PROBLEM-BASED LEARNING CONCEPT - used for training undergraduate medical students in UPNM (Universiti Pertahanan Nasional Malaysia)

1. interactive session
with
Prof Dr Edariah Abu Bakar
Head of MEQAR & PARASITOLOGY
FMDH, UPNM
Hotline: 107 333 4408
e-mail: edariah@gmail.com

2. the learning that results from the process
of working toward the understanding
or resolution of a problem.
Startpoint = a ‘problem’
(on PBL topic) (not a lecture!)
Prof Eda r i a h

3. • ability to USE knowledge
is more critical than
ability to store knowledge
Prof Edariah
• Acquire relevant Knowledge
• Develop useful Skills
• Emulate right Attitudes

4. • Pioneered by McMaster U (Medicine)
•  whole McMaster
•  other medical schools
•  non-medical professions:
- Health Sciences
- Non-Health
●  Schools!
Prof Edariah

6. * focus on
reasoning
critical
thinking
use / process
knowledge
Prof Edariah

7. • thinking skills  solve problems
Skills
Prof Edariah

8. •a process in which
individuals take
the initiative,
with or without help to:
•recognize their own learning needs
•formulate their own learning goals
•identify their own learning resources
•choose & implement their own learning strategies
•evaluate their learning outcomes
…Knowles, 1975
Prof Edariah
LEARNER ACTIVE

9. Skills
Attitude
• team spirit/skills
• leadership skills
• communication skills
Prof Edariah

10. SMALL group
☻Scribe (power of the pen!)
☻Members
☻Group leader
☻Facilitator
Prof Edariah
resources

11. Problem situation (trigger)
Read-Discuss ASK QUESTIONS ID problem Hypothesize Enquire
Learning Issues
Share knowledge (Present + Discuss)
Info search ENQUIRY (SDL/DSL)
MechanismMapping  MINITEST
Prof Edariah

13. problem situation
problem analysis (terms, clues)
IDENTIFY PROBLEM
generate hypotheses
enquiry (px, study)
review hypotheses
ANSWER questions ± solution of problem
enquiry (px, study)
Prof Edariah

14. Feraslah, a college student, was brought to the Emergency Unit of HKL because of abdominal pain.
On physical examination, Dr Kwek found her writhing in pain.
Her abdomen was tender in the right iliac fossa, especially at McBurney’s point. Other systems were normal.
Ask questions: What? Where? Why? How? etc?...
Feraslah, a college student, was brought to the Emergency Unit of HKL because of abdominal pain.
On physical examination, Dr Kwek found her writhing in pain.
Her abdomen was tender in the right iliac fossa, especially at McBurney’s point. Other systems were normal.
READ (aloud)
Prof Edariah

15. FACTS (case)
IDEAS (QUESTIONS, problems,hypotheses…)
FILIchart
LEARNING ISSUES
Scribe
Prof Edariah
flipchart

16. FACTS
(case)
IDEAS
(Qs, problems, hypotheses,etc)
LEARNING ISSUES
- Feraslah
- student
- female
- 20s
- pain/abdomen
- tender RIF, esp McBurney’s point
- etc
PROBLEM:
Pain in abdomen
- Pain: what? why? how?
- abdomen?
- organs in abdomen?
- RIF?
- McBurney’s point?
Why is px having pain?
HYPOTHESES:
? Infection
? Inflammation
? Tumor
Of organs in abd eg:
? stomach
? duodenum, small gut
?? pancreas, liver, ? etc
How do we feel pain?
• new / review TERMS
• PAIN: - vs tender
- mechanism
• Diseases involving
abdominal organs
Step 1: Identify learning issues
Prof Edariah

17. ………… Dr Kwek performed an appendectomy, where he had to cut through many layers of the abdominal wall to remove the offending organ.
The resected organ (Foto A) was sent to the Pathology Lab to confirm his clinical diagnosis.
The pathologist examined tissue sections of the organ (Foto B).
………… Dr Kwek performed an appendectomy, where he had to cut through many layers of the abdominal wall to remove the offending organ.
The resected organ (Foto A) was sent to the Pathology Lab to confirm his clinical diagnosis.
The pathologist examined tissue sections of the organ (Foto B).
READ Ask questions: What? Where? Why? How? etc?...
Prof Edariah

