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"Problem-Based Learning methods Netherlands."
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Lessons from problem-based learning
\"Problem-based learning (PBL) has excited interest among educators around the world for several decades. Among the most notable applications of PBL is the approach taken at the Faculty of Health, Medicine and Life Sciences (FHML) at Maastricht University, the Netherlands. Starting in 1974 as a medical school, the faculty embarked on the innovative pathway of problem-based learning, trying to establish a medical training program which applied recent insights of education which would be better adapted to the needs of the modem physician. The medical school, currently part of the FHML, can be considered as an 'established' school, where original innovations and educational changes have become part of a routine. The first book to bring this wealth of information together, \"Lessons from Problem-based Learning\" documents those findings and shares the experiences of those involved, to encourage further debate and refinement of problem-based learning in specific applications elsewhere and in general educational discussion and thought. Each chapter provides a description of why and what has been done in the Maastricht program, followed by reflection on the benefits and issues that have arisen for these developments. The final section of the book examines the application of PBL in the future, and how it is likely to develop further\"--Provided by publisher.
Book
Preferred teaching styles of medical faculty: an international multi-center study
Background
In the current wave of educational reforms, understanding teaching styles of medical faculty can help modify instructional strategies for effective teaching. Few studies have probed distinctive teaching styles of medical faculty. We compared preferred teaching styles of faculty from seven medical schools in United Arab Emirates, the Netherlands, Saudi Arabia, Malaysia, Pakistan, and Sudan.
Methods
The validated Grasha-Riechmann teaching style inventory was administered online for data collection and used SPSS version 20.0 for statistical analysis.
Results
Of the 460 invitees, 248 responded (response rate; 54%). Delegator teaching style was most common with a highest median and mean of 2.38 and 2.45, respectively. There was a significant correlation between expert and authority teaching styles, correlation coefficient 0.62. Similarly, we found a significant correlation between authority teaching style and nature of curriculum, correlation coefficient 0.30. Multiple regression analysis showed that only authority teaching style and male gender had significant correlation. Interestingly, 117 (47%) teachers disagreed with the teaching philosophy of
delivering course contents by strictly following learning outcomes
. Female teachers (114/248) were more
willing to negotiate with their students regarding how and what to teach in their course
, while male teachers tended
to allow more autonomy by allowing students to set their learning agenda
.
Conclusions
This study showed that the medical teachers preferred delegator teacher style that promotes students’ collaboration and peer-to-peer learning. Most teachers are conscious of their teaching styles to motivate students for scientific curiosity. These findings can help medical educators to modify their teaching styles for effective learning.
Journal Article
Signs of erosion
Nowadays many schools in higher education implement problem-based learning to foster active learning processes by students. In some schools with a number of years of experience with this approach, phenomena can be observed which indicate signs of wear. The implementation of a large-scale innovation such as problem-based learning (PBL) seems to provoke different activities and attitudes in those actors who are most involved. Students and staff members seem to behave in a way which could be counterproductive to the development of self-directed learning. In the first part of this paper, we briefly describe the cognitive psychological background of PBL. In the second part various adjustments observed in problem-based curricula and their effects on students' learning are analyzed. Arguments are presented about adverse effects on the implementation of this educational innovation. Special attention is given to teachers' concerns. In the third part suggestions are made about ways to revitalize PBL processes as well as suggestions about effecting educational innovations on a more solid basis. (HRK / Abstract übernommen).
Journal Article
Motivation and competence of participants in a learner-centered student-run clinic: an exploratory pilot study
Background
The Learner-Centered Student-run Clinic (LC-SRC) was designed to teach and train prescribing skills grounded in a real-life context, to provide students with early clinical experience and responsibility. The current studies’ theoretical framework was based on the Self-determination Theory. According to the Self-determination Theory, early involvement in clinical practice combined with a high level of responsibility makes the LC-SRC an environment that can stimulate intrinsic motivation. We investigated the different types of motivation and the proficiency in CanMEDS competencies of the participating students.
Method
Type of motivation was measured using the Academic Motivation Scale and Intrinsic Motivation Inventory. CanMEDS competencies were evaluated by faculty using a mini-clinical examination and by the students themselves using a post-participation questionnaire.
