Reflections on tutoring a Problem Based Learning (PBL) Group
By Dr Stephen Helme
"Medical schools [which fail to implement educational reform] will continue to graduate doctors who are, on the whole, largely adequate, but who could be so much more." (Max Kamien 1993.)
As a practicing GP, GP supervisor, a RACGP examiner, Emergency Department VMO and a casual lecturer in the Department of GP at WSU, I wondered what PBL could offer students in their early years of medical school that the didactic lectures I sat through couldn't.
"Problem-based learning is problem-based learning not problem-based teaching. It fits into the learning paradigm not the teaching paradigm and is part of a set of student-centred approaches…A lecturer using a PBL approach is not concerned with what and how they are teaching. Rather they are observing, looking, listening, stimulating and provoking student learning."
A typical PBL session consists of an initial 2 hours at the beginning of the week with an introductory clinical scenario. "Mr A (26yrs) walks into a GP surgery with a left leg limp and pain" Through group interaction the students formulate a diagnostic list and a plan for required information which slowly evolves over the session till they are ready to formulate a self-directed plan of learning objectives. They then use the intervening days to research all the objectives. At the end of the week a further 2-hour discussion session revolves around them presenting the results of their research to the rest of the group and the tutor. Students will have researched topics such as the structure of the knee, the inflammatory response, the differential diagnosis of monoarthritis. This research allows them to find up to date relevant information on a clinical subject preparing them to evaluate and critique evidence that is changing rapidly.
The students I am teaching may one day become my healers. I would like to think that through PBL I am moving them in better directions to be excellent physicians. I really don't fancy the thought of a computer managing my health!
A Foot in Both Worlds: Bilingual GPs Caring for CALD Cancer Patients
Year 4 community research students conducted a qualitative research project in February – March 2017 under the supervision of Drs Gisselle Gallego and Lawrence Tan. They interviewed GPs who spoke more than one language from Asia, Africa, the Middle East and the Pacific Islands and asked them about their experiences caring for patients with cancer from Culturally and Linguistically Diverse (CALD) backgrounds. Data from ten interviews were analysed. GPs found the shared language and culture was of great benefit in developing rapport and communicating with the patients. Challenges included the increased workload and time required to care for CALD patients, who also had similar health literacy and beliefs about the stigma of cancer as patients from an English-speaking background. Bilingual GPs could explain the world of the Australian health care system to patients who had arrived from worlds where health systems and health beliefs may differ. More multilingual and organisational resources to support CALD cancer patients following hospital discharge and to support the bilingual GPs caring for them would be welcome. This student group (Bo Ra Kim, Gwen Leong, Victor Loh and Priyanka Ray) will be presenting their work at a three-minute thesis competition at the Southwest Sydney Local Health District Research Expo in June.