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					Preparing faculty to develop problem
   oriented approach to teaching &
     learning : our experience at
Pramukhswami Medical College, India

              Himanshu Pandya
              Sarmishtha Ghosh

  Pramukhswami Medical College, Karamsad, Gujarat
                   INTRODUCTION
• Globally medical education has adopted an integrated, student
  centered and problem based approach.
• Medical Council of India recommends integrated and problem
  based learning approach.
• Switching to PBL requires training of the trainers who are mostly
  conversant with didactic mode of teaching
• Faculty development should aim at creating awareness regarding
  concepts of PBL, role of teacher as facilitator, group dynamics
  and designing of case scenarios.

                      OBJECTIVES
• Medical Education Unit [MEU] of Pramukhswami Medical College
  at Karamsad, Gujarat decided to expose its academic staff to the
  concepts of PBL and allied teaching strategies supporting adult
  learning on the lines of recommendations by MCI
This paper reports data collected from
two faculty development workshops :

Workshop I - Principles and
methodology of PBL in the form of
student experience

Workshop II -Techniques of writing and
refining case scenarios for PBL
sessions
                             METHODOLOGY
                  WORKSHOP- I                      WORKSHOP- II
                     [PBL]                         [Case Writing]

Selection of    2 faculty per department,      1 faculty per department,
  faculty      irrespective of experience,     interested faculty invited
                   nominated by Head

          Formation of Core group with       External expert from IIM-A.
 Strategy experienced in house faculty.
                                                In house coordinators
          External expert from CMC,          Didactic lecture, small group
          Vellore. Demonstration, small       discussion & large group
          group discussions & large                    interaction
          group interaction.

Schedule       2 days; morning- 4 hours             1day; 5 hours


 Number                   39                             25
registered
                   Workshop I; Morning session : 4 hours,
                                  DAY 1

 What is PBL
                                    Pre workshop test

                      Didactic interactive lecture on PBL

   Roles &
Responsibilities
 of facilitator         Demonstration of a PBL session


     7 steps of PBL




  Question-Answer
      Session
Morning session : 4 hours, DAY 1   Morning session : 4 hours, DAY 2

  STUDENT EXPERIENCE                   STUDENT EXPERIENCE
         Session- I                           Session- II


  6-7 members/group, 1
   facilitator; 6 groups              Small group activity contd

                                   1 hour              2nd page of
             Case given                               Case revealed
                                       Large group
    Small group activity
                                       presentation

              1 hour
                                     Question-Answer Session
       Large group
   presentation by group               Post Test & Evaluation of
      representative                          Workshop
                                  Case Writing Workshop

          Morning Session - 3 hours            Afternoon Session- 2 hours

                                                 1 hour       6 Preframed
          Introduction by External &                            scenario
               Internal Experts

                                                   Small group activity
              Small group activity
                     Case 1,
                   groups 1,2,3                       Large Group
One real scenario
                                   1 hour             Presentation
designed differently
                          Case 2,
                        groups 4,5,6


                       Large Group                   Evaluation with
                       Presentation                   questionnaire
                      RESULTS - WORKSHOP I

          Proportion of faculty trained at Workshop I

60


50


40
                                               28.6%
                                                                 Total
                                                                 Participated
30                             33%
        33%
20                6%                                        34.8%

10


0
     Professor     Addl.     Associate   Assistant   Lecturer/
                 Professor   Professor   Professor     tutor
Distribution of Faculty Participants according to their
                  designation, N=39




      Lecturer/ tutor             Professor
           21%                      20%


                                      Addl. Professor
                                            3%


                                    Associate
                                    Professor
          Assistant                   21%
          Professor
            35%
                                         Improvement in the perception of faculty regarding
                                         Problem Based Learning before and after Workshop
                                   120
    Percentage of responses from
                                   100



                                    80
            Participants



                                                                                          Pretest N=37 [100%]
                                    60
                                                                                          Post test N=26 [70.3%]

                                    40



                                    20



                                     0
                                            1          2         3        4           5

                                                Items in the Prestest and post test
                                                           questionnaire


1. What is PBL?
2. PBL is same as CBL, PBL, PSL, Inquiry Driven Learning, None
3. Role of faculty in PBL
4. Responsibility of student in PBL
5. Characteristics of an effective tutor
                                       Evaluation of PBL Workshop

                      16

                      14
Number of responses




                      12
                      10                                                     Slightly Agreed
                                                                             Strongly Agreed
                      8
                                                                             Slightly Disagreed
                      6                                                      Strongly Disagreed

                      4
                      2

                      0
                           understanding   exploring how    understanding
                            what is PBL     PBL works         the steps
                                                           involved in PBL
                                      Items in Questionnaire
                                      Evaluation of PBL Workshop [contd.]

