through two years of it, I can honestly say it does not suit me. The major benefit of PBL is reduced class time, which for us means having no more than two hours of lecture per day in first year and no more than four hours in second year (most days it's 2 hours/day). Although I don't like too many lectures either, I go to them, and I feel that by hearing it once, and then going through the lectures again, I retain information much better than through interactions in small groups, which I feel (for me anyway) is unorganized and an unsystematic way of learning.

[Guest byjude]

Thanks moo.

 

It sounds like we have similar learning styles, so it's helpful to hear about your experience!

 

I definitely agree about your comment about organized learning.. thinking back, some of my most difficult courses have been the ones where the teaching just seemed to be a huge mess with no structure (even though some of my classmates thoroughly enjoyed the exact same lectures I dreaded).

 

Personality definitely comes into play in teaching method, and in a way, it's a shame that all the Canadian universities can't open themselves up to a free market system allowing equal opportunity for all applicants regardless of regional background to allow each school to specialize and better address a particular learning style for self-selected applicants rather than trying to accomodate everyone. But, I think I take that back, because that might homogenize each class too much, wouldn't it?

[Guest moo]

Yes, that's exactly what I feel PBL is like--a huge mess with no obvious structure, whereas with our lectures, the instructor will list out the Lecture Goals and Objectives, and then give us a Lecture Abstract, which basically is the primary source for most of my studying (there are slides and textbook readings as well). In PBL, we'll get a case, and then we'll find some "learning issues" to divide up among the group members. We'll also discuss the case, list out some "hypotheses" and try to decide which fits our patient. Some people like this style of learning and many believe it's good prep for the wards with which I won't disagree, but again it's just not for me.

 

I think in Canada, Mac is pretty much the only school that is pure PBL. To get rid of the regionalization, I think there needs to be more private schools in Canada. If you think about it, all the universities and colleges in Canada are public. Private funding can eliminate much of the geographical limitations of applicants to a med school. But this is probably more suited for discussion in another thread.

 

I think wherever you go nowadays, with the exception of a few traditionalist schools in the US (I remember when I interviewed at Columbia and Cornell they were bashing each other's curricula--Cornell is strongly PBL based and Columbia has a very traditional curriculum), most schools have some form of PBL incorporated into the curriculum, which might not be that bad, as I said because you get reduced class time. I love being done by 10 or 11 three days a week... gives me time to work out, roller blade, volunteer, and takes the stress out of med school.

[Guest byjude]

Sounds like a great time! Rollerblading - would love to go do that right about now.

 

I definitely support the idea of specialization amongst Canadian med schools, but not sure about implementing private education given the current market. It works in the US because it's founded on a private education system, but to allow mixed private/public education in Canada would completely flip the current system on its head - inevitably, most of the current large universities would likely bid to privatize, basically pulling the rug out of the public system.

 

On the other hand, I do support deregulation - more control for individual universities in their own administration while maintaining a public system could be helpful. Sure, tuition rises, but so too do bursaries and scholarships.

 

But I think even under the current public situation, specialization for individual med schools could be viable - if they'll all stop worrying about regional interests and start focusing more on developing their own sense of identity. This is the strategy U of T has taken - from giving preferential treatment to Ontario residents to opening its borders to all Canadians (+ international students) and developing its own niche - trying to seek out the "best" students regardless of location.

 

I think that schools in locations with less tendency to attract distant students could maintain their quality of enrolment not by rewarding local applicants with lower expectations, but by developing a niche that can attract applicants from far away. This boosts their potential for attracting strong applicants and effectively could boost the university reputation based on number of applicants or cutoffs or demand for residents or whatever categories reputation and quality are determined by.

[Guest fox]

The whole idea with having an out of province quota is based on the fact that most people who really want into medicine will go ANYWHERE to study, but it doesn't mean they'll stay there for residency or practice there. People go where they know... I am from Ontario, but did my Masters in Edmonton and am now going to med school. By the end of med school I will have lived in Edmonton for 8 years, but am likely not staying here forever. Would I have gone to school in the NWT (for example) if I didn't get in anywhere else (and there was a med school there)? You bet. But I doubt I'd live there longer than I had to (I've never been, so I really don't know). And as for taking international students instead of Canadians, that doesn't seem very fair to me considering we are extremely short of doctors and it is so difficult to get in.

 

As for PBL, I am pretty sure it is a requirement for a school to be accredited by the CMA. I think Sask was at risk of losing their accreditation if they didn't introduce PBL, and I know U of A changed their curriculum a few years ago so there would be PBL and they are being reviewed in the near future.

 

Whether you should apply to Mac or not is a personal decision. However, I applied to as many places as I could to increase my odds of getting in. IF you get an interview, then you can talk to people in the program about what it's like etc. To me, med school anywhere was better than nowhere. If you do end up with a choice, then you can choose based on the curriculum.

