“Resource Lite”

So I had to make a complete mental shift in my thoughts about PBL this past week. 

In all my past experience with PBL this is the way it works…  The first tutorial of each new week the students are introduced to a brand new (unfamiliar problem-hence the name… Problem Based Learning).   During discussion of the problem and hypotheses to explain it the students develop a series of “learning issues” they can research to help them understand the problem.  Before they meet for the second tutorial usually two days later,  they access text books, attend a lecture or two and come back to tutorial 2 with answers to all their learning issues.  Then they get new information about the patient and move further on with the problem…

Here’s the rub… for this to work the students HAVE to be able to access resources that allow them to answer their learning issues.

This past week in Nepal however I was met with the unprecedented situation (for me)  where students were unable to uniformly access the text books that would allow them to answer their learning issues.  Despite having about 20 copies of the two books they needed, only two were on reserve in the library and the rest were out on 2 week loan.  I however was not aware that the books were not available to most of the class so the educational consequence was that I (as their tutor) was frustrated  because I couldn’t figure out why they didn’t seem to be returning with their learning issues sufficiently answered.   I know the students are very bright and motivated to learn so what was the explanation?   The students were frustrated because I kept telling them they did not answer their learning issues (despite doing their best job with inadequate resources).  It wasn’t until after the third tutorial of the week when I asked them how many had been able to read the recommended text book (and only 3 out of 8 in my group had), that I had an inkling of what was going on.  At the end of week “case wrap up session”  we polled the entire class and found that only 20 of the 60 students were accessing the textbooks between the tutorials.  The upshot is that you can’t do PBL without resources for learning.

In the short term we have made some alterations at the library and now all of the copies of text books are now on RESERVE and available for 2 hour loan so all students in the class should be able to share the resources that are there.

The long term plan however is to ensure that by next year there will be  60 copies of the two recommended textbooks in the library and available for loan.  That will require some strategies back home to raise the money for purchase of books for the library. 

The lesson I learned was the importance of access to adequate resources for PBL learning….  and to always ask the students first if they can get the information they need.

Onward to week 3…

Reflections on PBL

I am feeling a set of contrasting thoughts as I write this.  Recently a UBC medical student wrote a critique of the UBC PBL tutorials, that was published in Canadian Medical Association Journal.  I respect the student’s opinion, and no doubt it reflects a perspective that we (as professors and facilitators) don’t experience.  

This week however I am having an extraordinary experience running PBL tutorials here in Nepal. The Nepali students are embracing PBL with a gusto that is quite amazing.  They attack “brainstorming” on the first day.  Many ideas are put up on the board, and then later followed up or abandoned.  Opinions are challenged (respectfully) and trains of thought are followed to logical conclusions.  During the second tutorial of the week (this would be the equivalent to our Wednesday tutorials) the Nepali students in my PBL group attacked the learning issues they had researched after the first tutorial.  Discussion was lively and thorough.  While I have had this experience with groups at UBC, one difference here was that the Nepali students seemed to be in no hurry to rush on to getting new material on the case.  At UBC students seem at times to be more focused on the clinical scenario and rush through the basic science learning issues.  Students in Nepal PBL are just finished high school and come in with comparatively little basic science, and that may account for some of the difference in focus between UBC and here.   Regardless of the reason, being surrounded by this much enthusiasm for learning and appreciation for the opportunity to learn is a heady experience for this professor!