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Reply 5800
Hi. :smile:
Original post by iceman_jondoe
well i generally knew nothing in pbl sessions i was prob the most wuiet because i just wanted to get out of the sessions as quickly as possible!


This is very interesting.

As part of this bsc, we had a pbl on pbl. There are loads of psychological and educationalist theories as to why it theoretically should work in medical schools. However in application, at least in the short term, traditional courses seem to be better. According to the literature, pbl is more interested in developing life long learners and so has a longer lasting effect on student learning (theoretically). Now this raised the issue - medical students are more interested in the short term (they just want to pass their exams to make it to the next year), so why on earth do some medical schools use pbl? Of course once we qualify, we become more intrinsically motivated and learn because we want to, but it was quite an interesting way to look at these things.

It's also funny you mentioned you just want to get on with it (I do that too...EVERYTIME) - apparently that's the reason pbl doesn't work as effectively as it should do. We usually bunch up steps 3,4 and 5 of the pbl process in order to leave early. And even when we return for step 7, people just rattle on/read things they've found out. Now that's not necessarily down to our laziness etc. (well atleast not all the time) but probably down to poorly written pbls that allow you to guess the objectives as soon as you read it. Those are easier to write, yes, but they defeat the purpose of pbl, that is, to activate your prior knowledge, allow you elaborate on your ideas through discussion and of course to solve a realistic problem in a similar context that you'd have to do in the future.

We've had loads of people come in to talk to us - some pro pbl, others against it, and people who think it works if it's done properly and not all the time. We were told this course would turn us all into scrutinisers of medical education and where we think it has gone wrong, and tbh it's already happening. Loving it so far (bar the excessive reading, but I'm getting used to it). So much debating - people on the course with me have so many different experiences and opinions it's fantastic when we are just left to discuss matters.
Original post by Medicine Man
This is very interesting.

As part of this bsc, we had a pbl on pbl. There are loads of psychological and educationalist theories as to why it theoretically should work in medical schools. However in application, at least in the short term, traditional courses seem to be better. According to the literature, pbl is more interested in developing life long learners and so has a longer lasting effect on student learning (theoretically). Now this raised the issue - medical students are more interested in the short term (they just want to pass their exams to make it to the next year), so why on earth do some medical schools use pbl? Of course once we qualify, we become more intrinsically motivated and learn because we want to, but it was quite an interesting way to look at these things.

It's also funny you mentioned you just want to get on with it (I do that too...EVERYTIME) - apparently that's the reason pbl doesn't work as effectively as it should do. We usually bunch up steps 3,4 and 5 of the pbl process in order to leave early. And even when we return for step 7, people just rattle on/read things they've found out. Now that's not necessarily down to our laziness etc. (well atleast not all the time) but probably down to poorly written pbls that allow you to guess the objectives as soon as you read it. Those are easier to write, yes, but they defeat the purpose of pbl, that is, to activate your prior knowledge, allow you elaborate on your ideas through discussion and of course to solve a realistic problem in a similar context that you'd have to do in the future.

We've had loads of people come in to talk to us - some pro pbl, others against it, and people who think it works if it's done properly and not all the time. We were told this course would turn us all into scrutinisers of medical education and where we think it has gone wrong, and tbh it's already happening. Loving it so far (bar the excessive reading, but I'm getting used to it). So much debating - people on the course with me have so many different experiences and opinions it's fantastic when we are just left to discuss matters.


Well for me it did instill a desire to become a lifelong learner and it has taught me to do things in chunks rather than all in one go. I just felt that if i had done the work at home (which i always did) i didnt see the point in coming in to discuss my answers because i could use that time to do something else more productive...like go to the gym or revise something else for example.
Reply 5803
Original post by GodspeedGehenna
Or if that's too complex:



Great! That's a very underrated program.
Original post by Medicine Man
This is very interesting.

As part of this bsc, we had a pbl on pbl. There are loads of psychological and educationalist theories as to why it theoretically should work in medical schools. However in application, at least in the short term, traditional courses seem to be better. According to the literature, pbl is more interested in developing life long learners and so has a longer lasting effect on student learning (theoretically). Now this raised the issue - medical students are more interested in the short term (they just want to pass their exams to make it to the next year), so why on earth do some medical schools use pbl? Of course once we qualify, we become more intrinsically motivated and learn because we want to, but it was quite an interesting way to look at these things.