18. Foto A
Foto B
Prof Edariah
Prof Edariah

19. 1 ID learning issues
2 Seek knowledge
3 Share knowledge
Prof Edariah
4 Mind Map & Assessment

20. FACTS
(case)
IDEAS
(problems, hypotheses,etc)
LEARNING ISSUES
- Feraslah
- student
- female
- 20s
- pain/abdomen
- tender RIF, esp McBurney’s point
- etc
Problem:
Pain in abdomen
- Pain: what? why? how?
- abdomen?
- organs in abdomen
- RIF?
- McBurney’s point?
Hypotheses:
 ? Where is source of pain:
? organs in abd eg:
? stomach
? duodenum, small gut
? large gut
? pancreas, ? etc
 How is pain caused?
(mechanism)
•TERMS
•PAIN: - vs tender
- mechanism
•ABDOMEN: - ? what
- surface anatomy – ? organs/structures
- ? RIF
- ? McBurney’s point
Step 1: Identify Learning Issues
Prof Edariah

21. Ezry
Aida
Nurul
Shimri
Fara
Elan
Nani
Step 2: Seek knowledge (SDL)
SHARE
load of seeking knowledge
USE your RESOURCES:
•library: books, journals
•internet
•seniors
•subject experts
•etc

22. Men in Black
learning from
Girls in Brown
Peer Teaching in PBL
Step 3: Share knowledge
Prof Edariah

23. Step 4: Mechanism Mapping
Minitest & Feedback
Prof Edariah
Eg by expert
Eg by students

24. PBL: STUDENT EVALUATION GUIDELINES
Mark (0-2)
A: ATTENDANCE AND PUNCTUALITY
2
Present and punctual / early
1
Present but slightly late (1-10 minutes)
0
Present but very late (more than 10 minutes)
0
Absent without reason /acceptable reason ( fails PBL/SGS/ECE)
-
Absent with acceptable reason (MC / letter to HOD)
Mark
(1-8)
B: PARTICIPATION / DISCUSSION
0
No verbal participation (even after prompting) & NOT interested eg sleeping. (Make sure student is NOT SICK)
1-2
No verbal participation (even after prompting) but shows interest. (Make sure student is NOT SICK)
3
Inappropriate participation (bad attitude eg disruptive / arrogant / rude / etc) – NOT typical of UPNM students.
4
(pass)
Some participation on prompting only.
5-7
Moderate - Active Participation
8
(perfect score)
Only in EXCEPTIONAL cases (PERFECT SCORE!)
Failure is mainly due to BAD ATTITUDE (absent / bad behavior)
Avoid giving PERFECT mark (except in EXCEPTIONAL cases)
Avoid FRACTIONS (eg ¼ or 0.5 mk)
Prof Edariah

25. PBL Discussion + Minitest => n% of CTX
DISCUSSION (Sessions 1 & 2)
A. ATTENDANCE & PUNCTUALITY = 2 marks (max)
B. PARTICIPATION / DISCUSSION = 8 marks (max)
A. TFQ (True/False Q) = 5-10 Q
MINITEST (10-15 MCQs) (Session 3)
B. ARQ (Assertion & Reasoning Q) = 0 – 5 C. BRQ (Best Response Q) = 0-5
FAILURE mainly due to BAD ATTITUDE
Prof Edariah

26. STUDENT FEEDBACK
Routine Activity
Prof Edariah Q-forms

27. •Conventional * PBL
•ROTE learning * THINKING memorizing understanding
•teacher-fed * student-discovery via lectures via problems
•teacher  student * dynamic team work
teacher-active student-active
•teacher-dependent * self-reliant
•teachers dictate * teachers facilitate
•LARGE group * small group
Prof Edariah

28. • PBL = powerful tool for students
to learn:
- how to learn }
- how to think } to
- how to be independent } SURVIVE &
- how to work in a team } THRIVE
- how to communicate }
● Needs a facilitator (not a spoonfeeder)
• Needs commitment from every player
Prof Edariah

29. Can YOU
rise up to
the CHALLENGE ?
Prof Eda ri ah

30. The only
STUPID question
is
the question
NOT ASKED!
Dr Green of ER
There’s no
such thing as
a stupid question…
Prof Edariah