Results
The 29 participating students were highly intrinsic motivated for this project on all subscales of the Intrinsic Motivation Inventory. Motivation for medical school on the Academic Motivation Scale was high before and was not significantly changed after participation. Students considered that their CanMEDS competencies “Collaborator”, “Communicator”, “Academic”, and “Medical expert” had improved. Their actual clinical team competence was judged by faculty to be at a junior doctor level.
Conclusion
Students showed a high level of intrinsic motivation to participate in the LC-SRC and perceived an improvement in competence. Furthermore their actual clinical competence was at junior doctor level in all CanMEDS competencies. The stimulating characteristics of the LC-SRC, the high levels of intrinsic motivation and the qualitative comments of the students in this study makes the LC-SRC an attractive place for learning.
Journal Article
Doing Philosophy Effectively: Student Learning in Classroom Teaching
An important aim of teaching philosophy in Dutch secondary schools is to learn about philosophy (i.e., the great philosophers) by doing philosophy. We examined doing philosophy and focused specifically on the relationship between student learning activities and teacher behavior; in doing so, a qualitative cross-case analysis of eight philosophy lessons was performed. The effectiveness of doing philosophy was operationalized into five learning activities comprising rationalizing, analyzing, testing, producing criticism, and reflecting, and scored by means of qualitative graphical time registration. Using CA we find a quantitative one-dimensional scale for the lessons that contrasts lessons that are more and less effective in terms of learning and teaching. A relationship was found between teaching by teachers and doing philosophy by students. In particular we found students to produce a higher level of doing philosophy with teachers who chose to organize a philosophical discussion with shared guidance by the teacher together with the students.
Journal Article
Understanding the effects of time on collaborative learning processes in problem based learning: a mixed methods study
Little is known how time influences collaborative learning groups in medical education. Therefore a thorough exploration of the development of learning processes over time was undertaken in an undergraduate PBL curriculum over 18 months. A mixed-methods triangulation design was used. First, the quantitative study measured how various learning processes developed within and over three periods in the first 1,5 study years of an undergraduate curriculum. Next, a qualitative study using semi-structured individual interviews focused on detailed development of group processes driving collaborative learning during one period in seven tutorial groups. The hierarchic multilevel analyses of the quantitative data showed that a varying combination of group processes developed within and over the three observed periods. The qualitative study illustrated development in psychological safety, interdependence, potency, group learning behaviour, social and task cohesion. Two new processes emerged: ‘transactive memory’ and ‘convergence in mental models’. The results indicate that groups are dynamic social systems with numerous contextual influences. Future research should thus include time as an important influence on collaborative learning. Practical implications are discussed.
Journal Article
Practice-based learning: an appropriate means to acquire the attitude and skills for evidence-based medicine
To evaluate a practice-based, self-directed EBM-course in an undergraduate medical curriculum in terms of EBM attitude and motivation beliefs.
This study was conducted in a 4-week course of the first-year undergraduate medical curriculum, which takes place twice in an academic year. One group of students (n=210) received a normal EBM-module in November. A practice-based EBM-module was implemented in January for another group of students (n=130). We approached all students following the courses for participation in our research project. In a quasi-experimental design, a validated survey was used to assess students' EBM task value and self-efficacy on a 7-point Likert-scale. In the experimental group, complementary qualitative data were gathered on attitude and motivation by open evaluative questions.
Overall response rate was 93,5%, resulting in 191 students in the control group and 127 students in the experimental group. We did not find differences between the groups in terms of EBM task value and self-efficacy. However, the experimental group showed a higher increased perception of the importance of EBM in decision making in clinical practice (60.0% vs 77.2%; χ
(1, N=318) = 8.432, p=0.004). These students obtained a better understanding of the complexities and time-consuming nature of EBM in medical practice.
The practice-based EBM-course helps students to reflect on practice and knowledge critically. Our findings indicate that integrating clinical practice in the undergraduate learning environment fosters attitude and motivation, suggesting that practice-based learning in EBM education may advance student development as a critically reflective practitioner.
Journal Article
Education on prescribing for older patients in the Netherlands: a curriculum mapping
Purpose
Pharmacology and pharmacotherapy education is being increasingly integrated in medical curricula, which might lead to a specific loss of knowledge in these subjects. This, in turn, could lead to harmful prescribing errors, especially in vulnerable older patients.