                      18
                      16
NUmber of Responses




                      14
                      12                                                                 Slightly Agreed
                      10                                                                 Strongly Agreed
                       8                                                                 Slightly Disagreed
                       6                                                                 Strongly Disagreed
                       4
                       2
                       0
                           understanding the   understanding the     understanding the
                           group dynamics in   responsibilities of   role of good PBL
                                  PBL              students              fcailitator

                                        Items in Questionnaire
                                Proportion of faculty trained in Case Writing, N=135

                         60                                                                       RESULTS - WORKSHOP -II
                         50
Number of Participants




                         40



                                                                                              Total
                         30
                                                                                              Partcipated

                         20




                         10

                                                                                               Distribution of faculty participants according to
                                                                                                Designation at Case Writing Workshop; N=25
                          0
                              Prof      Addl Prof     Assoc Prof   Assist Prof   Lect/Tutor

                                                    Designation



                                                                                                                               Professor
                                                                                                  Assistant Prof
                                                                                                                                  32%
                                                                                                       36%



                                                                                                                               Addl. Prof
                                                                                                                                  4%
                                                                                                                   Associate
                                                                                                                     Prof
                                                                                                                     28%
                           Evaluation of Case Writing Workshop; N=25, Responses elicited
                                                      21 [84%]

                      18
                      16
Number of Responses




                      14
                      12                                                               Slightly Agreed
                                                                                       Strongly Agreed
                      10
                                                                                       Slightly Disagreed
                      8                                                                Strongly Disagreed
                      6
                      4
                      2
                      0
                              understanding exploring how PBL exploring the skills
                           relevance of a case case scenario can necessary to refine
                             scenario in PBL     be developed       a PBL case
                                           Items in Questionnaire
                       Workshop I                 Workshop II

Valuable Aspects       Integrated group           Group dynamics,
                       discussion and role play   Integrated self learning
                       Practical demonstration    Brain storming sessions
                       and understanding of       and Exchange of views
                       PBL concept as a new
                       way of teaching,
Clarification Needed   Role and qualifications    Quality of a facilitator,
                       of a facilitator           Ways to develop a case
                       Designing a case           scenario by defining
                       scenario                   learning objectives for
                                                  different standards of
                                                  learners
Suggestions for        Frequent workshops         More frequent
Improvement            with longer sessions       workshops,Provide
                       and video clips of         websites where such
                       recording of a             casess would be
                       successful standard        available, formation of
                       PBL session                a core group pooled
                                                  from all specialties
              Conclusion
• Comprehensive faculty development programs
  are essential for initiating curricular change
• High satisfaction and considerable change in
  attitude was observed amongst faculty
  members
• Some faculty expressed concern regarding
  implementation of PBL in present setting and
  the assessment of the same
• Further workshop involving more faculty need
  to be conducted on a regular basis.
              Acknowledgement
• CMCL-FAIMER Regional Institute
• Mr. Sandeep Desai, CEO, H M Patel Centre for Med Care & Edu
• Dr. H. H. Agravat, Dean, Pramukhswami Medical College
• Dr. Rashmi Vyas, Christian Medical College, Vellore
• Dr. Dileep Mavlankar, Indian Institute of Management, Ahmedabad
• Core faculty of Pramukhswami Medical College- Dr. Barna
  Ganguly, Dr. Suman Singh, Dr. Praveen Singh, Dr. Anuradha Joshi
• Medical Education Unit,Pramukhswami Medical College
• Participant faculty at Workshop I & II.
                                  References
1. Physicians for the twenty First century: Report of the panel on the General
   Professional Education of the Physicians and College preparation for
   medicine, Association of American Medical Colleges, Washington, 1984.
2. Schmidt H: Problem based Learning: rationale and Description, Med Educ
   1983; 17: 11-16.
3. Medical Council of India. Salient features of Regulations on Graduate Medical
   Education, 1997 Available
   http://www.mciindia.org/know/rules/rules_mbbs.htm, accessed Oct 08, 2007
4. Wood, DF (2003): ABC of learning and teaching in medicine: Problem based
   learning, BMJ 326; 328-330. Available at
   http://bmj.com.cgi.content/full/326/7384/328, accessed on 11.10.2007
5. Barrows HS, Peters MJ: How To Begin Reforming The Medical Curriculum,
   Southern Illinois School of Medicine, Springfield. Ill. 1984: 21-27
6. Des Marchais JE, Jean P, Delorme P: basic training program in medical
   pedagogy: a 1- year program for medical faculty. Can Med Assoc J 1990; 142:
   734-740

				
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