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Problem Based Learning

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This week's blog is about teaching -- about my interest in problem-based learning (PBL) and interactive teaching.   My interaction with two students who do not like problem-based learning prompted me to write about this topic. 

First, everyone interested in this question, should, I think, view this resource:
Under 'audio of the program' you can click on 'listen' and hear the whole program. 

Professor Tan of the Nanyang Technological University in Singapore [O. S. Tan, Problem-based learning innovation: Using problems to power learning in the 21st century. Singapore: Thomson Learning. 2003.] describes PBL as a learner-centered approach that positions students as central to the process. He lists some common characteristics of PBL approach:

We begin the learning process with a problem to be solved.

The problem is similar to those that professionals or practitioners in the field encounter in the world and therefore has an unstructured feel to it. If it is a simulated problem, it is meant to be as authentic as possible.

The problem calls for multiple perspectives. The use of multi-disciplinary knowledge is a key feature in many PBL curricula. PBL encourages solutions that take into consideration knowledge from various subjects and topics.

Self-directed learning is primary. Thus, students assume the major responsibility for acquisition of information and knowledge. The tutor's role is as facilitator, consultant, resource person, and mentor.

Harnessing of a variety of knowledge sources are essential PBL processes.

Learning is collaborative, communicative, and cooperative. Learners work together in small groups with high levels of interaction.

The development of skills for how to ask questions and solve problems within the discipline is as important (if not more) than acquiring content knowledge needed for the solution of the problem.

Closure in the PBL process includes synthesis and integration of learning.

PBL also concludes with an evaluation and review of learner's experience and learning process.

Besides the characteristics mentioned above, the PBL approach highlights the importance of the transfer of skills [Oon-Seng Tan, Problem-based Learning Approach to Human Computer Interaction, World Academy of Science, Engineering, and Technology 76: 462-465, 2011]. Learners are expected to transfer concepts learned previously to new problems although spontaneous transfer can be hard without practice or expertise. Transfer often fails because problem solvers fail to retrieve relevant information or skills that they need. Since in PBL the knowledge is encoded in real-life problems, students are more likely to retrieve the knowledge when faced with future problems. For example, during each unit in my class we consider a DSM diagnosis or clinical condition and the brain areas that might contribute to maintaining that condition.   There are too many diagnoses to fit into the seven units of the course.   The goal is to teach a method of approaching learning how the brain fits into behavior so that students can tackle any diagnosis using the methods and resources they learned and find the information they need to come to an understanding.   Of course, this works better, since the information will substantially change each year.   Memorizing facts from this year will not prepare students for next year.

In medical education, we try to teach students a systematic way to approach new problems.   Given a disease you have never encountered before, what do you do?   We hope the student will know how to access the literature on that disease, will look for the theories of causation, transmission, risk factors, resiliency, treatments, and interactive effects.   Students will have practice in understanding that diseases that are categorized in any one specialty or organ system affect all organ systems and require knowledge from all disciplines.   The body is full inter-connected.   Similarly, our understanding of diseases changes daily and yesterday's facts are out of date already.

Can we teach classes that are not about memorization?  Can we bring problem-based, interactive learning to an online course? Problem-based learning because is evidence-based and performs so much better than more conventional methods.

The problem with problem-based, interactive learning is that the students have to participate and to interact with the teacher.  The argument for problem based learning is that the students learn up to 60% more material.  Plus, for students who engage in it, after the first shock of realizing that the class won't be memorization based, they report having a much better time and learning more.  Some students resist at first.  The American Radio Works program says, don't try this if you still need tenure(!).  But that is because it feels different.  A Harvard physicist in the program makes the point that it used to be that we couldn't easily get to the library to get information, so we needed to memorize.  Now there are endless online resources at the drop of a thumb, so we need to teach people how to find, translate, and use information.

Interactive, problem-based learning formats do seem disorganized to students who are used to conventional education .  Conventional educational practice lays out of body of material to be mastered (learned, memorized, etc.) and then tests the students on their temporary retention of that material through quizzes and exams.  These newer approaches to teaching attempt to engage the student in a discipline through interacting with it and learning its questions and challenges and where to find the relevant information.  There's not necessarily a body of knowledge to retain but rather a sense for how to orient oneself and find the information when needed again.  I can see how that could seem disorganized to someone who is used to conventional practices.  However, the literature suggests that the kinds of students who do best with these newer methods are just the ones who flounder at conventional education .  Many of the students who sail through college and graduate school without interruption are found to do well regardless of method used.

I'd like to see us change the culture of education .  The culture seems to resist frequent contact and interactive learning in favor of a kind of hierarchical isolation from the instructor.   This can become especially true in the on-line environment, which doesn't have to necessarily mean low contact with faculty.  I'd like to see students involved from the beginning in shaping the course the way they'd like it to go.  Interactive PBL requires student presence.  The University of Minnesota, Rochester, which is a health sciences campus that feeds the Mayo Clinic, entirely uses this approach and doesn't even have a lecture podium.

I have a way to go to get to where I'd like to be for the online environment.  For example, in one of my on-line classes, I still did two fairly conventional lectures each week with powerpoints though I encourage discussion.  Because I don't know who (if anyone) will attend, I need material upon which to fall back.  I also make my slides available as study guides/resources.  I'm still not generating the level of discussion I would like, so I have to be prepared to lecture.  I usually lecture for one hour and then have a half hour of discussion.

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Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, (more...)
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