Transcript What is problem-based learning (PBL)?

Problem-Based Learning at
Husson College:
Student Outcomes and Perceptions
February 11, 2008
Sondra G. Siegel, Ph.D., P.T.
Department of Physical Therapy
What is
Problem-based Learning?
“PBL is an approach to learning that uses a
problem to drive the learning rather than a
lecture with subject matter, which is
taught.”
Azer, 2001
Elements of PBL
 Instructor creates a scenario that will
engage the students in learning
 Students work in small groups with a tutor
 Tutor is not meant to be a source of
information
Steps of PBL
(Schmidt, 1983)
Clarify terms
Define and analyze the problem
Draw a systematic inventory of the
explanations inferred from step 3
4. Formulate learning objectives
5. Collect additional information
1.
2.
3.
(between sessions, individual “homework”)
6.
Synthesize, discuss and test the newly
acquired info
(next session)
Benefits of PBL Curricula, as compared
to conventional teaching methods
3.
More systematic reasoning (Patel, 1991)
Greater development of hypotheses, but
increased generation of errors (Patel, 1991)
Enhanced clinical reasoning (Thomas, 1997)
4.
5.
Enhanced self learning skills (Thomas, 1997)
Better self-directed learners, lifelong learning
1.
2.
Shin, 1993)
(
Can We Employ PBL at Husson in
a PT Program?
 Barriers:
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Additional personnel/time
On-site library resources are limited
Resistance to trying something new
Maturity level of students
Complete curriculum vs. single courses
General Research Question:
Can a single course in PBL (rather
than an entire PBL curriculum),
promote the proposed benefits of
PBL?
Specific Research
Questions:
1. Does one course in PBL change the
students’:
Expectations regarding future commitment to
life-long learning?
b. Independence in learning/motivation
c. Attitudes toward group problem solving
d. Perceptions of ability to diagnose/perform as a
primary health care practitioner
a.
Specific Research Questions,
cont’d:
2. Do students spend more time seeking out
information independently, as compared to
time they spend at this in a traditional
course?
3. Does one PBL course improve the students’
ability to critically analyze a case and
identify the learning issues?
Course mechanics
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26 Students
Four groups of students
One primary instructor/coordinator
Four faculty members
8 week course, 2 hrs/wk
Faculty meetings, 1 hr/wk
Research Participants
 Students in the final year of MSPT program
 Enrolled in PT620, Primary Health Care
 Total of 26 students in course
 24 students consented to participate
 Complete data for 23 students
 Approximately 1/3 of the students were nontraditional
Preferred Approach to Learning
New Material
Lecture
11
Small groups, seminar,
interactive
8
Independent, Self-directed
6
Hands-on
5
Visual, demonstration
4
Reading
3
Specific Research
Question:
1. Does one course in PBL change the
students’:
Independence in learning/motivation
b. Expectations regarding future commitment to
life-long learning?
c. Attitudes toward group problem solving
d. Perceptions of ability to diagnose/perform as a
primary health care practitioner
a.
Survey
 5 point Likert scale
 4 categories of randomized items
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Independent learning/motivation
Lifelong learning
Group process
Diagnostic abilities
 Some items had “reversed” scoring
Sample survey items:
Motivation level/attitude toward independent
learning
“ I learn best when I am provided the important
information in a lecture format”
“ Learning is most effective for me when I have to seek out
the information on my own”
“ I feel I have the skills necessary to continue as a selfdirected learner after I graduate from this program”
Independent Learning
4.6
4.2
*
3.8
Pretest
Post test
3.4
3
2.6
p=.05
Sample survey items:
Attitudes toward life-long learning
“ In the future, I intend to rely heavily on journal sources to stay
current in my field.”
“ I expect that keeping up in my field of practice will involve a
considerable effort and expenditure of time”
“ After completing my physical therapy degree, I will have
sufficient knowledge to treat patients without doing additional
research”
Lifelong Learning
4.8
4.4
*
Pretest
Post Test
4
p=.02
3.6
Sample survey items:
Group process/group dynamics
“ I am confident that I can make important
contributions to small group learning situations”
“Learning in small groups stimulates me to engage
in the content.”
