Abstract
A key principle in problem-based learning (PBL) is the student linking learning from different sources to enrich understanding. We have explored how medical students based in a clinical environment use clinical experience within PBL groups. We recorded the discussion of 12 third-year groups, which were meeting for the second time on a PBL case, where students report back on the learning objectives. Discussions covering five separate PBL paper cases were recorded. Analysis of the transcripts was based on constant comparative method using a coding framework. The range of discussion segments of clinical experience was 2–15, with 9 of 12 groups having at least five separate segments. Our initial coding framework covered 10 categories, of which the most common were: a specific patient encounter (19%); an experience in the community (15%); and a personal health experience (15%). Students often used emotive phrases with 37 examples in the clinical experience segments compared with 9 from the longer non-clinical discussion. Most clinical descriptions triggered further discussion with almost half leading to some related medical topic. The discussion segments were subsequently coded into; ‘confirming’ (40); ‘extending’ (40); and ‘disconfirming’ (16) the understanding of the group for that topic. Discussion of clinical experience encouraged students to connect to the affective aspects of learning. It helped students to bridge between the tutorial and real clinical contexts. A clinical experience was often a powerful pivotal point, which confirmed, extended or refuted what was being discussed.
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References
Barrows H.S. (1986). A taxonomy of Problem-based learning methods Medical Education 20: 481–486
Bickman L., Rog D.J. (Eds). (1998). Handbook of Applied Social Research Methods California. Sage Publications.
Boshhuizen H.P.A., Bromme R., Gruber H. (Eds.) (2004) Professional Learning: Gaps and Transitions on the Way from Novice to Expert Netherlands, Kluwer Academic Publishers
Boter H., Van Delden J.J.M., De Haan RJ, Rinkel G.J.E. (2003) Modified informed consent procedure: consent to postponed information British Medical Journal 327: 284–285
Dammers J., Spencer J., Thomas M. (2001) Using real patients in problem-based learning: students’ comments on the value of using real, as opposed to paper cases, in a problem-based learning module in general practice Medical Education 35: 27–34
Denzin N.K., Lincoln Y.S. (Eds). (2000) Handbook of Qualitative Research California, Sage Publications
Diem S.J., Lantos J.D., Tulsky J.A. (1996) Cardiopulmonary resuscitation on television – miracles and misinformation New England Journal of Medicine 334: 1578–1582
Dornan T., Bundy C. (2004). What can experience add to early medical education? Consensus survey British Medical Journal 329: 834–7
Dornan T., Scherpbier A., King N., Boshuizen H. (2005). Clinical teachers and problem-based learning: a phenomenological study Medical Education 39: 163–170
Foley R.P., Polson A.L., Vance J.M. (1997) Review of the literature on PBL in the clinical setting Teaching & Learning in Medicine 9: 4–9
Greenhalgh T., Taylor R (1997). How to read a paper: papers that go beyond numbers (qualitative research) British Medical Journal 315: 740–743
Jones A., McArdle P.J., O’Neill P.A. (2002). Perceptions of how well graduates are prepared for the role of a pre-registration house officer: A comparison of the outcomes of a traditional and a Problem-Based Learning Course at a UK Medical School Medical Education 36: 16–25
Jones A., Willis S., O’Neill P.A. (2003). A Qualitative Study of the Attitudes to Teamwork of Graduates from a Traditional and an Integrated Undergraduate Medical Course Advances in Health Sciences Education 8: 139–148
Kenny N.P., Beagan B.L. (2004) The patient as text: a challenge for problem based learning Medical Education 38: 1071–1079
