Thursday, April 14, 2011

My amazing experience in Problem based learning (PBL) Class

Hello There,

I am so excited to share my experience in Problem based learning class, which I think is way better than traditional teaching methods like class room teaching or lectures. In today’s education system you have so many varieties of teaching & learning methods that are adapted by many schools and colleges, and very few methods are effective & interactive and one of them is Problem based learning or PBL. Personally I have never experienced problem based learning classroom till recently and frankly speaking i wish i had something like this in my college days L
Big thanks to St John’s Medical College (Bangalore, India) for giving me and my friend Vivek permission to attend one of the PBL sessions in their college. We are so glad that we got the opportunity to be part of this class, which was such an effective, enjoyable and self learning class. St John’s College is practicing PBL from past 3 years, they started PBL in the year 2008 & though it is not a mandatory method by MCI(medical council of India), it is still successfully adapted as extracurricular activity.   
I think it’s time for MCI to make this mandatory or atleast make colleges to try this learning and see the results & then probably think about mandating.

Before I narrate my experience I will give you little insight about PBL process and its value:
PBL was pioneered in the health sciences at McMaster University in the late 1960's and subsequently it has been adopted by other medical school programs and also been adapted for undergraduate instruction.
PBL is a student-centered pedagogy in which students learn about a subject in the context of complex, multifaceted, & realistic problems. Working in groups, students identify what they already know, what they need to know, & how & where to access new information that may lead to resolution of the problem. The role of the tutor is that of facilitator of learning who provides appropriate scaffolding of that process by (for Example) asking probing questions, providing appropriate resources & leading class discussions, as well as designing student assessments. (Check the link below)

For more information check this link:

PBL benefits students in enhancing,
  1. Real time exposure to simulated medical cases
  2. Problem solving skills  
  3. Critical & creative thinking
  4. Decision making
  5. Exposure to variety/rare cases   
  6. Collaboratively working among team
  7. Better communication
  8. Longer memory
                and More

How we got there!  Well first we contacted Dr Nachiket & Dr Swarna Rekha Bhatt in St John’s (medical education department) very dynamic people & so passionate about their profession. We got the appointment without any hassle. We met & spoke to them about what we are planning to do (which you can find in my previous blog) and they were really excited when they heard what we wanted to do around PBL. We were also interested to know more about the PBL, its uses and its adaptability in SJ; hence we wanted to attend the PBL class.
Dr Nachiket helped us in getting the permission to attend the PBL class from Dean and after we got the permission we were all set to attend the PBL class in coming days. We were so excited; entry into medical college & back to college feel was just awesome.

Brief about my experience in the class:
1) The First PBL class was a introductory class: All the 4th sem students of medical & some nursing students were present in the introductory class. As we entered the room, we saw they were curious & wondering what is this method and how are they going to do PBL. Dean, Dr Nachiket & other professors gave introduction about the PBL, Especially the Dean gave a very good speech by starting “In life we go through problem based learning as we encounter problem every time, your learning is determined by the problem you encounter”, He also said in abroad the PBL is extensively used by Medical schools, this is very effective learning as he has experienced in the McMaster university in Canada.
Dr Nachiket introduced the PBL, how it is different from problem solving, how a PBL process is & class would look like using ppt and also conducted a Mock PBL class with generic problem. What we saw there is students were not open to discussions, most of them were mum and few gave their input but overall the participation was less however they were able to understand the method.
After the Mock PBL, Dr Nachiket gave the logistics of the class which is 2 hrs/week for 2 months, 7 - 8 members in a group out of which 1 or 2 are nursing students and remaining are medical students. Importantly he mentioned this is not marks based learning, no evaluation, its free class to students to interact and here teacher will be silent listeners. Also students don’t have to be right and can ask lot of questions. He also gave some of the statistics of the previous PBL batch feedback and was shocked as all most all the students liked the PBL sessions, wanted to attend more and their suggestions to make it better was also discussed.
Since it is not part of the curriculum they are doing it for student’s good, to make sure they get the best learning experience and asked them to make best use of it. The group members were decided (smartly by keeping best friends in different groups). Class dispersed for Tea/coffee and for some snacks and would meet in the next PBL class.

