ABSTRACT
Without the appropriate facilitation of discussion in a problem-based learning (PBL) course and the use of specific educational tools that enhance cognitive skills, students might deprive themselves of achieving the deep learning experience expected to take place in a PBL course. One of the educational tasks in PBL is the creation of mechanisms for hypotheses made by the students, based on their knowledge of the basic sciences and the psychosocial issues raised in a particular case scenario. The whole task is student-constructed and should enhance their ability to explain the scientific basis of the symptoms and clinical signs of the patient enlisted in the case. Because students usually discuss the case without enough prior related knowledge, they might find it difficult to address different aspects of their mechanisms. These gaps in knowledge may be considered part of their “learning issues”. In tutorial 2 (a PBL case is usually discussed in 2 or 3 tutorials at the maximum; each tutorial is 2 hours long), students should be able to build a comprehensive mechanism reflecting their deep understanding of the problem. However, students might not be able to integrate information learnt and their mechanisms might show a number of shortcuts and/or lack integration of information, and the flow of the pathophysiological changes may not be logical. This manuscript describes 5 key open-ended questions in PBL tutorials to facilitate students’ discussions as they create their mechanisms.
An important aspect of problem-based learning (PBL), particularly in the early years of the undergraduate medical, physiotherapy, nursing and dental courses, is teaching basic science in a clinical format.1,2 This approach should enhance students’ skills to develop reasoning strategies, use information in relevant situations, generate hypotheses for problems identified and build mechanisms. Mechanisms are usually described as diagrammatic flowcharts illustrating a sequence of events. The main aim of including mechanisms in a PBL template is to encourage students to use knowledge learnt and information provided in the case scenario, including psychosocial issues, to explain how a hypothesis suggested by the group could explain the patient’s problems.3 During this process, the group might discover that they are unable to provide a thorough explanation and that they lack information in areas such as physiology, anatomy, pharmacology, microbiology, pathology, biochemistry or pathophysiological changes. The group may choose to include these deficiencies in their knowledge as part of their “learning issues” list.4
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