It's also funny you mentioned you just want to get on with it (I do that too...EVERYTIME) - apparently that's the reason pbl doesn't work as effectively as it should do. We usually bunch up steps 3,4 and 5 of the pbl process in order to leave early. And even when we return for step 7, people just rattle on/read things they've found out. Now that's not necessarily down to our laziness etc. (well atleast not all the time) but probably down to poorly written pbls that allow you to guess the objectives as soon as you read it. Those are easier to write, yes, but they defeat the purpose of pbl, that is, to activate your prior knowledge, allow you elaborate on your ideas through discussion and of course to solve a realistic problem in a similar context that you'd have to do in the future.

We've had loads of people come in to talk to us - some pro pbl, others against it, and people who think it works if it's done properly and not all the time. We were told this course would turn us all into scrutinisers of medical education and where we think it has gone wrong, and tbh it's already happening. Loving it so far (bar the excessive reading, but I'm getting used to it). So much debating - people on the course with me have so many different experiences and opinions it's fantastic when we are just left to discuss matters.


We did a small amount of PBL, about 2 sessions. Absolute nightmare. You have medical students, who know sod all, teaching medical students, who know sod all. It can be literally the blind leading the blind. Sure, we had a session after to fill in the gaps, but why not just cut out the middle man and go to the lecture? You know that the lecture will be a) relavent (unlike some PBL material, and b) probably correct (teaching each other can be like chinese whispers when you haven't actually understood something). It is true that the lecture format is one of the worst ways to deliver information - because people sleep or the speed of the lecture is either too quick or slow, but this depends very much on the lecturer - the medical schol does feedback and tends to weed out the less talented ones. The issue is that for undergraduate medical education, you are not expected to know the rareities, but in group work this is what usually pops up - because people like looking up things that are rare, and therefore interesting. Alot of the bread and butter work is largely dull donkey work until you get to a point where you know enough to start using it - there is alot of effort initially for little gain (although this changes in clinical years, you learn things quicker, but there is still alot of time and effort before clinical accumen improves). For me at least, PBL would be ab absolute disaster.

I don't see how it makes anyone into lifelong learners any less than lectures. You still need to learn the lecture material, there is still thought required. My gripe with PBL is that for undergrad med, you need to have a sense of perspective - ie learn more about big common things, less about rare things, and when you start out, you have none of that, I know our sessions arn't in any way representitive, and it dosn't help that faculty don't like PBL. As someone who did pbl once told me 'you waste too much time because you don't know what you're doing'.

I think part of the short-termist view is that at postgrad, there is nobody to force you to study for Membership, you do it because you want to learn and it's your own career. I think part of it (from personal experience) is that in medical school you have no idea how little you know, and when you start realising that, the fear kicks in) This is a different kind of fear to the 'oh **** I have exams fear', this is more like ' oh **** I know so little I'm probably dangerous' fear.

I guess the other point is that 'traditional methods' have turned out doctors for generations, whereas PBL is the new kid on the block. What would be interesting is to do a study on final years, or just starting F1s, and put them through one single exam like the MRCP and see what happens, make them do all of it, regardless of failing parts, and then we might be able to tease out if there are any systemic knowledge or clinical skills differences between schools that are independent from on the job learning and experience. If PBL is just as good, then the results should be indistinguishable from traditional methods, assuming a similar bell distribution of ability across all medical schools.

The problem I see with medical education is that we're getting too much on things like phycological theories of illness (year two friday mornings is a block of psych), which not many people go to, and too little on things that will actually increase clinical accumen. I know what every generation bemoans standards falling, but as one of our consultants pointed out ' you can't communicate with a dead patient'. It's not so much standards falling, but just the increased emphysis towards non medical 'holistic' care. You can afford to be holistic if you're confortable with the medicine, if you have no idea whats going on with this patient in front of you, holisticness isn't going to help. You take in kids that are 18/19/20s - by that age, if they can communicate with people, if they have social skills they will already have them. It is true that communicating with patients is different to having a drink down the pub, but anyone who has done coustomer service will probably be able to adapt.

What would I do? Have some communication stuff, but what would really sort peopel out would be to force them to go on wards and just talk to patients - I would have every medical school link up with the local trusts' staff bank office and offer locum HCA work to medical students. Everyones a winner - students get 'communication skills practice', a well paid flexible job, patients get care, and it's cheaper for the trusts because all the security checks have been done. Simples. And they'll pick things up on the wards too. Thats the way to be more confortable dealing with patients.
Original post by Wangers
We did a small amount of PBL, about 2 sessions. Absolute nightmare. You have medical students, who know sod all, teaching medical students, who know sod all. It can be literally the blind leading the blind. Sure, we had a session after to fill in the gaps, but why not just cut out the middle man and go to the lecture?

