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9. Large group sessions and problem-based learning
- Hong Kong University Press, HKU
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9 Largegroupsessionsandproblemv base dlearning " John Nicholls and L. C. Chan BACKGROUNDTOTHEPROBLEM Reformoftheundergraduatemedicalcurriculumin1997 In 1997 , the Faculty of Medicine changed th e undergraduate medica l curriculum from a discipline-based, pre-clinical/clinical-based approac h to one in which problem-based learning (PBL), organ system teaching , and integration of clinical and interpersonal skills were emphasized (Tang 2001). In th e firs t thre e years o f th e Ne w Medical Curriculu m (NMC) , students would have two two-hour PBL sessions as well as one half-da y between tutorials for information gatherin g and synthesis of knowledge per week. To accommodate these new changes, reducing the number of traditional lecture s o r large group sessions was proposed; otherwise , this would lead to overcrowding of the curriculum. Thi s proposal wa s in line with a faculty-wide consensu s to reduce th e factua l conten t o f large group sessions. Educational reviews of medical curricula, especially JohnNichollsandL. C.Chan by the General Medical Council of the United Kingdom, had found tha t information overloa d wa s a major concern ; a paradigm shif t i n th e objectives o f medical schools — t o produce a graduate competen t i n knowledge, skills and attitude, ready to progress to postgraduate trainin g (an 'undifferentiated' doctor ) — was required. The essence of this shif t was t o move a proportion o f require d medica l knowledg e fro m th e university undergraduate setting to a hospital-based postgraduate setting where it would be more appropriate for selected graduates. The role of the medical school would therefor e b e to ensure that a graduate woul d be a 'safe' intern or resident but not be overloaded with information tha t would not be essential to his or her role as an intern . Areductioninthenumberoflargegroupsessionscreatednegative feedback In the NMC, the number of large group sessions was reduced by 30% so that student s woul d hav e approximatel y on e lectur e pe r day . I n ou r regular staff-student feedbac k sessions , it became very clear in the early stages of the NMC that student concerns were not as much with the PBL process as with th e lectures. Feedback comment s wer e '.. . to o muc h information .. . lecturer rushed .. . too detailed .. . nee d more lectures .. . not enough time...'. Analysis of the lectures showed that although ther e had been a reduction of the time allocated for lectures, the content ha d not been reduce d b y the sam e factor. Thi s feedback concer n was als o due to the assessment procedures tha t we adopted fo r the progressio n from yea r t o yea r i n th e NMC , i n tha t a majo r componen t o f th e examination relied on information transmitte d i n lectures. APPROACHTOTHEPROBLEM Educationalprincipleswereusedtoreformthelectures We decided t o focus o n th e mode o f lecture deliver y and investigat e educational principles tha t would reduc e student dissatisfactio n wit h [18.191.211.66] Project MUSE (2024-04-17 23:05 GMT) Largegroupsessionsandproblem-basedlearning18 1 these large group sessions W e started with the premise that our chang e to PBL was based o n educational principles (Schmid t 1993 , Arseneau and Rodenburg 1998 ) (Tabl e 9 1 ) that could be applied t o large group sessions in the following wa y TABLE9.1A comparisonofPrinciplesforSuccessfulCognitiveLearning Schmidt(1993) 1.Prio rknowledgeisthemost importantdeterminant. 2.Prio rknowledgeneedsto beactivated. 3.Knowledg eisstructured. 4.Storin gandretrievingof informationisenhancedwhen elaborationtakesplace. 5.Contextua lcuesare important. 6.Mor etimeisneededwith motivation. ArseneauandRodenburg(1998) 1.Prio rknowledgeisthekeyto learning. 2.Prio rknowledgeneedstobe activated. 3.Student smustbeactivelyinvolved intheunderstanding.Thelinksare moreimportantthantheelements. 4.Mor etimemeansmorelinksand strongerlinks. 5.Contex tprovidesimportantcuesfor storingandretrievinginformation. 6...