Title: Disrupted Practices of Problem-based Learning in First-year Medicine
Presenter: Dr Sarah Hyde (Senior Lecturer Medical Education)
Co-presenter(s): Katelyn Beller, Dr Hugh Le Lievre
Faculty / Division: FoSH
School / Unit: Rural Medicine
Session Type: Paper
When: Thursday, 18 November 2021 @ 12:15pm – 1:15pm
Background/Context: The first year of the Joint Program in Medicine (JPM) at Charles Sturt began this year, amidst a number of lock-downs which impacted the design and delivery of the program. Our first- year cohort is a diverse group of 43 students, with a mean age of 23. The majority live in on campus accommodation and come from a variety of rural and regional locations across and inter-state. This is the first year of a five-year degree where students experience early clinical contact one day per week in the hospital and complete 2 x 2-week placements in small communities in first and second year. Problem-based learning (PBL) in groups of 8 students is central to preparing students for these clinical learning encounters and is the pivot point for integrating scientific and clinical knowledge and reasoning (McLean, 2016). Each of the six PBL groups is facilitated by a local clinician.
Outline of initiative: Student learning was scaffolded not only through the PBL pedagogy but additionally through the design of cases deployed as workbooks in PebblePad. Knowing that students were going to be out on placements and still need to complete the PBL cases, PebblePad was utilised to facilitate student completion of cases remotely and build cognitive presence (Garrison, 2011). In this challenging year, this was fortuitous as it meant students in lockdown at one point or another could still participate in the discussion and could use the work-book to revise and review key learning objectives from each case. PebblePad is also used to scaffold learning in other streams of the program, including clinical skills, personal and professional development, medicine in community, and reflective portfolio’s which run throughout the course.
The intended curriculum and its delivery has been disrupted at several points throughout 2021. Firstly, just after mid-year when eight students were stuck in one of the affected Sydney LGAs and could not return to campus. This meant that the PBL program became blended – with 2-3 students in each group joining the tutorial remotely via Zoom twice a week. Secondly, various students at one point or another were close contacts in the first Orange lockdown and so joined remotely for two weeks at a time – creating a Hyflex course (Chan, 2021). Thirdly, the most current lock-down which commenced in August meant that all students and tutors joined the tutorial remotely via Zoom. Therefore, there has been three different modes of delivery of PBL in this first year, only one of which was intended: face to face, blended, and fully online. The design and scaffolding of cases has meant that teacher, social and cognitive presence could be maintained and fostered throughout. The PBL pedagogy is commensurate in many ways with the key principles underpinning e-learning (Kassymova et al, 2020).
Method (s) of data collection and analysis: The presenters explore the impact and change in delivery of the PBL curriculum from the perspective of student, tutor and designer. Together, we have collaborated to explore the views of our peers qualitatively and quantitatively in this pilot study.
Evidence of effectiveness: One of the challenges has been maintaining group cohesion in these various modes of disruption and change in delivery focus. A secondary challenge is related to proficiency with the technology. The presenters will describe the challenges and adaptations needed to ensure the effective delivery, facilitation and participation required for this pedagogical practice. New practices emerged between groups that were shared and adopted by others as each group struggled to maintain some degree of normalcy and relieve the tension created by these disruptions.
Chan S. (2021) TEL Supporting VET into Industry 4.0. In: Digitally Enabling ‘Learning by Doing’ in Vocational Education. SpringerBriefs in Education. Springer, Singapore. https://doi.org/10.1007/978-981-16-3405-5_6
Garrison, D.R. (2011). E-Learning in the 21st century: A framework for research and practice
(2nd ed.), Routedge, New York
Kassymova G., Akhmetova A., Baibekova M., Kalniyazova A., Mazhinov B., and Mussina S. (2020). E-Learning Environments and Problem-Based Learning. International Journal of Advanced Science and Technology Vol. 29, No. 7s, 346-356.
McLean, M. (2016). Problem-based learning in undergraduate medicine: Perspectives, challenges and approaches. In R. Henderson (Ed.), Problem-based learning: Perspectives, methods and challenges (pp. 69-114). Nova Science Publishers.