“Working in small groups is usually frustrating for
me.”
Group Process
4.3
4.1
3.9
3.7
Pretest
Post test
3.5
3.3
p=.46
3.1
Sample survey items:
Ability to Diagnose and Perform as a Primary
Health Care practitioner
“ I am confident in my ability to identify signs and symptoms that
are indicative of non-musculoskeletal system pathology.”
“I feel confident that I will know when I need to refer a patient to a
physician for a condition that may require medical treatment.”
“I am well-prepared for the clinical responsibilities of a primary care
practitioner..”
Self Perception of Diagnostic Abilities
4.6
4.2
*
Pretest
3.8
3.4
3
Post test
p=.04
Specific Research
Question:
2. Do students spend more time seeking out
information independently, as compared to
time they spend at this in a traditional
course?
Time spent on PBL
 Pre-course estimate of number of hours
spent in independent research for a typical 3credit course
 Post-course estimate of number of hours
spent in independent research for this course
How much time is spent "looking up information":
4.5
4
*
Hours Per Week
3.5
3
2.5
2
Typical C lass
PBL C lass
1.5
1
0.5
0
P<.001
Specific Research Question:
3. Does one PBL course improve the students’
ability to critically analyze a case and
identify the learning issues?
Case Analysis
 Problem solving case (pre- and post-course)
“Define the learning issues in this following case.
In other words, if you were the therapist treating
this patient, what questions come to mind that
require further research on your part? What would
you want to research in order to best understand
and treat the patient?
For this exercise, assume you are working as a
primary care provider, in a place where it is
common for patient visits to be initiated without a
referral from an MD.”
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Your patient is a 49 year old woman whose primary
complaint is urinary incontinence.
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On interview she tells you that she has had this problem
for about 3 yrs, but has been embarrassed to see
someone about it.
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She tells you that she typically wears an absorptive
disposable undergarment at work, which needs to be
changed several times each day.
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Recently she has been bringing another pair of pants to
work since she sometimes soaks through the pad.
 She works for MBNA at a local call center. Her job is not
strenuous, but her supervisor has reprimanded her for
taking frequent breaks to use the restroom.
 Over the last month, she has seen a dramatic worsening
of the incontinence, and she feels she has almost no
control of her bladder.
 She has a cast on her left arm. When asked, she says that
she has gotten clumsier as she has gotten older, and she
tripped and fell on her porch 3 weeks ago and broke her
arm.
 She has not seen a doctor for the incontinence.
 She is a single mother of 3, with kids ranging in age from 9
to 15.
Examples of Identified
Learning Issues
Progression of incontinence (prognosis)
2. Secondary problems arise with incontinence?
3. Innervation of pelvic floor muscles?
4. Connection between loss of bladder control and poor
balance?
5. Medications for incontinence?
6. State laws regarding workplace accommodations?
7. Lab tests associated with incontinence?
1.
Case Analysis
Avg Number of Issues Identified
9
8
*
7
6
5
4
Pretest
Post test
3
2
1
0
P<.001
Summary
A short 8-week problem-based learning course
can lead to:
1.
2.
3.
Improved attitudes toward lifelong learning
Improved attitudes toward independent
learning
Improved ability to identify case-related
issues
Conclusions
 PBL can be an effective teaching method at
Husson
 PBL does not necessarily need to be carried out
throughout the whole curriculum to achieve
some of its benefits
 PBL may need to be combined with some more
traditional methods of teaching in order to best
reach our students
Student Perceptions
of the Course
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Less retention of the material
Less knowledge gained
“Not sure if we learned the right information”
Loved the independent aspect of it
Should have more PBL courses in the program
Should be combined with a lecture component
Course Changes
 Hybrid course
 One PBL session per week
 One traditional session per week
 More specific objectives given after each case
 Change in the assessment procedures
 Exam
 Case analysis