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problem based learning: what is it ? Presentation Transcript

  • 1. Outcome Based Education Problem Based Learning What is it ? How would it run at Medanta ?
  • 2. Yesterdays StudentsBased on factsStress on what does the student know ?Subject based curriculumEducational research: Lecturers from experts doesnot influence practice 2
  • 3. Tomorrows studentsWhat can the student do ?CompetenciesOutcome based curriculum(competency based) 3
  • 4. Outcome based curriculumOutcome: What should the student be able to do ?Outcome based curriculum: decisions about curriculum are driven by exit learning outcomesProduct defines content & process 4
  • 5. Outcome based curriculumClearly define exit outcomesCurriculum driven by exit outcomesLearning strategies & opportunities to match learning outcomesAssessment process matches outcomesRegular feedback on progress 5
  • 6. Types of outcomesExit outcome: to diagnose & manage pt with asthmaIntermediate outcome: take respiratory history of a pt . Perform general examination of respiratory system.Introductory outcomes: Describe airway physiology 6
  • 7. Levels of Educational OutcomesLevel 1. An awareness of procedureLevel 2. A full theoretical understanding of the procedureLevel 3. Observation of the procedureLevel 4. Carrying out some part of the procedureLevel 5. Undertaking the procedure under supervisionLevel 6. Undertaking the procedure unsupervised. 7
  • 8. Levels of competencies & Performances Dryfus & Dryfus model1. Student2. Novice3. Advanced learner4. Competent5. Proficient6. Expert7. Master 8
  • 9. Target Zero Problem Based Learning (PBL)• begun in 1950’s as a movement to restructure medical school education• 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 9
  • 10. Principles of adult learning Adults are motivated by learning that:• Is perceived as relevant• Is based on, and builds on, their previous experiences• Is participatory and actively involves them• Is focused on problems• Is designed so that they can take responsibility for their own learning• Can be immediately applied in practice• Involves cycles of action and reflection• Is based on mutual trust and respect 10
  • 11. Problem-Based Learning“PBL is any learning environment in which the problem drives the learning. 11 NJCATE 4 June 2000
  • 12. Problem-Based Learning“PBL is any learning environment in which the problem drives the learning. That is, before students learn some knowledge they are given a problem. 12 NJCATE 4 June 2000
  • 13. Problem-Based Learning“PBL is any learning environment in which the problem drives the learning. That is, before students learn some knowledge they are given a problem. The problem is posed so that the students discover that they need to learn some new knowledge 13 NJCATE 4 June 2000
  • 14. Problem-Based Learning“PBL is any learning environment in which the problem drives the learning. That is, before students learn some knowledge they are given a problem. The problem is posed so that the students discover that they need to learn some new knowledge before they can solve the problem.” - Don Woods 14 NJCATE 4 June 2000
  • 15. Problem-solving vs. problem-based learning - different but inter-related -Problem-solving: arriving at decisions based on prior knowledge and reasoningProblem-based learning: the process of acquiring new knowledge based on recognition of a need to learn 15
  • 16. Tenets of PBL• requires students to solve authentic, open- ended problems with many correct answers possible• authentic problems faced by scientists, doctors, engineers, lawyers, educators, administrators, counselors, etc.• Problems given to students are ill defined with many potential solutions. Problems should be authentic 16
  • 17. Tenets of PBL• emphasizes students’ pre-existing knowledge; “start with what you know”• students actively participate by helping plan, organize, and evaluate the problem solving process• interdisciplinary connections stressed• students undertake authentic roles 17
  • 18. Basic steps of PBL• students divided into groups• real problem is presented and discussed• students identify what is known, what information is needed, and what strategies or next steps to take (identify gaps)• individuals research different issues, gather resources 18
  • 19. Basic Steps of PBL• resources evaluated in group• cycle repeats until students feel the problem has been framed adequately and all issues have been addressed• possible actions, recommendations, solutions, or hypotheses are generated• tutor groups conduct peer/self assessments 19
