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Structuring Problem-based Learning - Mine, Ours and Yours
1. Structuring Problem-based Learning –
Mine, Ours, Yours
Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg
Annual Conference of Tripartite Training Institution in Manila
March 27, 2015
2. Structuring Problem-based Learning –
Mine, Ours, Yours
Problem-based learning (PBL)
- the learning that is triggered and acquired as
a result of attempts to resolve a problem
encountered
3. Structuring Problem-based Learning –
Mine, Ours, Yours
PBL
• most effective way of learning by any human
being with sound mind in terms of retention and
recall of knowledge and skills
• most effective educational method that should be
used by learning organizations regardless of type
of profession
4. Structuring Problem-based Learning –
Mine, Ours, Yours
PBL
• promotes self-directed learning which is required by
all human beings as they continue to live in this world
and by all practicing professionals
• above statement is based on the fact that nobody will
ever know everything in one’s life time and one has to
keep on learning up to the last moment of life
5. Structuring Problem-based Learning –
Mine, Ours, Yours
In the practice of medicine, surgery included, even
after graduation from medical school, residency and
fellowship training programs,
• nobody should say that learning has been
completed.
Self-directed learning still continues as there are still
infinite things to learn.
6. Structuring Problem-based Learning –
Mine, Ours, Yours
How do practicing physicians continue learning
after graduation from the formal training courses
mentioned above?
It is through problem-based learning.
7. Structuring Problem-based Learning –
Mine, Ours, Yours
In the practice of medicine, the following events actually or
should take place:
1. A physician meets a patient without prior knowledge of
what the patient’s problem is.
2. During the encounter, the physician establishes rapport,
diagnoses, treats, and gives advices with the goal of
resolution of the health problem of the patient.
8. Structuring Problem-based Learning –
Mine, Ours, Yours
In the practice of medicine, the following events actually or
should take place:
3. In the process of understanding and resolving the patient’s
problem, the physician invariably encounters some
insecurities, questions, and gaps in competencies.
9. Structuring Problem-based Learning –
Mine, Ours, Yours
In the practice of medicine, the following events actually or
should take place:
4. The physician fills in the gaps in competencies through
various means, such as self-study and learning from other
people like consultations, referrals, and enrolling in a formal
course.
5. The new competencies acquired are used by the physician
on the patient on hand and on future patients.
10. Structuring Problem-based Learning –
Mine, Ours, Yours
The abovementioned 5 events or steps constitute the lifetime
learning method of certified physicians after graduation from
formal training courses.
The 5 steps constitute the PBL method during practice of
medicine.
11. Structuring Problem-based Learning –
Mine, Ours, Yours
If PBL is the method practicing physicians will use after
certification and for life for self-directed learning,
• it is but logical to advocate, if not insist,
• that all medical learning and training institutions should
inculcate this learning method among their students or
learners
• who will one day be practicing physicians and
• who will and have to use PBL for their continuing
professional education.
12. Structuring Problem-based Learning –
Mine, Ours, Yours
I started being an advocate of PBL when I helped establish
the Ateneo de Zamboanga University School of Medicine in
1994.
I helped in the formulation of the curriculum which carries
this label: competency-based, problem-based, and
community-based medical curriculum.
14. Structuring Problem-based Learning –
Mine, Ours, Yours
In the University of the Philippines College of Medicine
Department of Surgery, I have been advocating PBL for the
medical students and surgical residents who have been
assigned to me for coaching.
15. Structuring Problem-based Learning –
Mine, Ours, Yours
In Manila Doctors Hospital Department of Surgery, I have
been advocating PBL for the medical students and surgical
residents who have been assigned to me for coaching.
16. Structuring Problem-based Learning –
Mine, Ours, Yours
In the Ospital ng Maynila Medical Center Department of
Surgery, I have been advocating PBL since 2001 when I
became its chairperson.
17. Structuring Problem-based Learning –
Mine, Ours, Yours
All of us
to a certain extent
are using PBL in our field of specialty (surgery).
Some are structured but most are not.
Some have maximized its usage but most have not.
21. Structuring PBL – Mine (ROJ)
In my clinic, in operating room, in inpatient rooms, in medical
conferences, anywhere and whenever I interact with patients,
students, and colleagues -
• in the process of understanding and resolving a patient’s
problem,
• I invariably encounter some insecurities, questions, and
gaps in competencies.
22. Structuring PBL – Mine (ROJ)
What I do is to jot down these insecurities, questions, and
gaps in competencies as PBL Issues (PBLI) in a sheet of
paper or in a notebook.
23. Structuring PBL – Mine (ROJ)
Then, as soon as I can, and as much as I can, I use the
Internet mostly and ask people in the know to fill in the gaps
in my competencies.
I put the learnings that I got in my computer files or in my
websites.
24. Structuring PBL – Mine (ROJ)
Then, as soon as I can, and as much as I can, I use the
Internet mostly and ask people in the know to fill in the gaps
in my competencies.
I put the learnings that I got in my computer files or in my
websites.
25. Structuring PBL – Mine (ROJ)
I share my learnings with other people – my patients, my
students, and my colleagues.
It goes without saying that I put my learnings to use in my
current and future patients.
29. The PBL framework of problem trigger – learning
issues – independent study – information
reporting – knowledge reinforcement – learning
outcome evaluation was utilized and continually
developed.
30. The weekly postoperative and preoperative
conference, weekly case presentation and
discussion, and discussion topic for the
month were the main sources of problem
trigger.
31. The learning issues consisted primarily of
patient management insecurities in clinical
diagnosis, paraclinical diagnostic process,
and treatment process, the resolution of
which, were all geared towards
incorporation into the department’s clinical
practice guidelines.
PBLI: Hirschsprung’s Disease
Question: In patients with documented HD, what is the
percentage of collapsed / distended bowel but contain
ganglion cells?
32. The independent study utilized mainly
Internet search for information. The venue
for information reporting was either in the
Tuesday and Thursday conference hours or
in the department’s group email. In subsequent years,
reporting is also done
in FB group.
33. The independent study utilized mainly
Internet search for information. The venue
for information reporting was either in the
Tuesday and Thursday conference hours or
in the department’s group email. In subsequent years,
resident-intern
partnership was created
for the PBL activity.
34. Application to subsequent patient
management, debates and action
researches were main methods of
knowledge reinforcement.
35. Outcome evaluation consisted mainly of
continuous observation for positive
changes in study habit and patient care.
36. With systematization, the surgical residents
acquired a clearer concept of PBL,
appreciated the self-directed learning effect
of PBL, and developed an efficient way of
PBL which they could use after graduation.
37. Challenges: problems in fulfilling the requirements
of the independent study by the residents:
absence of accomplishment, tardiness, and no
follow-through.
Discipline and perseverance are the
recommended strategies.
38. Structuring Problem-based Learning –
Mine, Ours, Yours
Sharing
Ours – OMMC Surgery
Current Status:
Up to now, under Chairperson, Dr. Hazel Turingan,
OMMC Surgery is still promoting problem-based
learning habit among the residents and medical
students.