Methods
Teachers who coordinated education in Dutch medical schools completed a structured interview on (geriatric) pharmacology and pharmacotherapy education. A list of core learning goals was developed. Pharmacology and pharmacotherapy education in general was compared to geriatric pharmacology and pharmacotherapy education.
Results
All Dutch medical schools participated. Contact hours for education in pharmacology and pharmacotherapy ranged from 39 to 107 h; ECTSs (representing 28 study hours) ranged from 0 to 3. The various curricula covered, on average, 79 % of all learning goals for these subjects: knowledge 85 %, skills 76 %, and attitudes 66 %; the curricula also covered specific geriatric goals: knowledge 87 % and skills 65 %. All geriatric learning goals were met if a geriatrician was among the coordinators. Half (4 of 8) of the medical schools lacked appropriate assessment procedures. Evaluation was mostly based on students’ opinions. Teachers rated students as being moderately well prepared for daily practice.
Conclusions
There are large differences in the quantity and quality of (geriatric) pharmacology and pharmacotherapy education in Dutch medical schools. In general, more time should be devoted to skills and attitude, and the assessment procedures should be optimized with high priority. Other curricula with a problem-based approach might benefit from the points of improvement described in this article.
Journal Article
Case-based e-learning to improve the attitude of medical students towards occupational health, a randomised controlled trial
ObjectivesUndergraduate medical teaching in occupational health (OH) is a challenge in universities around the world. Case-based e-learning with an attractive clinical context could improve the attitude of medical students towards OH. The study question is whether case-based e-learning for medical students is more effective in improving knowledge, satisfaction and a positive attitude towards OH than non-case-based textbook learning.MethodsParticipants, 141 second year medical students, were randomised to either case-based e-learning or text-based learning. Outcome measures were knowledge, satisfaction and attitude towards OH, measured at baseline, directly after the intervention, after 1 week and at 3-month follow-up.ResultsOf the 141 participants, 130 (92%) completed the questionnaires at short-term follow-up and 41 (29%) at 3-month follow-up. At short-term follow-up, intervention and control groups did not show a significant difference in knowledge nor satisfaction but attitude towards OH was significantly more negative in the intervention group (F=4.041, p=0.047). At 3-month follow-up, there were no significant differences between intervention and control groups for knowledge, satisfaction and attitude.ConclusionsWe found a significant decrease in favourable attitude during the internship in the experimental group compared with the control group. There were no significant differences in knowledge or satisfaction between case-based e-learning and text-based learning. The attitude towards OH should be further investigated as an outcome of educational programmes.
Journal Article
Illness script development in pre-clinical education through case-based clinical reasoning training
To assess illness script richness and maturity in preclinical students after they attended a specifically structured instructional format, i.e., a case based clinical reasoning (CBCR) course.
In a within-subject experimental design, medical students who had finished the CBCR course participated in an illness script experiment. In the first session, richness and maturity of students' illness scripts for diseases discussed during the CBCR course were compared to illness script richness and maturity for similar diseases not included in the course. In the second session, diagnostic performance was tested, to test for differences between CBCR cases and non-CBCR cases. Scores on the CBCR course exam were related to both experimental outcomes.
Thirty-two medical students participated. Illness script richness for CBCR diseases was almost 20% higher than for non-CBCR diseases, on average 14.47 (SD=3.25) versus 12.14 (SD=2.80), respectively (p<0.001). In addition, students provided more information on Enabling Conditions and less on Fault-related aspects of the disease. Diagnostic performance was better for the diseases discussed in the CBCR course, mean score 1.63 (SD=0.32) versus 1.15 (SD=0.29) for non-CBCR diseases (p<0.001). A significant correlation of exam results with recognition of CBCR cases was found (r=0.571, p<0.001), but not with illness script richness (r=-0.006, p=NS).
The CBCR-course fosters early development of clinical reasoning skills by increasing the illness script richness and diagnostic performance of pre-clinical students. However, these results are disease-specific and therefore we cannot conclude that students develop a more general clinical reasoning ability.
Journal Article