  • 20. Teachers as facilitators• a facilitator is key to these learning environments• models higher-order process skills• probes for student understanding• never identifies issues or states an opinion while students frame problems• Asks open ended questions: where can you ..? What do you think ….? What are the next steps ? 20
  • 21. Advantages of PBL• greater recall of knowledge, retention• interdisciplinary, can require accessing and using information from a variety of subject domains; better integration of knowledge• development of life-long learning skills:how to research, how to communicate in groups, how to handle problems 21
  • 22. Advantages of PBL• increased motivation, interest in subject areas• increased student-student interaction, and student-instructor interaction• Shifts paradigm from teacher centered to student centered 22
  • 23. Traditional system : Teacher centered…the individuals learning the most in the teacher-centered classrooms are the teachers there. They have reserved for themselves the very conditions that promote learning: actively seeking new information, integrating it with what is known, organizing it in a meaningful way, and explaining it to others. 23
  • 24. Comparison of ParadigmsTeacher-Centered Knowledge is transmitted from professor to student.Learner-Centered Students construct knowledge through gathering and synthesizing information and integrating it with the general skills of inquiry, communication, critical thinking, and problem solving. 24
  • 25. Comparison of ParadigmsTeacher-Centered Students passively receive informationLearner-Centered Students are actively involved. 25
  • 26. Comparison of ParadigmsTeacher-Centered Emphasis is on acquisition of knowledge outside the context in which it will be usedLearner-Centered Emphasis is on using and communicating knowledge effectively to address enduring and emerging issues and problems in real-life contexts. 26
  • 27. Comparison of ParadigmsTeacher-Centered Instructor’s role is to be primary information giver and primary evaluator.Learner-Centered Instructor’s role is to coach and facilitate. Instructor and students evaluate learning together. 27
  • 28. Comparison of ParadigmsTeacher-Centered Teaching and assessing are separate.Learner-Centered Teaching and assessing are intertwined. 28
  • 29. Comparison of ParadigmsTeacher-Centered Assessment is used to monitor learning.Learner-Centered Assessment is used to promote and diagnose learning. 29
  • 30. Comparison of ParadigmsTeacher-Centered Emphasis is on right answers.Learner-Centered Emphasis is on generating better questions and learning from errors. 30
  • 31. Comparison of ParadigmsTeacher-Centered Desired learning is assessed indirectly through the use of objectively scored tests.Learner-Centered Desired learning is assessed directly through papers, projects, performances, portfolios, and the like. 31
  • 32. Comparison of ParadigmsTeacher-Centered Focus is on a single discipline.Learner-Centered Approach is compatible with interdisciplinary investigation. 32
  • 33. Comparison of ParadigmsTeacher-Centered Culture is competitive and individualistic.Learner-Centered Culture is cooperative, collaborative, and supportive. 33
  • 34. Comparison of ParadigmsTeacher-Centered Only students are viewed as learners.Learner-Centered Professor and students learn together. 34
  • 35. OutcomeMoving away from: Are students getting the right answer?Moving to: Can students demonstrate the qualities that we value in educated persons, the qualities we expect of college graduates? 35
  • 36. OutcomeCan students gather and evaluate new information, think critically, reason effectively, and solve problems?Can [students] communicate clearly, drawing upon evidence to provide a basis for argumentation?Do [students’] decisions and judgments reflect understanding of universal truths[/concepts] in the humanities and arts [etc.]? 36
  • 37. OutcomeCan [students] work respectfully and productively with others?Do [students] have self-regulating qualities like persistence and time management that will help them reach long-term goals?Evidence based, Independent Life Long Learner 37
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  • 41. How does a case serve as a stimulus for learning? 41
  • 42. Example:PBL tutorial process1. Case presentation: The tutor provides the group with some introductory clinical information about a hypothetical patient. Mary Smith, a 28-year-old office worker and part-time swimming instructor, comes to see her GP because of pain in her chest and shortness of breath. This has been a recurring problem in recent months and seems to be gradually worse. On the previous evening, while participating in a swimming gala, she became so short of breath that she found it difficult to walk. 42