You're demonstrating a fundamental misunderstanding of what PBL is here, which is very common and partly why there's such widespread disdain for it. And that's probably because you've had two sessions on it. No PBL team gets slick at it with two sessions! A PBL isn't strictly about 'teaching' each other. At least it isn't in my experience. It's about highlighting learning points/weak areas and discussing what you've learnt as a group. Also, you have a facilitator for a reason...

You know that the lecture will be a) relavent (unlike some PBL material, and b) probably correct (teaching each other can be like chinese whispers when you haven't actually understood something).

The only thing that's close to certain from a lecture in my experience is that it will be soporific. And I've come across mistakes in lectures many times, which isn't great when people take them as gospel.

It is true that the lecture format is one of the worst ways to deliver information - because people sleep or the speed of the lecture is either too quick or slow, but this depends very much on the lecturer - the medical schol does feedback and tends to weed out the less talented ones. The issue is that for undergraduate medical education, you are not expected to know the rareities, but in group work this is what usually pops up - because people like looking up things that are rare, and therefore interesting. Alot of the bread and butter work is largely dull donkey work until you get to a point where you know enough to start using it - there is alot of effort initially for little gain (although this changes in clinical years, you learn things quicker, but there is still alot of time and effort before clinical accumen improves). For me at least, PBL would be ab absolute disaster.

Again: facilitator. Wavering off track from what you're supposed to cover doesn't get you out of covering what you're supposed to cover.

I don't see how it makes anyone into lifelong learners any less than lectures. You still need to learn the lecture material, there is still thought required. My gripe with PBL is that for undergrad med, you need to have a sense of perspective - ie learn more about big common things, less about rare things, and when you start out, you have none of that, I know our sessions arn't in any way representitive, and it dosn't help that faculty don't like PBL. As someone who did pbl once told me 'you waste too much time because you don't know what you're doing'.

Again again: facilitator!
I think the idea is that because a lot of the information required in PBL you have to actively seek out with other resources than a powerpoint slide with everything on, it means that when you come to something that a lecture doesn't cover, you're more adept at distilling it out of the other resources and deciding which resources will best suit your need.
Original post by Wangers
We did a small amount of PBL, about 2 sessions. Absolute nightmare. You have medical students, who know sod all, teaching medical students, who know sod all. It can be literally the blind leading the blind. Sure, we had a session after to fill in the gaps, but why not just cut out the middle man and go to the lecture? You know that the lecture will be a) relavent (unlike some PBL material, and b) probably correct (teaching each other can be like chinese whispers when you haven't actually understood something). It is true that the lecture format is one of the worst ways to deliver information - because people sleep or the speed of the lecture is either too quick or slow, but this depends very much on the lecturer - the medical schol does feedback and tends to weed out the less talented ones. The issue is that for undergraduate medical education, you are not expected to know the rareities, but in group work this is what usually pops up - because people like looking up things that are rare, and therefore interesting. Alot of the bread and butter work is largely dull donkey work until you get to a point where you know enough to start using it - there is alot of effort initially for little gain (although this changes in clinical years, you learn things quicker, but there is still alot of time and effort before clinical accumen improves). For me at least, PBL would be ab absolute disaster.

I don't see how it makes anyone into lifelong learners any less than lectures. You still need to learn the lecture material, there is still thought required. My gripe with PBL is that for undergrad med, you need to have a sense of perspective - ie learn more about big common things, less about rare things, and when you start out, you have none of that, I know our sessions arn't in any way representitive, and it dosn't help that faculty don't like PBL. As someone who did pbl once told me 'you waste too much time because you don't know what you're doing'.

I think part of the short-termist view is that at postgrad, there is nobody to force you to study for Membership, you do it because you want to learn and it's your own career. I think part of it (from personal experience) is that in medical school you have no idea how little you know, and when you start realising that, the fear kicks in) This is a different kind of fear to the 'oh **** I have exams fear', this is more like ' oh **** I know so little I'm probably dangerous' fear.

I guess the other point is that 'traditional methods' have turned out doctors for generations, whereas PBL is the new kid on the block. What would be interesting is to do a study on final years, or just starting F1s, and put them through one single exam like the MRCP and see what happens, make them do all of it, regardless of failing parts, and then we might be able to tease out if there are any systemic knowledge or clinical skills differences between schools that are independent from on the job learning and experience. If PBL is just as good, then the results should be indistinguishable from traditional methods, assuming a similar bell distribution of ability across all medical schools.

