Problem-based learning (PBL) has been adopted by many medical schools as an innovative method to deliver an integrated medical curriculum since its inception at McMaster University (Dornan et al., Med Educ 39(2):163–170, 2005; Finucane et al., Med Educ 35(1):56–61, 2001; Barrows, Tutorials in problem-based learning: A new direction in teaching the health professions, 1984). The student experience in PBL has been explored in detail (Merriam, New Directions for Adult and Continuing Education 89: 3–13, 2001; Azer, Kaohsiung J Med Sci 25(5): 240–249, 2009; Boelens et al., BMC Med Ed 15(1): 84, 2015; Dolmans et al., Med Teach 24(2):173–180, 2002; Lee et al., Med Teach 35(2): e935-e942, 2013) but the tutors who facilitate PBL have valuable insight into how PBL functions and this aspect has not been extensively researched.The integrated curriculum for years 1 and 2 at the Graduate Entry Medical School at the University of Limerick is delivered though problem-based learning (PBL). This programme requires collaborative teamwork between students and the tutors who facilitate small-group tutorial sessions. All PBL tutors at GEMS are medically qualified, with the majority (68%) currently working in clinical practice.MethodsA mixed-methods approach was adopted, utilising two surveys and follow-up focus groups to fully understand the tutor experience. Thirty-three tutors took part in two online surveys with a response rate of 89%. Thirteen tutors participated in two focus groups. Descriptive analysis was completed on survey data and thematic analysis on focus group discussions which highlighted five main themes.ResultsTutors reported challenges with managing group dynamics, development of confidence in tutoring with experience and a willingness to learn from peers to improve practice. Findings are in keeping with previously published work. Results also identified several less commonly discussed issues impacting student engagement in PBL including the use of mobile device technology, unauthorised access to learning objectives and PBL cases, and the importance and need for professional development amongst tutors, including the impact of tutoring on clinical practice. This study revealed that experienced tutors spend considerable time preparing for PBL tutorials in the basic sciences and that this input is rewarded by the benefits it brings to their clinical practice.ConclusionsUnderstanding PBL from the tutor’s perspective reveals valuable insights which can inform ongoing tutor development and support. Limited research exists in the area of PBL tutor’s experiences which may be of interest to medical educators, clinicians and the wider medical community. Findings highlight the value of shared tutor experiences as a resource that can be capitalised on to benefit both novice and experienced tutors.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1214-2) contains supplementary material, which is available to authorized users.
Background: To explore graduates' perceptions of significant factors affecting professional identity formation (PIF) throughout their graduate medical school education journey and early practice years. Methods: A qualitative study with medical graduates using non-probability sampling. Data collected with graduates via face to face and telephone interviews. Interviews (n = 9) completed with medical graduates of the School of Medicine, University of Limerick. Results: Graduates described their experiences in general practice, during the early patient contact programme and the longitudinal integrated clerkship (LIC) as highly influential. The lasting impact of positive role models was highlighted. The importance of socialisation and entering a community of practice were identified as drivers of professional development. Role modelling and mentorship between students and GP tutors were pivotal as part of early clinical years and clinical LIC. This seemed to have a positive influence on graduate's consideration of general practice as a future career pathway. Conclusion: Professional identity formation occurs for medical students who participate in early patient contact programmes and longitudinal integrated clerkships in GP. Factors such as positive role modelling, good mentorship, communities of practice and a positive learning environment appear to be the main contributors to this process. Experiences as part of longitudinal integrated clerkships are meaningful for graduates, regardless of postgraduate specialisation choices. Educators should acknowledge this when designing medical curricula to ensure that students' professional identity formation is optimally facilitated. Training should be available to support the educators involved in longitudinal integrated clerkships, as they become role models and mentors to students.
We provide a narrative review of the crucial elements for online Problem Based Learning (PBL) and a reflective overview of factors to consider when temporarily moving to online tutorials, forming a practical guide for educators in the health professions and beyond. We give general set-up advice based on the literature and our own recent experience (tutor and learner observational feedback, departmental meeting notes, newly-developed written resources and performance reports) of transitioning between temporary online PBL and face-to-face PBL but note that the majority of this advice translates easily to many types of virtual, interactive tutorial. We also include contextual evidence and theories from existing literature, with a focus on online PBL facilitation, learning and quality assurance. Despite widespread implementation of online teaching, there remain unanswered questions about whether deep learning occurs. The focus of this reflective paper is to better align online PBL practice with the principles of contextual, active, collaborative and self-directed learning and learning issues to be pursued.
Background Transition from final-year medical student to newly graduated doctor is challenging with evidence of associated increased patient mortality and medical errors. Previous work suggests tackling preparedness alone does not ‘solve’ this transition. The current focus on mentoring and support provision during this period and is an under-researched area. The COVID-19 pandemic represents a unique disruptive critical incident in which to examine mentoring and support practices, exposing strengths and weaknesses. The perspectives of this cohort and their implications remains an under-researched area. Methods Individual semi-structured interviews were conducted with nine graduate-entry final-year medical students. An inductive latent phenomenological approach explored individual experiences of mentoring and support practices during final-year and transition to professional practice. Results Three major themes emerged: 1) Mentoring & Support; 2) Clinical Exposure; 3) Graduation & Transition. A journey metaphor was used to aid the description of participants’ lived experience of mentoring and support practices during their final year. Final year medical students (FYMs) felt under-supported and found practices inadequate. Reduced clinical exposure yielded unpreparedness and regression, potentially impacting future careers. Positive experiences were variable and unstructured. ‘The COVID Doctors’, subtheme provided rich insights into shared narratives and identities amongst participants. Discussion and Conclusion Cultural change and reframing transitions as critically intensive learning periods may allow better engagement with the idiosyncrasies of workplace environments and support legitimate peripheral participation. Recommendations from the current study include updating contingency plans, balancing clinical exposure with patient safety issues, and providing support to ‘bottom-up’ mentoring practices.
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