  • 43. 2. Identifying key information3. Generating and ranking hypotheses: e.g., Infection, cardiac problem, allergy, asthma, broken rib. Allergy ˃ cardiac problem4. Generate an enquiry strategy: What additional information is required? e.g., Previous medical problems and relevant drug, family & psychosocial histories, physical exam, lab. tests. 43
  • 44. Additional informationFurther discussion with her GP reveals that Ms Smith’s chest pain and shortness of breath come on following exercise, particularly in a cold environment. When she becomes particularly short of breath, she starts to wheeze. She sometimes has a dry cough and has never had haemoptysis. There is no recent history of physical trauma and no personal or family history of heart disease. She had eczema in childhood but has never had asthma. She has smoked for the past 5 years and increased her smoking to 40 cigarettes a day since she broke up with her intimate friend 3 months ago. She takes an oral contraceptive pill but no other medication. 44
  • 45. New information Revising their hypotheses Discard / Re-rank / Other hypotheses• Broken rib • Asthma • Anxiety attacks with hyperventilation • Cardiac problem • Possible thromboembolic disease due to oral contraceptive use 45
  • 46. 5. Defining learning objectivesOnce the students have decided on a preferred hypothesis (e.g., allergy), they must explain the biomedical science mechanisms that link their hypothesis to the presenting problems.What students know?What they do not know?What they need to know?to further their understanding of the underlying mechanisms, and their ability to solve the clinical problem.e.g., Students may identify gaps in their knowledge of the mechanics of breathing, anatomy of airways, mechanisms of oxygen delivery to tissues, or mechanisms of pain perception. 46
  • 47. 5. Defining learning objectives (cont.)The identification of gaps in knowledge helps students to define their learning objectives and these become the focus of self-directed study in the interval between tutorials.Learning objectives should be clear and specific and of appropriate scope to be addressed in the time available between tutorials (typically 2-3 days).At each tutorial, the group might identify three to five major learning objectives and perhaps an equal number of lesser objectives. 47
  • 48. 5. Defining learning objectives (cont.)Although the PBL tutorial is student-centered, major learning objectives are identified in advance by the case writers as part of the overall curriculum design. Tutors may need to provide prompts to ensure that major objectives are identified and pursue d.In PBL, as knowledge is acquired in the context of a specific clinical problem (the problem is encountered before the student has the knowledge to understand it), it is likely to be better focused and retained. 48
  • 49. 6. Reporting backIn the follow-up tutorial, students reconvene to report on their self-directed study and share and integrate new knowledge.All students should contribute to the report-back and their unique perspectives are incorporated into the process of knowledge building. The exchange and debate of ideas promotes the consolidation and elaboration of new knowledge and understanding 49
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  • 51. 7. Integrating new knowledge• Based on the principle that knowledge is consolidatedmore readily in context, students, guided by thetutor/facilitator, should relate new biomedical knowledge tothe patients problem.• Students are required also to extend their discussionbeyond the biomedical and clinical sciences and considerthe public health, socioeconomic, ethical and legal aspectsof the case. 51
  • 52. How does PBL work ? College of Medicine, Sharjah University , UAEin collaboration with Monash University, Australia 52
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  • 57. Learning Strategies1. PBL tutorial session2. Resource sessions3. Laboratory sessions4. Review sessions : Team based Learning5. Clinical skills sessions6. Hospital visits7. Community Health visits8. Self directed learning9. Student Portfolio10. Academic Advising 57
  • 58. End of Unit AssessmentWritten paper: MCQ & SAQObjective Structured Practical Exam: OSPEObjective Structured Clinical Exam: OSCE 58
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