The problem I see with medical education is that we're getting too much on things like phycological theories of illness (year two friday mornings is a block of psych), which not many people go to, and too little on things that will actually increase clinical accumen. I know what every generation bemoans standards falling, but as one of our consultants pointed out ' you can't communicate with a dead patient'. It's not so much standards falling, but just the increased emphysis towards non medical 'holistic' care. You can afford to be holistic if you're confortable with the medicine, if you have no idea whats going on with this patient in front of you, holisticness isn't going to help. You take in kids that are 18/19/20s - by that age, if they can communicate with people, if they have social skills they will already have them. It is true that communicating with patients is different to having a drink down the pub, but anyone who has done coustomer service will probably be able to adapt.

What would I do? Have some communication stuff, but what would really sort peopel out would be to force them to go on wards and just talk to patients - I would have every medical school link up with the local trusts' staff bank office and offer locum HCA work to medical students. Everyones a winner - students get 'communication skills practice', a well paid flexible job, patients get care, and it's cheaper for the trusts because all the security checks have been done. Simples. And they'll pick things up on the wards too. Thats the way to be more confortable dealing with patients.



Did anyone ever come up with questions such as "what is the role of the nurse specialist" etc etc those questions were the worst!!
Leicester is part PBL and part lectures so from a student point of view: we learn far more from the groupwork than the lectures and our groupwork sessions are built on the content of the lectures however the lectures will only give us basic information and the groupwork session is there to implement the knowledge through case studies. I can't imagine doing only PBL as it's going to be very hard to know when to stop going into detail and with lectures only - you're not going to develop your problem solving skills as much as you would through the PBL groupwork. Also Leicester did try PBL only and it just didn't work so they went back to lectures. For me; I think that's the best way as you get the best of both worlds but obviously I've only ever learnt like that do very much biased :tongue:
Original post by lekky
was I so annoying when I was a first year? Surely not. They just won't keep quiet in the library and are all so keen :p:


The year below me are super super keen, they work in the library very late in the day. But the year above us say that we're the workaholic year so not sure, but heard someone in the library mention how the metabolism lectures 'are so long, there's 30 slides!', I want to hear their response when they find out the immunology lectures are 100+ PowerPoint slides. (Yes I'm very much serious.)
Reply 5809
Original post by Kinkerz
You're demonstrating a fundamental misunderstanding of what PBL is here, which is very common and partly why there's such widespread disdain for it. And that's probably because you've had two sessions on it. No PBL team gets slick at it with two sessions! A PBL isn't strictly about 'teaching' each other. At least it isn't in my experience. It's about highlighting learning points/weak areas and discussing what you've learnt as a group. Also, you have a facilitator for a reason...


The only thing that's close to certain from a lecture in my experience is that it will be soporific. And I've come across mistakes in lectures many times, which isn't great when people take them as gospel.


Again: facilitator. Wavering off track from what you're supposed to cover doesn't get you out of covering what you're supposed to cover.


Again again: facilitator!
I think the idea is that because a lot of the information required in PBL you have to actively seek out with other resources than a powerpoint slide with everything on, it means that when you come to something that a lecture doesn't cover, you're more adept at distilling it out of the other resources and deciding which resources will best suit your need.


I agree with all these points!

Although I'm not a die hard PBL fan and recognise the (sometimes significant) disadvantages I definitely think it's the way forward with the right balance of support in terms of labs and lectures. Can't even imagine how I'd cope in a traditional course.
Who knew it was so difficult to find patients to present at grand rounds. Probably was a bit mad for the ward as we all arrived at once mind.
Original post by Wangers

I don't see how it makes anyone into lifelong learners any less than lectures. You still need to learn the lecture material, there is still thought required.

But you're spoon fed. There is no critical thought involved. There is no development of research skills or ability to assess information. You sit there passively for an hour, try not to fall asleep, and then go home and stare at it for a while and maybe make some fluorescent pen flowcharts. And when you're a professional later on, maybe you develop those skills on your own but maybe you don't, and maybe people die because you never learned how to learn instead of getting taught.

I guess the other point is that 'traditional methods' have turned out doctors for generations, whereas PBL is the new kid on the block. What would be interesting is to do a study on final years, or just starting F1s, and put them through one single exam like the MRCP and see what happens, make them do all of it, regardless of failing parts, and then we might be able to tease out if there are any systemic knowledge or clinical skills differences between schools that are independent from on the job learning and experience. If PBL is just as good, then the results should be indistinguishable from traditional methods, assuming a similar bell distribution of ability across all medical schools.


That would be interesting.

The problem I see with medical education is that we're getting too much on things like phycological theories of illness (year two friday mornings is a block of psych), which not many people go to, and too little on things that will actually increase clinical accumen.


Like being able to spell? Seriously.