Littlewood S., Ypinazar V., Margolis S.A., Scherpbier A., Spencer J., Dornan T. (2005). Early practical experience and the social responsiveness of clinical education: systematic review British Medical Journal 331: 387–91
MacPherson R., Jones A., Whitehouse C.R., O’Neill P.A. (2001). Small Group Learning in the Final Year of a Medical Degree: A Quantitative and Qualitative Evaluation Medical Teacher 23: 494–502
Norman G.R., (2000). The epistemology of clinical reasoning: perspectives from philosophy, psychology and neuroscience Academic Medicine 75: S127–S133
O’Neill A.P., Metcalfe D., David T.J. (1999). The core content of the undergraduate curriculum in Manchester Medical Education 33: 121–129
O’Neill P.A., Baxter C.M., Morris J. (2000). Evaluation of a new problem-based learning course in a clinical environment Medical Education 34: 222–230
O’Neill P.A., Willis S., Jones A. (2002). A Model of How Students link Problem-Based Learning with Clinical Experience Through Elaboration Academic Medicine 77: 552–561
O’Neill P.A., Jones A., Willis S.C., McArdle P.J. (2003). Does a New Undergraduate Curriculum Based on ‘Tomorrow’s Doctors’ Prepare House Officers Better for their First Post? A Qualitative study of the Views of Pre-Registration House Officers Using Critical Incidents Medical Education 37: 1100–1108
Patel V.L., Groen G.J., Scott H.M. (1988). Biomedical knowledge in explanations of clinical problems by medical students Medical Education 22: 398–406
Patel V.L., Groen G.J., Norman G.R. (1991). Effects of conventional and problem-based curricula on problem solving Academic Medicine 66: 380–389
Pope C., Ziebland S., Mays N. (2000). Analysing qualitative data British Medical Journal 320: 114–16
Prince K.J.A.H., Van de Wiel M.W.J., Scherpbier A.J.J.A., Van der Vleuten C.P.M., Boshuizen H.P.A. (2000). A qualitative analysis of the transition from theory to practice in undergraduate training in a PBL-medical school Advances in Health Science Education 5: 105–116
Prince K.J.A.H., Boshuizen H.P.A., Van der Vleuten C.P.M., Scherpbier A.J.J.A. (2005). Students opinions about their preparation for clinical practice Medical Education 39: 704–712
Remmen R., Denekens J., Scherpbier A.J.J.A., et al. (1998) Evaluation of skills training during clerkships using student focus groups Medical Teacher 20: 428–432
Schmidt H.G., Machiels-Bongaerts M., Hermans H., Ten Cate T.J., Venekamp R., Boshuizen H.P.A. (1996). The development of diagnostic competence: comparison of a problem-based, an integrated, and a conventional medical curriculum Academic Medicine 71: 658–664
Schwartz R.W., Donnelly M.B., Nash P.P., Johnson S.B., Young B., Griffin W.O. (1992) Problem-Based Learning: an effective educational method for a surgical clerkship Journal of Surgical Research 53: 326–330
Silverstone Z., Whitehouse C.R., Willis S., McArdle P.J., Jones A., O’Neill P.A. (2001) Students’ Conceptual Model of a Good Community Attachment (‘A Good G.P’) in a Problem-Based Learning Curriculum Medical Education 35: 946–956
Van Boxtel, C. (2000). Collaborative concept learning: collaborative learning tasks, student interaction, and the learning of physics concepts. Enshede, Printpartners Ipskamp
Visschers-Pleijers A.J.S.F., Dolmans D.H.J.M., Wolfhagen I.H.A.P., Van Der Vleuten C.P.M. (2004). Explorations of a method to analyze group interactions in problem-based learning Medical Teacher 26: 471–478
Visschers-Pleijers A.J.S.F., Dolmans D.H.J.M., De Lang B.A., Wolfhagen I.H.A.P., Van der Vleuten C.P.M. (2005). Analysis of verbal interactions in tutorial groups: a process study Medical Education 40: 129–137
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O’Neill, P., Duplock, A. & Willis, S. Using Clinical Experience in Discussion within Problem-Based Learning Groups. Adv Health Sci Educ Theory Pract 11, 349–363 (2006). https://doi.org/10.1007/s10459-006-9014-6
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DOI: https://doi.org/10.1007/s10459-006-9014-6