What is problem based learning Is not problem

�What is problem based learning? �Is not problem solving but it uses appropriate problem to increase knowledge and understanding

�Generic skills and attitudes �Teamwork �Chairing a group �Listening �Recording �Cooperation �Respect for colleagues views �Critical evaluation of literature �Self directed learning and use of resources �Presentation skills

What happen in a PBL tutorial?

�Step 1: identify the problem �Step 2: explore pre-existing knowledge �Step 3: generate hypotheses and possible mechanism � step 4 : Identify learning issues � step 5: Self study �Step 6: re-evaluation and application of knowledge to the problem �Step 7: assessment and reflection on learning

ROLLES PLAYS OF ALL PARTICIPATS �Tutor �Scribe �Chair �Group member

TUTOR �Encourage all group members to participate �Assist chair with group dynamic and keeping to time �Check scribe keeps an accurate record �Prevent side-tracking �Ensure group achieves appropriate learning objectives �Check understanding �Assess performance

�Hallmark of successful tutorial �Student centeredness �Ground rules �Team work �Dialogue between tutor and case-writers

SCRIBE �Record points made by group �Help group order their thoughts �Participate in discussion �Record resources used by group

CHAIR �Lead the group through the process �Encourage all members to participante �Maintain group dynamics �Keep to time �Ensure group keeps to task in hand �Ensure scribe can keep up and is making an accurate record

GROUP MEMBER �Follow the steps of the process in sequence �Participate in discussion �Listen to and respect contributions of others �Ask open questions �Research all the learning objectives �Share information with others

�Trigger material for PBL scenarios �Paper based clinical scenarios �Experimental or clinical laboratory data �Photographs �Video clip �Newspaper articles �All or part of an article from a Scientifics journal �A real or simulated patient �A family tree showing an inherited disorders �

How to create effective PBL scenarios �Learning objective �Stage of curriculum and level of student �Sufficient intrinsic interest or future practice �Integration of knowledge �Stimulate discussion �Open ended problem �Promote student to gather information from various resources

PBL in curriculum design �Entire curriculum �Individual course

Advantage of PBL Student center Generics competencies Integration Motivation Deep learning Constructivitist approach Practical work Stimulate real-life experiences

Disadvantage of PBL �Tutors who can’t teach �Human resources �Other resources �Role models �Information overload �Time consuming �unguided

Criteria for PBL problem construction �Stimulating thinking , analysis, reasoning �Assuring self –directed learning �Using previous basic knowledge �Proposing a realistic context �Leading to the discovery of learning objectives �Arousing curiosity �Choosing topic related to public health �Assuring a contextual detail �Choosing an appropriate vocabulary

Scenario �A 35 year old part nurse presented to her general practitioner Dr X with a six month history of weight loss (12. 5 kg). when questioned she said she was eating well but had diarrhea. She also felt exhausted and had developed insomnia. on further questioning she admitted to feeling increasing hot and shaky and to having muscle weakness in her legs particularly when climbing stairs. she was normally well and had not seen the doctor since her last pregnancy eight years ago.

�Free thyroxin 49. 7 pmole (normal range : 11 -24. 5) �Total thyroxin 225 nmol (normal range: 60 -150) �Thyroid stimulating hormone 0. 01(0. 4 -4)

�Dr X referred her to endocrinologist where initial investigation confirmed a diagnosis of Graves disease she was treated with carbimazole and propranolol for the first month followed by carbimazole alone.

Learning objectives � 1 -describe the clinical features thyrotoxicosis and Graves disease � 2 -Interrpret thyroid function and pituitary thyroid axis � 3 -List the type of treatment for thyrotoxicosis, indication , mode of action and potential effects