PBL sessions are designed to develop your confidence in a safe setting before transitioning to the clinical setting where you will be doing case discussions with a lot more weight attached to them. And I don’t know of any medical course in the country that is completely PBL. It would be impossible, impracticable and insanely expensive for the medical school to facilitate this. From what I understand from the course I hope to attend next year, the PBL is essentially a framework for your lecture-based and independent learning where you apply the knowledge you gain over the course of a week to a real case, preparing you for the case discussions you’ll be doing in clinical years and in practice. In theory, facilitators are there to encourage participation from everyone and to make sure no one person comes to dominate a session and obviously the success of facilitators in doing so is bound to vary. But it’s important to develop these skills early and PBL is an almost ideal environment to do this.
The trust I work for recruits heavily from two medical schools, one of which is PBL based and the other of which is not. I dare say that it sometimes shows and the communication from the PBL based uni and the holistic thinking is often quite a bit more developed in the PBL based university doctors. In a rare private moment with the consultant when I told him I was thinking of studying medicine he told me that PBL is the best teaching development he’s seen in 40 years as a doctor. In his words, less obscure rubbish and more more practical values, by which he meant that in a specialty like his you need the skills of MDT working, collaboration, confident communication and initiative that PBL will encourage from an early stage far more than you do knowledge of rare and weird diseases that he spent his clinical years stuffing his brain with (his words again!). Certainly we in the wider team value doctors with these qualities and skills as well so I definitely see his point, although I imagine it’s not universally valuable across all medical specialties.
With regard to introvertedness being a barrier to PBL, let me point out this. I’ve seen junior doctors who are incredibly timid in handovers or MDT and don’t say a word. They’ll sometimes creep up soon or even long after it’s over and ask me or other members of the MDT what something we said meant. Sometimes the questions they ask make me cringe a little because they’ll sometimes reveal a long held misunderstanding that has potentially led to them making errors in their clinical practice. Then there’s others who’ll outspokenly interrupt a meeting to ask the same sort of question, derailing discussions and making the handover all about them and what they want to know. Neither is necessarily better or worse than the other although they can be roughly divided into introverted and extroverted camps. The more permanent staff always welcome questions and we’d rather a question came at us than it didn’t. Over time, they improve with confidence and they usually get to a point where they will confidently (and politely) ask appropriate questions at the right time and place. Just because you’re an introvert doesn’t mean you’re unsuited for a particular learning style. It just means you have different things to learn from it than someone who is more extroverted. And it’s all good preparation for the job you eventually have to do. So I recommend you embrace it and remember that participation doesn’t mean that you have to change your entire personality, nor does it mean you have to be terrified to speak or obliged to come up with something to say every session.
Hope this helps.