Problem-Based Learning

Students work in small groups (8-10 students) in which a faculty member serves as a facilitator. Rather than listening to a lecture on a given topic (teacher-centered learning), students are presented with a patient case which typically integrates previously learned information with a great deal of new content. The group must come to consensus about what they would need to know in order to manage the patient case. They do this by developing "learning issues" or topics which represent questions about the case. Sample learning issues might be: How does a stroke involving the middle cerebral artery stroke typically present? What is the anatomy and function of the lymphatic system? Are the patient's weakness and gait dysfunction related? How? What is the epidemiology of myasthenia gravis? On an individual basis, students then research the topics by using textbooks, review articles, peer-reviewed research, and electronic data bases.

Later in the week, students regroup to discuss their findings and apply them to the patient case at hand. Rather than lecturing, the faculty member facilitates discussion and asks questions to ascertain that students are learning the material to the appropriate breadth and depth required of a physician assistant.

An Ability to Apply Information to Real-World Situations

Research indicates that PBL embodies a learning approach that effectively helps students to develop scientific thinking about patients' problems and to acquire both basic science and clinical information in a manner that ensures retention and transfer [of learning] to the real-life task of the clinician. (Barrows) Recent studies indicate that graduates of problem-based health care educational programs perform well (most studies indicate better than students from more traditional educational programs) on board exams and exhibit secure clinical learning and reasoning skills to the betterment of their patients.

Problem-Solving Skills

Since the acquisition of new material revolves around a patient case, students constantly learn and apply information in the context of solving a patient problem. For example, students might be required to answer the following questions posed by the tutor: based on the pathophysiology of his disease process, what precautions would be important when treating this patient? How would you handle the patient's emotional affect in order to accomplish your treatment? How might the patient's medications influence the outcome of today’s intervention? What tests and measures might be appropriate for the patient given their current status?

Research Skills

As Chatham physician assistant students are learning how to ask questions through the PBL process, they also learn to research the answers. Our students become quite skillful at database searching, critiquing journal articles, and synthesizing information from a variety of sources.

Communication Skills

Since group members are dependent on each other for enriching discussion and subsequent learning, each student must participate in PBL sessions, whether by volunteering information, asking questions, seeking clarification, confirming the thoughts of a peer, or relating information to the patient case. Inherent in the PBL process, Chatham students learn how to function as individual members of a team, conferring for the greater good (learning the material/treating the patient).

Students also have an opportunity to evaluate the participation skills of their classmates (preparation, clinical reasoning, quality of learning resources, team skills, respective listening) and themselves, in written and oral formats. This teaches critical reflection and the skills of providing/receiving constructive criticism.

Medical Knowledge

When encountering an unfamiliar problem, the student will be able to build, organize, and articulate the basic science knowledge and concepts which can explain the problem and which can then be employed to resolve the problem.

Clinical Reasoning

The student will demonstrate the ability to use the clinical reasoning process in the investigation and solution of medical problems.

Self-Directed Learning and Self-Assessment

When a student encounters a problem that he or she is unable to explain, the student will be able to design and implement satisfactory learning strategies, monitor the adequacy of personal knowledge and skills, assess the effectiveness of the self-directed learning strategies used, and critically assess the learning resources for adequacy, quality, and credibility.

Professional, Clinical, and Interpersonal Skills

The student will demonstrate:

1. Appropriate interview and physical examination techniques
2. Effective interpersonal skills while interacting with patients, peers, faculty and others
3. Cultural sensitivity