Computer-based management of content in planning a problem-based medical curriculum

Does the tutors' academic background influence the learning objectives in problem-based learning?

Background: Problem-based learning (PBL) is an essential element of the curriculum of the Medical University of Vienna (MUV) and is performed in an eight steps model with: clarifying, defining, analysing, shifting & sorting, identifying learning objectives, going to learn and coming back to talk and feedback. With an annual intake of up to 740 students the MUV has to recruit PBL tutors from various academic backgrounds including undergraduate near-peer students. Therefore, we were interested to see whether a tutor's academic background had an influence on the resulting PBL sessions as reflected by the percentage of learning objectives (LOs) which were actually achieved in relation to the intended LOs. Methods: For each PBL session "intended learning objectives" (ILOs) were defined. ILOs were communicated to all tutors by means of PBL session guides in order to provide homogenous learning opportunities to all students. However, it was not mandatory to reach all ILOs. The PBL coordination regarded a range of two thirds to three quarters of ILOs as a desirable goal. For analysis we retrieved data concerning ILOs, characteristics of tutors and PBL groups from the institution's PBL quality assurance system. Results: From 2012-2014, 216 PBL groups were facilitated by 106 tutors with different academic backgrounds. On average, 70.8% (95% CI: 69.2-72.5%) of the ILOs were achieved; MUV clinicians reached 74.3% (70.8-77.8%), MUV non-clinicians 74.2% (71.7-76.6%), external faculty (clinicians and non-clinicians) 68.6% (64.4-72.8%), and near-peer students 64.7% (61.8-67.7%). Statistically significant differences were found between near-peer students and MUV clinicians (p<.001) as well as MUV non-clinicians (p<.001). Conclusions: ILOs were reached within a satisfactory range. However, groups taught by near-peer students reached significantly fewer ILOs than groups taught by MUV faculty tutors. This finding raises the question whether tutor training for near-peer students should be intensified. Also, further research is needed to explore the group dynamics of student-led PBL groups.

Peer assessment of professional behaviours in problem-based learning groups

CONTEXT

Peer assessment of professional behaviour within problem-based learning (PBL) groups can support learning and provide opportunities to identify and remediate problem behaviours.

OBJECTIVES

We investigated whether a peer assessment of learning behaviours in PBL is sufficiently valid to support decision making about student professional behaviours.

METHODS

Data were available for two cohorts of students, in which each student was rated by all of their PBL group peers using a modified version of a previously validated scale. Following the provision of feedback to the students, their behaviours were again peer-assessed. A generalisability study was undertaken to calculate the students' professional behaviour scores, sources of error that impacted the reliability of the assessment, changes in student rating behaviour, and changes in mean scores after the delivery of feedback.

RESULTS

Peer assessment of professional learning behaviour was highly reliable for within-group comparisons (G = 0.81-0.87), but poor for across-group comparisons (G = 0.47-0.53). Feedback increased the range of ratings given by assessors and brought their mean ratings into closer alignment. More of the increased variance was attributable to assessee performance than to assessor stringency and hence there was a slight improvement in reliability, especially for comparisons across groups. Mean professional behaviour scores were unchanged.

CONCLUSIONS

Peer assessment of professional learning behaviours may be unreliable for decision making outside a PBL group. Faculty members should not draw conclusions from peer assessment about a student's behaviour compared with that of their peers in the cohort, and such a tool may not be appropriate for summative assessment. Health professional educators interested in assessing student professional behaviours in PBL groups might focus on opportunities for the provision of formative peer feedback and its impact on learning.

Charting a global future for education in physiology

The 2005 Claude Bernard Distinguished Lecture was presented at the XXXV International Congress of Physiological Sciences (IUPS) in San Diego, CA, by Ann J. Sefton. Dr. Sefton is an Emeritus Professor of Physiology of the University of Sydney and co-Chair of the IUPS Education Committee. A full profile of Dr. Sefton is included in this issue's The Physiology Teacher.

New approaches to medical education: an international perspective

Internationally, medical education has increasingly been the subject of scrutiny and debate. This article represents a review of the burgeoning literature on medical education. The focus is on encouraging teachers to improve the quality of students' learning. The educational rationale for some of the major current developments is considered. Change imposes significant challenges for teachers and students, although there are helpful examples from the literature. The curriculum must be internally consistent, based on well-defined educational principles and effectively managed. Goals or outcomes--broadly defined--must be debated and determined so that they are clear to staff, students and the community. Several interrelated issues must be considered and resolved--student selection, specification of content, identification of core clinical skills and broader academic and professional behaviours. The most effective educational processes must be determined in order to support active learning. Problem-based learning is now well established and its underlying principles are discussed. Assessment of students must encourage learning and ensure that well-defined academic and professional skills are achieved. Programmes must be subject to evaluation so that the quality of the experiences of students, staff and patients is progressively improved. In order to develop effective skills in teaching and in the management of programmes, teachers need to be supported by good staff development.

Using problem-based learning to redesign nursing administration masters programs

Problem-based learning (PBL) is offered as an appropriate pedagogy to prepare nurse managers for the uncertainties of future administrative practice. It is a student-centered, experiential learning strategy aimed at developing clinical reasoning, structuring knowledge in real-life contexts, motivating learning, and developing self-learning skills. Health professions and business schools report positive feedback from their stakeholders after adopting this new learning paradigm.