This presentation is prepared for qualified nurses to provide an overview of problem based learning with examples of how they may use this approach in their teaching

1. Problem based learning
Principles and Practice
An overview
Grace Lindsay BSc(Hons)RN MN PhD
Nursing Faculty
Umm Al Qura University
Makkah

2. Overview Session
• Historical timelines
and origins of PBL in
medical education
curricula
• Key components of
the learning methods
• Considerations for
learners and
educators
• Reflections for nurse
education

4. Central learning forum: planning,
exchange shaping, thinking, concluding
+++ ………

5. PBL...lessons from medical
education
• Government, higher
education institutions,
society striving for
higher standards of
education; ‘fit for
purpose’
• Technological
advances
• Increase in research
activity and
knowledge generation
• Emphasis on evidence
based practice
• Need for greater
critical appraisal and
cognitive reasoning
skills
• Changes in public and
patients expectations
• Healthcare delivery
evolving…. self-care;
new
investigations/treatme

6. New Horizons in Medical Education
• Patient’s expectations
• HC delivery (style of doctors)
• Medical knowledge exponential
growth
• Traditionally curriculum structured as a
progression from basic sciences to clinical
sciences; little integration
• Failing to prepare students adequately for
diversity of problems they will encounter as
professionals.

7. What was the response to these
challenges?
• The development of new curricula
incorporating new themes & different
educational strategies
• The introduction of new learning situations
& the use of new tools & aids to learning
• New methods of assessment [OSCE - tests
performance & competence in a wide
diversity of clinical settings; Formative
Assessment; Portfolio assessment; Work-
based assess]

8. Problem based Learning (PBL)
• Helps learners build a bridge between what
already known ……to…. what need to know
to find answers to problem
• Active learning, which has been shown to
be more satisfying than passive teacher-to-
student learning; enhances retention and
recall
• Emphasizing student-centered learning in
which students are actively involved in
setting their own broader learning goals in
line with learning outcomes of curriculum
unit

9. PBL: What is it?
• Problem-based learning (PBL)- learners first
encounter a problem followed by a
systematic, learner-centered inquiry and
reflection process.
• PBL designed to support learning sciences
basic to medicine….. at same time as they
develop reasoning processes used by
physicians and other health professionals in
clinical practice.
􀂄 The problem presented first without
advance readings, lectures, or preparation.

10. Subliminal learning
Professional practice needed
to change…..
• Positive attitudes and
values, behaviors,
• Engaging, partnership
working
• Caring, supportive
• Learning from each other
• Fostering positive beliefs in
others
• Encourages respect for
others

11. Supported with Tools & Aids
• Use of Study Guides
• Use of Computer Assisted Programs &
Internet
• Use of Videos to teach Clinical
Skills/consultation techniques
• Role of Simulators embraced
• Simulations in aspects of physical exam &
practical procedures

12. • Challenge of
integrating a large and
growing knowledge
base with innovative
teaching methods
• Greater emphasis on
cognitive skills
attainment
• Equipped to practice in
an evolving
professional context
Objectives

13. *Critical thinking
*Information
management
*Communication
skills
Clinical skills
Scientific
basis
Professional
values,
attitudes
Population
health
PBL model

14. PBL Group in action (1)
• No need for prior
knowledge to
generate ideas for
further collective &
personal learning
• Each member brings
experience and
distinctive contribution
• Tutor focus to manage
interactions
• Students nominate a
scribe and chair
• Safe environment for
sharing and testing new
knowledge & ideas
• Brainstorming
• Group evaluates
contributions; feedback
from peers and tutor
• When accompanied by
clinical exposure-
intellectual & practical
skills develop in parallel

15. The role of the ‘problem’
• a focus …. trigger or
catalyst for learning
• Framework for
assembling
knowledge and
learning
• not specifically about
problem-solving skills
themselves but using
a problem as a focus
for learning
development
Group knowledge for
analysis
Source
knowledge and
information to
answer
questions
Identify
key
questions
A
problem

16. The ‘problem’ is deliberately
selected to be ‘ill-defined’

17. PBL Group in action (2)
• Broad thinking leads to array of ideas and
mechanisms
• Evidence base utilization encouraged
• Reasoning and hypothesis generation
• Need for additional information identified
• Summary of process/sources/dates
• Actions/Tasks to be undertaken (by whom)
before next meeting

18. Sifting and selecting
knowledge
Answering questions
More specific
knowledge
search
Generatin
g new
focused
questions
• Deciding what is
relevant
• Involves
understanding of
rationale
• Extent to which
preliminary
questions can be
answered
• Refining questions
Output from problem ‘search engine’’

19. Searching for information- Cautions
additional skills

20. Tutor guidance: Sensitive balancing
act
X

21. Evaluation of learning outcomes
• Formative/summative
• Scenario designed
according to pre-set
learning objectives
• Fit with overall
curriculum goals
• In line with learning
style
• Breadth of learning
captured?

22. Summary: PBL process/educational
context

23. Advantages
• Encourages independence as students identify
& meet individual learning needs
• Stimulates reflection & self-direction for life-long
learning
• Supports ongoing self-assessment
• Introduces clinical reasoning
• Enhances critical thinking & evidence-based
decision making
• Lateral thinking
• Ensures that knowledge is transferred, applied
& retained by providing a relevant, integrated

25. Disadvantages
• Cultural change
• Collaborative +/-
• Ownership of
problem
• Extra workload
• Additional time
• Potentially greater
cost
• More staff

26. Strategies for re-direction?

27. Some differences compared to general group
work
• More formal process
with agreed rules of
operating
• Identifying learning
needs
• Ongoing
• Iterative
• Prioritizing importance
of learning areas
• Student-led

28. Problem based learning scenario: example
what has
happene
d?
• Demographics?
• How are they?
• Who else needs to
be informed/involved
Is it
serious?
• Clinical
assessment
• Laboratory
assessment
How
do you
treat?
• Identify problem
• Identify
treatments
Who is
this?
What
does it
mean?

29. Is this
serious?
local
self
care
Prof.
interventio
ns
systemic
routine
measureme
nts
One dimension of problem

30. Opportunity to develop wide
range of skills
• Real world issues
• Information identification,
collecting, synthesis skills
• Problem solving
• Computing/library
• Time management
• Teamwork
• Thinking and decision
making
• Communication/cooperatio
n
Based around a
specific topic

31. Staff development
• Enhanced skills in
facilitation of team-
working;
• Interpersonal skills
management
• Managing group
dynamics
• Assessment of learning
outcomes;
• Time management;

32. Conclusions:
PBL Emphasis in learning on….
• ‘Meaning’ not only facts
• Higher level of
comprehension
• Self-motivated attitude
• Interpersonal skill
development fostered
Commonality with many
management processes
(inc. nursing)

33. PBL-Component Summary
Thank you for your invitation, attention and engagement

34. Questions & Answers