PROBLEM BASED MEDICINE EDUCATION AND ITS IMPACT ON MEDICAL PRACTICE

By: Chandra W S (030.06.049)

MEDICAL FACULTY TRISAKTI UNIVERSITY JAKARTA 2010

OVERVIEW
Problem-based learning (PBL) is a total approach to education began at McMaster University Medical School over 25 years ago.

Dr. Howard Barrows and Ann Kelson of Southern Illinois University School of Medicine have defined PBL as:

What is problem-based learning?

A learning method based on the principle of using problems as a starting point for the acquisition and integration of new knowledge. H.S. Barrows 1982

Curriculum change - Why?

Too much information - too little time The need to foster the skills for selfdirected life-long learning

Objectives of the PBL process To develop:

Knowledge - basic and clinical content in context Skills - scientific reasoning, critical appraisal, information literacy, the skills of self-directed, life-long learning Attitudes - value of teamwork, interpersonal skills, the importance of

Traditional NewSPICES Medical Innovative Curricula Curricula Continuum S Student-centered Teacher-centered P Problem-based Information gathering I Integrated C Community-based E Elective S Systematic Discipline-based Hospital based Standard Apprenticeship-based

 Traditional
Tutorial

Tutor

Students


PBL Tutorial

Tutor

Students

PBL Classroom

PBL Tutor Room

PBL Skill Room

The Advantages of PBL

Emphasis on meaning, not only facts Increased self direction Higher comprehension and better skill development Interpersonal skills and teamwork Self-motivated attitude Facilitator-student relationship Level of learning Better knowledge retention and application.

RESEARCH ON PBL
Thirty unique studies were included. Knowledge acquisition, measured by exam scores, and doctors performance in the hospital were the most frequent outcome reported; 12 of 15 studies found no significant differences. Individual studies demonstrated either improved clerkship (N = 3) or residency (N = 1) performance, or benefits on some clinical competencies during internships for PBL (N = 1). Three of four studies found some benefits for PBL when evaluating diagnostic accuracy. Three studies found few differences of clinical (or practical) importance on the impact of PBL on practicing physicians.

RESULT OF PBL ON CLINICAL PRACTICE

Graduates are slightly better in term of: Communication skills, Teamwork, Ethics, Information, Technology, Audit, Management in their daily practice. But, their knowledge of basic sciences are inferior to those students taught on traditional courses.

CONCLUSION
The PBL and traditional course had approximately equivalent learning outcomes. The successfulness of PBL curriculum is back to the student themselves. Combining both traditional and PBL is the best way to boost graduates clinical performance and keeping knowledge quality.

REFERENCES
Learning in practice, problem based learning in continuing medical education: a review of controlled evaluation studies. Available at: http://www.bmj.com/cgi/content/full/324/7330/. Accessed January 15, 2010. Problem-based medical education in general practice: experience from Linkping, Sweden. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1239023/. Accessed January 15, 2010. Problem-based medical education in general practice and health care quality assurance. Available at: http://www.emeraldinsight.com/Insight/viewContentItem.do;jsessionid=CC38712A6C36ADEC6819 CDA2760A8F7D?contentType=Article&hdAction=lnkhtml&contentId=840922. Accessed January 15, 2010. Albanese MA, Mitchell S. Problem-based learning: a review of literature on its outcomes and implementation of issues. Acad Med 2000;68:52-81. Problem based learning improves undergraduate outcomes. Available at: http://www.bmj.com/cgi/content/full/324/7330/0/f. BMJ 2002 324: 0. Accessed January 15, 2010. Patient-based not problem-based learning: An Oslerian approach to clinical skills, looking back to move forward. Available at: http://www.jpgmonline.com/article.asp?issn=00223859;year=2009;volume=55;issue=3;spage=198;epage=203;aulast=Franklyn-Miller#cited. Accessed January 15, 2010. Problem-based learning in medical education: 22 years of outcome research. Available at: http://informahealthcare.com/doi/abs/10.3109/01421590903200789. Accessed January 15, 2010.