[Guest byjude]

Sorry, I didn't mean to imply that Canadian schools should open their doors to international students. I was just referring to U of T's change in policy from preferring Ontario residents to looking at all Canadians equally AND also accepting international students.

 

I still stand by my argument that opening a medical school's doors to applicants from all regions helps encourage out of province students to pursue a residency or set up practice in their "new home". If a resident of a given province is sick of living in that province, they will eventually leave that province, whether or not it happened to give them a seat in its medical school (once residency opens up the doors to all other locations in Canada).

 

Such a tactic could still be used in a more "deregulated" medical school market. Regions that traditionally have difficulty attracting practitioners could maintain quota or special admissions strategies to attract local applicants, while universities in other regions that traditionally attract a large number of out of province applicants to their other programs (eg, UBC, Dalhousie, U of A, McGill especially) could open up their doors and move toward a more specialized curriculum. I'm not saying that this is definitely better than the current system -it's something interesting to consider, it would certainly allow medical schools to develop more of their own niche rather than spreading themselves thin trying to do a little of everything in terms of teaching.

 

I'm curious: does the proportionate regional distribution of Canadian medical students approximately represent the regional distribution of the Canadian population? Regardless, every province has its urban areas and rural areas, and even if you give preferential treatment to students from, say, BC at UBC, this doesn't say anything about your ability to produce new doctors to work in those rural areas. I bet you'd have a much easier time getting an OOP doctor to work in Vancouver than you would finding one to work in northern BC (or even northern/rural regions of their home province); so is regional protectionism all that effective if it doesn't even target the areas that need the most support?

[Guest moo]

I bet you'd have a much easier time getting an OOP doctor to work in Vancouver than you would finding one to work in northern BC (or even northern/rural regions of their home province); so is regional protectionism all that effective if it doesn't even target the areas that need the most support?

 

That's why UBC is opening up the island program at UVic and some program at UNBC. I think most Canadians have to believe that it will work. Whether it does or not remains to be seen, but I am all for them trying to get docs into rural areas. Statistically if you are from a small town, you will go back there to practice, so hopefully by opening these new branch campuses, people will stay there. I was rejected two years ago by UBC, but to tell you the truth, I am kind of glad they didn't take me, because they really should take people who are willing to practice in the rural areas. These are the truly underserved and they deserve to have physicians who will take care of them (most likely because I won't want to live in Northern BC, away from my entire family and livelihood that I am used to).

 

Anyway, back to the PBL thing. I don't think it's a requirement that PBL be introduced or anything to get accreditation. The CMA and the US counterpart LCME both do the accrediting at the same time (it's a joint effort) and I am sure that PBL is not at all a requirement to retain accreditation, otherwise schools like Columbia, Hopkins and Vanderbilt (top US schools) would lose their accreditation since the LCME accredits schools from Canada and the US. USask is on probation for other reasons (inadequate library, inadequate teaching staff, etc.) but I really don't think PBL is one of them. I could be wrong though.

[Guest drews97]

I have to agree with Moo when I say I don't really like PBL. In therory I think it is a great idea but in reality is doesn't work too well. Most people complete their PBL at the last minute and the cases that we cover in PBL are often totally unrelated to what we're covering in lecture. Additionally, the effort that people put into PBL varies vastly to the point where some know everything about a particular case whereas someone else may have 5 lines of 'data' that they got from a sketchy web-site. Liking PBL or not obvoiusly has a lot to do with how you learn. I find it MUCH easier to be presented with the information and then to try and learn that information and read around the subject as necessary. I don't like being given no information on something I know nothing about then have to go and find it myself. I also find that, in our PBL groups, we often get really far off topic and go off in crazy tangents. Someone will invariably have a PhD in something and tell us WAY more than we want to know or take over that part of the discussion form the person to whom that task had been assigned. Oh, and you can't skip PBL either when you don't feel like going;)

[Guest blinknoodle]

Most people complete their PBL at the last minute... I find it MUCH easier to be presented with the information and then to try and learn that information and read around the subject as necessary.

 

I am currently in an undergraduate problem that uses PBL extensively. What I don't understand from all these comments is that YOU are in control of your own learning. PBL allows you to do that (why do you think there are less hours of classtime?).

 

So what does that mean? If you know you like to be spoonfed your information first before you feel like venturing out... go find someone to spoonfeed you. Go find a textbook.. All you have to do is find an expert and know the right questions to ask. Then figure out if the expert actually is right!!