I know what every generation bemoans standards falling, but as one of our consultants pointed out ' you can't communicate with a dead patient'. It's not so much standards falling, but just the increased emphysis towards non medical 'holistic' care. You can afford to be holistic if you're confortable with the medicine, if you have no idea whats going on with this patient in front of you, holisticness isn't going to help.


There is a massive literature on how things like comms skills have concrete effects on outcomes. This is the standard gripe of people who have issues with their comms skills; that it's useless, and that you can't improve it anyway so it's pointless to try. Wrong and wrong. Kids all want to be like House or Dr Cox, but at the end of the day some of their patients will die because they will think "what a c*** that doctor was" and fail to comply with advice. The last generations of people who think "1. wow, that doctor was a real arrogant prick. 2. ??? 3. therefore he must be super good" are dying off as we train, and even in that case people are less likely to disclose things like embarassing problems.
The PBL argument always seems a tad pointless to me. We just go round in circles whilst those of you who do PBL point out it's usefulness, and those of us who don't do PBL are criticised for not understanding, whilst pointing out it's flaws. Surely it's just a case of horses for courses. I wouldn't want to do PBL, yet I don't think that will make me a worse doctor. So long as we end up with the same knowledge at the end and the same capacity to learn beyond medical school, who really cares how we got there? Just as PBL is not being left to get on with it, lecture based teaching is not spoonfeeding, so how about we cut the assumptions and just let people learn how they want to learn? It's not as if we are forced down one route or the other.
It's probably my fault for going off on a tangent! :colondollar: But I do agree with yoI BeccaSarah.

In other news, I haven't seen you around yet? :ninja:
Original post by Becca-Sarah
The PBL argument always seems a tad pointless to me. We just go round in circles whilst those of you who do PBL point out it's usefulness, and those of us who don't do PBL are criticised for not understanding, whilst pointing out it's flaws. Surely it's just a case of horses for courses. I wouldn't want to do PBL, yet I don't think that will make me a worse doctor. So long as we end up with the same knowledge at the end and the same capacity to learn beyond medical school, who really cares how we got there? Just as PBL is not being left to get on with it, lecture based teaching is not spoonfeeding, so how about we cut the assumptions and just let people learn how they want to learn? It's not as if we are forced down one route or the other.
This BSc makes me want to cry already.
Original post by Becca-Sarah
The PBL argument always seems a tad pointless to me. We just go round in circles whilst those of you who do PBL point out it's usefulness, and those of us who don't do PBL are criticised for not understanding, whilst pointing out it's flaws.

I won't criticise (I don't think I criticised Wangers anyway) someone who logically points out its flaws having understood what it actually is. I'm not a militantly pro-PBL person, but I dislike lectures strongly.
Original post by crazylemon
Those saying you don't Learn research skills outside pbl bull****. We have a mock paper in yr 2 (research) and then the Intercalated degree.

Not saying PBL is the only way to gain research skills, obviously. Just saying it's a superior way to develop them than through learning lecture slides.

Pbl only works well with a motivated group, facilitator that knows what they are doing and really good feedback. Even then I suspect a tutorial would confer more info.

I agree that tutorials and seminars are better than PBL. But I just think you get more from PBL than lectures in many cases.
Original post by Supermassive_muse_fan
Leicester is part PBL and part lectures so from a student point of view: we learn far more from the groupwork than the lectures and our groupwork sessions are built on the content of the lectures however the lectures will only give us basic information and the groupwork session is there to implement the knowledge through case studies. I can't imagine doing only PBL as it's going to be very hard to know when to stop going into detail and with lectures only - you're not going to develop your problem solving skills as much as you would through the PBL groupwork. Also Leicester did try PBL only and it just didn't work so they went back to lectures. For me; I think that's the best way as you get the best of both worlds but obviously I've only ever learnt like that do very much biased :tongue:

But there aren't any* courses that do only PBL. PBL schools will still include lectures and tutorials in their teaching, it just won't be a 09:00-17:00 didactic "here's a powerpoint, go forth and memorise..."

And I agree with what you say: a mixture is probably best, I'd just prefer some dilution with the archaic concept of lectures.

*if there are, I'm not aware of them.
We do a few hours of group work per day but it's generally lead by work books and education fellows. S'aight
Original post by Medicine Man
It's probably my fault for going off on a tangent! :colondollar: But I do agree with yoI BeccaSarah.

In other news, I haven't seen you around yet? :ninja:


I actually thought what you said was quite interesting, having never done PBL it's not something I've ever really considered on a theoretical basis.

That would be because I'm hiding down at Mile End - made it down to BL for Toga (I still have the bruises to prove it) but nothing else just yet.

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