Problem-Based Learning Curriculum
The problem-based learning (PBL) entry-level Doctor of physical Therapy program places the student in a position of active responsibility for learning and mastering content. Developed by Barrows1 and colleagues at McMaster University, ON for medical education, PBL is a rigorous, highly structured teaching methodology which places the student in a position of active responsibility for learning and mastering content. In a group of peers, the student learns new material by confronting and solving problems in the form of a clinical patient case. Barrows and colleague demonstrated that PBL effectively helps students to develop scientific thinking about patients’ problems and to acquire both foundational science and clinical information in a manner that ensures retention and transfer [of learning] to the real-life task of the clinician.1 The Evidence 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.
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. In a group of peers, the students learn and apply new knowledge in the context of a clinical patient case. Students work in small groups (7-8 students) facilitated by an expert clinician. 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 (Physical Therapy Clinical Reasoning). The group must come to consensus about what they would need to know in order to manage the patient case.
Based on the pathophysiology of his disease process, what precautions would be important when treating this patient?
How would the patient’s emotional status influence the plan of care?
How might the patient’s medications influence the outcome of the intervention?
What tests and measures might be appropriate for the patient given their current status
Through the PBL process, students are learning how to ask questions and to explore the answers. They do this by developing “learning issues” or topics which represent questions about the case. 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 an entry level physical therapist. Carefully crafted scenarios are the “anchors” around which other content is taught. The curriculum includes extensive laboratory experiences (Patient/Client Management and Foundational Sciences) as well as special topic seminars (Professional Topics) which complement and reinforce content learned in PBL sessions.
Students become skillful at searching for and critically analyzing the evidence, and synthesizing information from a variety of sources. Since group members are dependent on each other for enriching discussion and subsequent learning, each student must participate in the tuhtorial 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, 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.
- Barrows HS, Tamblyn RM. Problem-based learning: an approach to medical education. New York: Springer Publishing Company; 1980: xii.