2) PBL Class 2: The students and tutor meets in PBL class in the afternoon in a room which has table, chairs placed across the table & all the students were facing each other. I and vivek went to different PBL classes, I met Dr Yashoda the Tutor, very energetic lady, so much interested in education and very friendly to students (ideal). I was there to just observe & take notes in my laptop.
The class had 6 medical students and 1 nursing student. The first trigger “Problem 1, Trigger1” (in paper) is given to all the students. Here a medical Problem/case is cut into 2 parts and these parts are called trigger 1 and trigger 2. Each trigger has information about the patient history & complaint, lab results and physical examination etc. Students have to identify, list the objectives & have to cover these objectives in their discussions, if they miss some objectives, tutor can guide them in the end or middle of the PBL class. The tutor will have the Objectives lists, Areas/topics the problem touching and references, which they do not share with the students however they can guide if the students miss any. Tutor briefed again on the approach to trigger, as the students are new to this method & tutor stated again that students are not here to solve the case but to identify what they know & what they don’t ; learn the new topics & recall the old ones, in the mean time they actually solve the case.
Tutor asks the group to select one scribe (who write the objective) and one chair (who assign the task among the group) In this class the scribe was listing the objectives by discussing with the group. The student’s couldn’t cover all the objectives and that’s where the tutor pitched in and suggested some of the points which made the students to think and finally they listed the all the objective. The discussion was not that intense and everyone was not participating that easily and even the communication was not that effective (which is about to change in the coming class). The Coffee was served in the middle of the class to everyone, they got refreshed and discussion continued (This was given in all the PBL classes though).

Students were little hesitant and most of the time facing towards the tutor to explain her, however the tutor played smart and motivated them to discuss among themselves and told them to forget that she is around. Tutor was hardly interrupting the discussion & was telling me that how slowly they are adapting to this learning. The Chair assigned the objectives to each student at the end of the class and asked the students to do research on those topics and get all possible materials to support their findings. Then they dispersed.

3) PBL Class 3: Students enter the room, one student was absent today and remaining 6 students were energetic. Not all the students were carrying the trigger 1 paper, but they were carrying all the research materials such as, text books, note books etc & pen drive. The students started the discussion as per chair’s direction, here chair only started the discussion, students were liking the talks, however the discussion was between 2 students only the rest of them were just listening.
The speaker’s eye contact was towards only one student and remaining were looking like left out in the scene, however things changed later and speaker was looking at everyone. Then every student started to speak, others were listening, taking notes & discussing. They also used some Audio/Visual aids which was so catchy, brought interest in the students and information grasping was high compared to only lectures which I felt. There are few things in discussions which even the tutor was not aware about, so she also noted few things (learning to the tutor as well). Students were moving from one place to another, having fun & at the same time discussing. Even tutor drops in once in a while and increase the enthusiasm in the students.
The students also spoke about the medical terms & definition, and then finally the tutor asked the students to come to the conclusion of the trigger1, suggestions for patient care at the moment, any tests you would want to suggest etc. Students listed, discussed and it was evident that their critical thinking & decision making skills was clearly visible.
Trigger2’ was handed over to the students, which had EEG report of patient. The students repeated the process at listing the objectives, discussion & assignment. The task assigned to the absentee is taken by one of the student and agreed to research that item/topic before next class and dispersed.

4) PBL class 4: The students gathered in the class, today all the students were present. The discussions started with the Video and audio which sets the mood of the class as the students were so passionately started watching, followed by ‘how to read the EEG report’ PPT and the information presented by student was so easy to understand even by a non medical student like me. Tutor said to me that the ‘EEG report’ one of tough topic to understand by the final year students but these document & video made the job so easy.
Improved communication, active participation, every one speaking, writing and researching data in easy to understand form was evident in this class. It was so nice to see the class like this. Finally the students reached the conclusion of the Trigger 2. The Next problem’s Trigger 1 was suppose to be given in next class but the students wanted insisting to give in this class as they need more time to research. Tutor happily gave the “Problem 2, Trigger1” seeing the student’s enthusiasm. They did the usual thing for this trigger also & dispersed.

