Barbara Miflin

A Conceptual framework to guide the Development of Self-directed, lifelong learning in problem Based Medical Curricula

The information explosion and continual changes in the means of accessing information have reinforced the importance of preparing graduates to direct their own learning throughout their careers. Increasingly, medical schools are turning to problem‐based curricula to develop in graduates the capacity to ‘self‐direct’ further learning.

Problem-based learning: where are we now?

The definition of problem-based learning (PBL) as an educational concept is as elusive in 2008 as it has been since the concept was first expressed over forty years ago. A definitive guide to the practice of PBL is equally elusive. Like all worthwhile educational ideas, PBL has proved attractive to those teachers who seek improvements for their courses. Its appeal has transcended the traditional boundaries in formal education so that there are examples of PBL from primary to tertiary education, and across many disciplines within these. Dissemination, however, has wrought confusion in understanding and practice, and consequent difficulties for researchers in evaluating its efficacy, and lack of clear advice for those who would like to adopt PBL. Rather than attempting to be definitive, this Guide explores the various interpretations and practices that claim the label PBL, and critiques these against the original concept and practice. The primary aim is to provide insight into the causes of the confusion about PBL in 2008. The second aim is to point a feasible way forward so that, where appropriate, the potential of PBL as a whole-of-curriculum concept may be realised; and, where it is not possible to implement the whole concept, worthwhile educational principles that have been associated more or less with PBL may be recognised as such and given value in their own right.

A lesson from the introduction of a problem‐based, graduate entry course: the effects of different views of self‐direction

Difficulties in the early years of a new curriculum are to be expected as staff and students come to terms with new structures, and with different approaches to teaching and learning. During the first year of implementation of the Graduate Medical Course at the Graduate School of Medicine, The University of Queensland, we experienced our share of ‘teething troubles’. One source of difficulty was different interpretations of the concept of ‘self‐directed learning’ as it was to be applied in the new course. This paper presents an analysis of the effects of these differences on the development of the curriculum.

The quality of medical teaching and learning in rural settings: the learner's perspective

Summary. During 1992–93, the authors produced a video‐based teacher development resource kit for rural and isolated general practitioners and hospital medical personnel who are involved in medical teaching. As part of the development process, we surveyed 240 medical undergraduate students of the University of Queensland about their experiences and perceptions of teaching and learning in rural settings in Queensland. For approximately 90% of undergraduate learners, the experience with a rural medical practitioner was extremely positive. The major positive features identified by students were: being treated as a colleague; being allowed/encouraged to work independently; receiving feedback on their work; and being given ample ‘hands‐on’ minor procedural experience and/or teaching. The 10% of students who reported unfavourably on their rural terms identified lack of opportunities to carry out solo consultations/work independently, lack of structure in teaching/learning experiences, and lack of hands‐on experience as the major disappointments. The results demonstrate clearly how and why the majority of rural medical teachers in Queensland are effective facilitators of undergraduate learning.

Using Assessment to Induct Students and Staff into the PBL Tutorial Process

The introduction of a new problem-based Graduate Medical Course with over 230 students and more than 200 staff required a systematic process for induction into the PBL philosophy and tutorial process. The 4SAT (4 Step Assessment Task) was designed for use as an instrument for formative and summative assessment of reasoning ability, elements of the PBL tutorial (group) process and individual learning outcomes. The instrument was developed through evaluative cycles based upon staff and student feedback, reflection and peer review. The 4SAT has face validity with the learning process and emphasises reasoning and integration of knowledge. An unexpected out come of its development was its use as a powerful tool to induct staff and students into the PBL group processes, scaffold development of hypothetico-deductive reasoning and provide guidance on the depth and breadth of learning expected in the course.

Problem-based learning: the confusion continues

change physician behaviour or health care outcomes? JAMA 1999;282 (9):867–74. 7 Boruch RF. Randomised Experiments for Planning and Evaluation. Thousand Oaks, California: Sage Publications 1997. 8 Shultz K, Chalmers I, Hayes R, Altman D. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995;273:408–12. 9 Cook TD, Campbell DT. QuasiExperimentation: Design and Analysis Issues in Field Settings. Chicago: Rand McNally 1979. 10 National Research Council. Scientific Research in Education. Washington DC: National Academy Press 2002.

A video-based teaching resource kit for rural medical teachers

Recent and ongoing changes in medical education in Queensland are placing increasing demands on community medical practitioners to teach their successors. Often rural medical teachers have difficulty accessing adequate education, training and support for their teaching roles, largely because of distance. In 1992–93, as part of a year-long project (Price & Miflin, 1994a) we developed a video-based kit, consisting of a 30-minute video and accompanying booklet, to provide a small, but nevertheless more accessible teaching resource for rural and isolated medical teachers. The kit is designed primarily to encourage self-reflection on teaching activities. It can be used independently by rural teachers, but is particularly appropriate as a workshop resource. Although a thorough evaluation of the kit in use in an independent, single-teacher mode has not been completed, we have used much of it in workshops in rural centres, and the response from participants has been very positive. Development and detail of the ki...

Taking the training to the teachers: Workshops for rural medical teachers

As part of a larger project which aimed to enhance the quality of medical teaching and learning in rural settings in southern Queensland, workshops for medical teachers were conducted in five rural centres. The workshops were the final intervention strategy in a series of direct contacts with rural medical teachers, including interviews, observations of their teaching, and videotaping of teaching/learning sessions for the preparation of an audio-visual kit. The workshops were designed primarily to continue the type of direct and practical support for rural medical teachers which was intrinsic to the project from its inception. They were also used to guide refinement of the model and the kit. Thirty rural medical teachers participated, and assessed the workshops as a worthwhile experience. This paper reports on the preparation, conduct and evaluation of the workshops.