Answer to "If PBL is about generating learning issues, why not give students the faculty learning outcomes, and, what happens if the PBL groups learning issues are different from what faculty expects?"

Providing students with the faculty-generated learning outcomes (rather than them generating their own learning issues) before an exhaustive discussion of the ‘problem’ would defeat the purpose of PBL. PBL is about starting from a point of not knowing (e.g. when a patient walks into ED or enters the General Practitioner’s consulting room for the first time) and gathering information through various avenues to promote hypothetico-deductive reasoning about all possible mechanisms that may have led to the clinical presentation. In so doing, learners identify gaps in their knowledge and understanding, which they then formulate into learning issues to be researched. It is at this stage (i.e. the end of Step 5), to quell any insecurities about what was expected and the required depth and breadth, that the faculty learning outcomes (i.e. minimum expectation) can then be released for comparison and to assure students are on the right track.

 

Notwithstanding, since the facilitator is a process expert, he or she, through Socratic questioning, would have guided the group towards the expected learning outcomes. It is thus imperative that the PBL facilitator understands where the students need to be guided not just in the PBL case in question but also in terms of the spiral learning approach. In an integrated, constructivist curriculum approach, it will be rare for content to be addressed once only during the 4-6 years of the medical programme.  Learning issues outside of those advertised by faculty will be identified and this should be encouraged. For Barrows (1996), “A major advantage of PBL is that students, responsible for their own learning and engaged in self-directed learning and stimulated by the problem, may pursue areas of study far beyond the fondest dreams of the course designer” (p. 9). Faculty-generated learning outcomes should thus be viewed as the minimum requirements.

 

With PBL being widely adopted in undergraduate programmes, much guidance is required in terms of supporting learning. Providing learners with the expected faculty outcomes once they have generated their own learning issues goes a long way to reassuring them of the consistency amongst the discussions within each PBL group. Ideally, each PBL group should map their learning issues against the faculty learning outcomes so that at the end of each semester or academic year, they will be assured of having covered all the expected outcomes (which inform the assessment blueprint).

 

References

BARROWS, H.S. (1996). Problem-based learning in medicine and beyond: A brief overview. (New Dir Teach Learn. 68:3-12).

KWAN, C-Y, and TAM, L. (2009). Commentary: hybrid PBL – what is in a name? (J Med Educ. 13:76-83).

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