The ‘problems’ are highly structured hypothetical clinical cases, each of which takes a week to work through. Each semester, students are divided into groups of seven or eight, each with its own tutor in a tutorial room, with PC, state of the art AV equipment and walls lined with whiteboards. The group meets with the tutor to work through the week’s case. The tutor does not act as a teacher, but as a facilitator, guiding your group through the sequence of steps which have been devised to help students learn from the clinical cases. Each step and new development in the case (such as results of investigations or details of drugs prescribed) is only given out after the group has finished discussing the previous step.
By working through the problem and hypothesising about what is wrong with the patient, the PBL group comes up with a list of learning issues that represent the key knowledge needed to understand what is happening to the patient. The group members then independently research these learning issues (also known as learning objectives) in their own time. At the next PBL tutorial, each group discusses what they have learned and the tutor distributes the next stage of the problem. The new information is discussed, new learning issues arrived at, and members again research independently. The group report back again and the final stage of the problem is explored and the case concluded. By this time, the group is likely to have worked through:
- The original presentation of the patient (either at A&E, an outpatient clinic or a GP clinic)
- The history taken by the doctor
- The examination findings
- Any investigations ordered and their findings (e.g. Blood results, x-rays, biopsies, etc)
- The course of the patient's illness (over hours, days, weeks, months or years) and the impact of this on the patient's life
- Treatment (pharmacological, surgical, psychiatric, etc)
- The involvement of family & others close to the patient
- Any complications that might have arisen
- The outcome of the case (including rehabilitation, on-going community care, etc.)
Independent learning times are not just about reading from textbooks. During these times, you are encouraged to visit and make use of the facilities of the Anatomical Skills Education Unit and Clinical Skills Education Unit. Staff will be on hand to provide support in whatever area you feel you need it. However, to a large extent, students in the programme will be both encouraged and expected to assume a high level of responsibility for their own learning. Students will not be ‘spoon fed’ and there is a deliberate strategy to minimise the amount of didactic teaching in the curriculum.