5) PBL Class 5: only few students turned up to attend the class & rest didn’t due to some reasons, they discussed about the problem but not in depth though. The students were talking about the smoking - the problem stared with person smoking habits, presents to the OPD with complaints of headache & giddiness for the last 3 months with his physical examination results. The students were moving in the problem solving direction, so the tutor had to jump in and suggested again the PBL intention is to work around the problem & not restricted to Problem solving.
One of the student had got a information on different problems that’s caused by head ache, but it was more like the presentation style & he was trying to present it to teacher, so the teacher asked the students to make a differentiators between the different terminologies, so that we know why not this problem, why this particular problem is related to this and so on. As i always say she handled it really well.
The teacher also sometime pushes the student to think in different terminologies like hypertension which can sometime lead to head ache, so it was good approach from tutor to guide the students in different direction which can make them learn other stuff and also important to restrict not go beyond a relevant points.
Students also spoke about the normal BP, when it goes high like during exercise or in anxiety etc.

6) PBL class 6: In this class all the students turned up and discussions began, students as usual spoke about lot of things, they covered all the objectives, brought some video, audio and PPTs which weres interactive. Not only students even I learnt a lot about the BP, hypertension etc. They also learnt what question to keep in mind when taking history, examining a patient, reading & understanding the physical examination report etc. Looks like the students had covered the objectives & arrived at conclusion, hence “Trigger 2” was given which had ECG report in it. Scribe listed the objective as usual and chair assigned the tasks and class dispersed.

7) PBL class 7: Since next class is a valedictory of PBL session, this is the last day of PBL class. The students & tutor spent about 30 minutes on the Feedback forms which includes 1) tutor to student 2) Student to tutor 3) student’s process evaluation. The Class started after the feedback, One of the students started speaking about smoking as he encountered many patients in his routine clinical class where they are suppose to take history from the live patients and he asked the patient about their smoking habits, frequency, type of medium they use for smoking like cigarette, bidi(local made), cigar, the kind of questions & probable causes that he learnt in his PBL classes last week. They were saying PBL class & real time patient experience gives a lot of learning & understanding to the group as they say gives them good understanding of the approach to the problem & depth of the problem and be able to do history taking, critical thinking, examining, decision making and problem solving much better.  They also continue to say this gives them the feel of professional Doctor.
Then the discussion was on ECG reports, how the electrical pulses work, so on and again they presented it so simple, that a non professional can understand very easily. One of the girls was so involved she got her ECG done and brought it to class to explain.
Finally they all understood the how practically it is important to experience and apply all your knowledge to solve a problem and find information in variety of resources for things that you don’t know.
They all agreed this is far better than just reading the text books & some lectures.

8) PBL Valedictory: The valedictory was fun Dr Nachiket and other professors & vice principal spoke about the PBL process and how St John’s is trying to teach its students all the best possible teaching and learning method to help students to become good Doctors, so on. There was interactive session between the students and professors where they shared their likes and dislikes about the PBL etc. (The feedback of the PBL class & statistics I have posted in next blog, please click: ). Dr announced PBL certificates will be given in their respective classes
Happy students moved to have tea/coffee and some snacks, so did we had some :) Discussions & suggestions continued after the valedictory class also and in the end all happy faces.

If you would like have PBL training or workshop please let me know, I shall make an arrangement for you or your institute.

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Please leave your feedback here. 


  1. Hello Kishan,

    Thank you sharing your experience. Yes, i agree with you. There is certainly a great benefit from PBL. Just like how we deal with issues and different situations that come up in our day to day life, we can only get better in approaching a situation or issue by looking at how we had dealt with them in the past. PBL is a good approach to open communication channels between different parties, i believe it gives a lot of confidence in an individual when he gets exposed to PBL and in turn make him/her ready to face real time situations in the outside world.

    All the best for your team :)

  2. Thanks for your feedback vinay and also made corrections that you indicated :) Thanks again

  3. Hi Kishan,
    Just wanted to express my opinion....
    PBL is a very effective way of gaining knowledge.....I think it will be very helpful to students if medical institutions collects the "difficult topics list" from final year medical students that they faced difficulty in understanding during there first few years and "incorporate those topics into PBL methododlogy". Since PBL methodology motivates students to think from different directions, it would be very useful if this way of knowledge sharing is incorporated to start from first year medical students itself.....Thanks for blogging on this useful topic....

  4. Awesome guru, i think thats a great idea. The logistics of implementing in which year can discussed but good idea on the tougher subjects/topics side. Thanks again guru and if you get anymore idea please don't hesitate to post.