Pedagogy of Problems

Abstract

N owadays, medical students are learning in a myriad of ways e some more traditional than others. For example, some students elect to attend class in person, while others take lectures online at 2x speed. While I am one of the only students in my class who still uses the analog pencil and paper, my iPad-laden counterparts and I converge for sessions involving group problem solving. Most American medical schools employ some variation of this idea in their curriculum, and common to academia, institutions often have a proprietary name for their version of it. During a problem-based learning (PBL) session, students are tasked with completing a case-based discussion with their team using pre-existing knowledge in their small group with the help of a preceptor. A recent systematic review of PBL pedagogy by Trull as et al. even asserted that one of the main benefits, in addition to learning objectives, is that this design promotes the development of other professional competencies required of healthcare professionals. In the four meta-analyses included in their review, objective metrics of knowledge acquisition from PBL sessions appear as good or better than traditional methods, but integrating self-learning with communication, social, and problem-solving skills could pay dividends later. Also of note, Trull as found that student satisfaction tended to be higher for PBL sessions compared to lecture-based classes e and I agree. Interestingly, PBL's superiority is unclear when compared to simulation-based activities, where learners apply clinical judgement and skills. Simulations can be even more resource-intensive than PBL methods. My school often uses team-based learning (TBL) sessions, where we similarly engage in solving a problem, now using the information we were assigned to learn beforehand. Unlike a traditional lecture, the learning is done prior to class time, and Q6 during each session, teams are working on applying the new information to a tricky patient vignette (our recent session on SLE was a doozie). Typical to TBL, students complete individual and group evaluations before entering the case time, with peer evaluations at the end (Burgess). These may have an impact on the degree of preparation students arrive with, which is key for getting the most out of the session. Actively engaging with the material is the crux of why these designs are proposed to work. When evaluating hypothetical patient cases, we are encouraged to use outside resources, including recent literature and diagnostic guidelines attempting to fill in gaps in our knowledge. Working with other students in a PBL or TBL session aids in preparing for times when learners will have to have similar discussions on the wards or when presenting a patient. These sessions on the calendar ensure that I take ownership of the material; if no other evaluation lies between myself and the test, it'd be much easier to learn it when I am comfortable, but this compels me to be ready and contribute to my team. For traditional lectures, I feel more in control of my learning when note taking at my own pace, and the TBL sessions allow me to put my learning methods to the test under the scrutiny of our professor's challenges. Little time to tackle this much material often means that students arrive with different piecemeal frameworks for a disease process, and we need to feed off one another to