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July 1997
Volume 61 |
Number 7
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| Reflections on
the Problem-Based Learning Discussion Program |
Philip L. Liu, M.D., Chair
Committee on Problem-Based Learning Discussions
The 1997 ASA Problem-Based Learning Discussion Program (PBLD)
is the sixth rendition of this program. What inferences can be
made from the six-year experience with this entirely new format
for anesthesiology learning in a postgraduate setting? The innovative
elements of the ASA PBLD program was that it was designed to be:
1) active learning, 2) small group discussion, 3) case based,
4) learner centered and 5) problem oriented.
These are all-important elements of traditional problembased
learning format that is typically employed in a medical school
setting. The ASA PBLD program is a unique adaptation of Problem-Based
Learning (PBL) that I designed for the particular circumstances
of the ASA Annual Meeting. There is a large debate raging amongst
medical school educators as to whether the large numbers of medical
schools changing their curriculums to PBL is justified on the
basis of educational outcomes. Nevertheless, there continues to
be a large increase in the numbers of PBL medical schools despite
the lack of objective data in the literature to support better
outcomes with PBL. However, the consistent findings in many studies
is that learners seem to strongly prefer and are happier with
the PBL format than traditional methods. The contribution of this
positive mindset toward the educational milieu in producing favorable
outcomes has been underestimated in the educational literature.
The ASA PBLD program supports the concept that the learner, even
the postgraduate learner, enjoys the PBL format. We have much
evaluation data that indicates that PBLD learner/discussants have
very positive feelings about their educational experience at a
PBLD session. In addition, the popularity of the PBLD program
attests to the allure of the PBL concept. In summary, I believe
we can safely conclude that similarly to medical students, anesthesiologists
are happy with PBL.
The popularity of PBL within the specialty of anesthesiology
has grown enormously since the inception of the ASA PBLD program.
There is a widespread usage of PBL in resident programs and medical
student clerkships all across North America. The New York State
Society of Anesthesiologists Annual Postgraduate Assembly Meeting
offered and continues to offer a PBL format. This program began
shortly after the inaugural ASA offering. It is my belief that
availability of the ASA PBLD cases in the ASA PBLD book has accelerated
the popularity of this format. In addition, many faculty and residents
come to the ASA to experience a PBL session and return to their
home educational institution with praise for this method. Many
anesthesiologist medical educators have told me that they are
incorporating the ASA PBL cases in their residencies. The ASA
has recently received a request from the Australian Society of
Anesthetists to employ PBLD in their Scientific Program. I have
also received a request from a neurologist colleague that is interested
in PBLD as a model for their national meeting. It is very apparent
that the ASA PBLD program is putting anesthesiology in the forefront
of a worldwide surge of enthusiasm towards PBL. Like many innovations
in medical education, PBL will have to survive the test of time.
However, it is safe to say that at the ASA, PBLD has found a home!
What Is the PBLD Program?
It is an adaptation of a method that has been employed by many
medical schools in the United States and Canada in the reform
of their curriculum. This format is a case-based, small-group,
problem-oriented, student-centered discussion.
Each PBLD will consist of a small group of discussants/ learners,
who will meet with their moderator/facilitator to discuss the
anesthesia problem case written by their moderator/facilitator.
The atmosphere will be informal, collegial and supportive of learning
and interchange of ideas. A buffet breakfast, luncheon or refreshment
will be served.
All discussants/learners will receive their case (one to two
pages) by mail several weeks in advance of the discussion session
so that there should be ample time for each participant to do
the obligatory preparation to contribute cogently and to benefit
maximally from the discussion. Discussants/learners will be expected
to demonstrate their mastery of the topic by engaging in high-quality
analytical discussion and setting the discussion agenda. Moderators/
facilitators will not be primary information providers in these
sessions.
This format approximates the problem-solving process that anesthesiologists
practice on a daily basis in caring for their patients. It allows
for in-depth exploration of many aspects of a case that has been
selected particularly for discussion by our expert moderators/facilitators.
Advantages of PBLD
- Application of learning to a case, not just a didactic presentation
- Insight into problem-solving strategies used by peers
- Practice in utilization of available educational resources
- Small-group format with opportunity for dynamic interaction
with peers and the faculty moderator/facilitator
- Active learning as contrasted to passive learning (lecture)
- Learner-centered rather than faculty-centered format
- Promotion of teamwork in clinical problem-solving
Responsibility of Discussants/Learners
- In advance of the discussion session, do your best to study
and solve the problem(s) in the case. This may involve researching
the topic, using texts, literature searches and reprints, discussion
with colleagues and hypothesis formation.
- At the discussion session, be prepared to discuss the problem
in the case, the underlying basic science, mechanisms of the
problem and your analysis of the case. Expect challenges from
your peers!
- Respond to our feedback survey.
Feedback From 1996 PBLD Discussants/Learners
- 490 feedback forms were returned in 1996.
- 99 percent indicated that they would participate again in
future PBLDs.
- 99 percent felt they would recommend PBLDs to a friend.
- PBLD experience was felt to be aptly described as meaningful,
enjoyable, stimulating, rewarding, motivating, leading to new
questions and not tedious.
PBLD Books
In the 1996 program, a collection of PBLD cases was published
in the 1996 Problem-Based Learning Discussions book (price $15).
These PBLD books contained the case objectives, cases, references
and model discussion outline.
Although we advocate the active learning experience of participation
in the PBLD program as discussants/learners, the model discussion
outlines in the PBLD book are suitable for use by learners who
do not attend the PBLD. The model discussion outline, available
in the PBLD book, enables even those who do not attend the PBLD
to use the PBLD cases for their own educational purposes.
Discussants/learners will receive a PBLD book. PBLD books also
may be purchased at the Annual Meeting Book Sales Room or by mail
from the ASA Executive Office for $15 after the 1997 Annual Meeting.
Location, Cost, Choice and Time
PBLD will be held in the San Diego Marriott Hotel and Marina
on Saturday through Tuesday, October 18-21. Specific room assignment
information will be provided on the PBLD tickets. Breakfast sessions
will be held on Saturday and Sunday, October 18 and 19, from 7:30
a.m. to 8:45 a.m. Luncheon sessions will be held Saturday through
Tuesday, October 18-21, from 12:30 p.m. to 1:45 p.m. Refreshment
sessions will be held on Monday and Tuesday, October 20-21, from
3:45 p.m. to 5 p.m.
A new descriptor of each PBLD is now provided to assist learner/discussants
in choosing the PBLD that they wish to attend.
Cost for each discussant/learner will be $30 for breakfast sessions,
$50 for luncheon sessions and $20 for refreshment sessions. This
includes breakfast, luncheon or refreshment service and the 1997
Problem-Based Learning Discussions book, which contains objectives,
cases, model discussion outlines and references for all of the
PBLD sessions.
Assignments will be made on a first-come, first-served basis.
Please list alternative sessions so that you may be accommodated
with alternative choices if your primary choices are filled. Past
experience has demonstrated that the most popular PBLD sessions
are sold out very early!
The PBLD schedule, including a listing of the participating faculty
with their topics, appears in the Annual Meeting registration
booklet mailed to all ASA members in June.
As we embark on this sixth rendition of the PBLD Program, I would
like to personally express my gratitude to the discussants/learners,
moderators/facilitators, PBLD committee members, ASA leadership
and ASA Executive Office staff for their contributions to this
project. It is their efforts that have created this achievement.
Philip L. Liu, M.D., is Professor and Chair,
Department of Anesthesiology, and Professor of Pharmacology and
Physiology, University of Medicine and Dentistry of New Jersey,
University Heights, New Jersey.
E-mail the author.
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