 

I agree that one of the disadvantages is that you are dependent on your group members to pull their own weight. (the next question to ask, is which categorydo you fall into?). But if they/you don't, how do you remedy the situation? Remember that you are in control of your own learning... furthermore, PBL encompasses more than simply asking the right questions and finding the answers. It includes critical evaluation and group dynamics. If you're too busy and only have time to google something, why not first try the sources that are geared for busy professionals (probably what you'll use once you are in the workforce) and see how their information stacks up to what the rest of the group determines (ie. Uptodate, Cochrane).

 

I'm not trying to start a debate on PBL, but it bothers me when you realize that physicians are supposed to be self-regulated (kudos for saying what you think). But you have to determine what works best for you and your group and figure out how to accomplish that. Don't tell me it works great in theory -- you have the ability to make it work in the real world.

 

...just some food for thought....

 

-blinknoodle

[Guest drews97]

Hey! I'm just giving you my opinion of PBL as I have experienced it!! I had never been exposed to PBL in undergrad and so only had my first taste of it in medicine. Some people have said that they like PBL because it decreases their class time, but for us it is the opposite, it adds to our class-time. We have lectures from 8:30-12:30 everyday and PBL is every Monday afternoon from 1:30-4:30. If you've experienced PBL and have had success learning that way I would encourage you to look into a medical school that uses a lot of PBL in their curriculum such as MAC or U of C. My biggest problem with it is that we're presented with 4 hours of lectures per day on a unified subject (ie://dermatology) then have 3 hours per week on a totally unrelated subject. Most people are focusing their studying (at least I am) on the in class lectures and PBL often seems like more of an afterthought. In my experience, a lot of people do complete their PBL at the last minute. People at my school are obviously hard working and very intelligent so it's not like they're lazy slackers, but there's so much else going on that it's hard to spend hours a week consulting experts, doing extensive research, etc that would be required to really benefit from PBL. I obviously do learn something from PBL, so in that sense it is useful. For example, we often are given very specific values (such as the normal range for leukocytes in a blood count) that we don't receive in lecture. Anyway, I think PBL works well for some and less well for other (I know some people who love it). Regardless, it is a part of nearly every Canadian medical school and thus will continute to play a role in training future physicians.

[Guest Lorae]

Hi Drews. I'm pretty sure Calgary doesn't emply PBL. From my understanding their curriculum consists of lectures + small group work. From what I've read and been told, the small group work involves reasoning through case scenarios, however it is rarely the student's responsibility to teach the information to the group (as is the case in PBL).

 

I am only a hopeful student of Calgary so perhaps one of the moderators could describe it better.

[Guest fox]

What you described at Calgary sounds exactly like what PBL is... It totally depends on your group, because if your group decides to split up a topic and everyone takes one thing to look up, then it's more like you're teaching your group. I don't like that way of doing PBL. We usually have a case that we discuss, try to figure out, look up stuff we don't understand etc and then everyone researches stuff and we come back and discuss it.

The thing with PBL is that personalities tend to come out very strongly. You have people who hate it and don't say anything, people who are too shy to say anything, people who never stop talking, people who know everything and don't offer up the goods unless they're prompted, and then those who are suited for PBL. Our PBL at U of A is quite good, in my opinion, but there are people who hate it. I find it supplements the lectures very well and I learn a lot more than if I just depended on lectures. However, if I had to larn strictly from PBL then I would prob flounder and spend way more time doing work than I do now. We usually only have about 5 hours of PBL a week, so it's a good balance and unfortunately really doesn't take away from much class time.

[Guest blinknoodle]

I'm curious..

 

Fox, as part of your PBL, is there an emphasis on personal reflection? Do you ever get to bring up issues with group dynamics and the such or is it more focused on the end product (the case study)?

 

-blinknoodle

[Guest fox]

No, we don't talk about group dynamics or anything like that.... We do get an evaluation from our preceptor, but nothing from the group. Our PBL group switches every block, so for most of the year we've only had the same group for six weeks, which isn't long. However, we're in CPR now and have the same group for 14 weeks.

[Guest Jerika81]

Yeah Lorae is right.

At U of C we don't really have PBL, or at least not what is traditionally seen as PBL. Our small group sessions generally consist of going through cases with a preceptor- but the difference is that we have already covered all the material needed to "solve" the cases in lecture- so there is no need for anyone to look stuff up. We get a problem (or a number of them) at the beginning of a session, and we work through it as a group with our preceptor, and by the end of the session we all know what the diagnoses/investigations/treatments/etc. are.

Interestingly, in our current unit (renal) we are having a few PBL sessions, I'm guessing just because the people running this unit like them, since this is the first time we've ever done this. So far we've had one session where we met for a half hour to talk about a new case, and then split the work up, then we met a week later to discuss what we'd found. Personally I didn't really like it and didn't find it as useful as our normal small group sessions, but that's just me.