Small group learning in the final year of a medical degree: a quantitative and qualitative evaluation

Abstract

The new undergraduate medical curriculum in Manchester uses problem-based learning (PBL) throughout the course. However, the major difference from other PBL schools is that in years 3 & 4 (phase 2) the students can use clinical experience when discussing the paper cases. The process is then developed further in year 5 (phase 3), in which there are no set PBL 'triggers' and students bring their own cases to the groups for discussion. In this study, we have explored what happens in the phase 3 (year 5) group sessions and how the students view them. A questionnaire and focus groups were used to generate data, from which a model was developed of what happens in a 'good' group session. The data suggest that most groups run on a case-presentation and discussion format, most commonly about clinical management and diagnosis. Students want tutors to act as an expert resource and to be flexible in allowing students to direct the discussions. University guidance about the group sessions was not generally used.

PBL in Undergraduate Medical Education: A Qualitative Study of the Views of Canadian Residents

“…As in our own study, other research has found that the biggest risk in having clinicians facilitate small groups is a tendency to take over the group process either by directly questioning students (Gilkison, 2003;MacPherson et al, 2001;Silver and Wilkerson, 1991) or by teaching rather than encouraging student discovery and learning (Kaufman and Holmes, 1998;Wilkerson and Irby, 1998). Other problems with tutors identified in our study and the literature also points to inadequate amounts of guidance and feedback they give to students (O'Hanlon et al, 1995).…”

Clinical teachers and problem-based learning: a phenomenological study

“…Already, our students link clinical experiences to their discussions of hypothetical problems (see http://www.parable.man.ac.uk). 11 Tutorial discussions that use real patients as their starting point have shown promise in 2 phases of our curriculum 12,13 . However, real situations too easily take teachers and learners across the theory−practice divide, so they concentrate on problem solving – or clinical expertise – at the expense of theoretical understanding.…”

Experience-based learning: a model linking the processes and outcomes of medical students' workplace learning

“…After limited clinical exposure in Years 1 and 2, students continue thematic learning in Years 3 and 4, but now with clinical skills training and simultaneous community and hospital attachments to provide access to a breadth of clinical problems and contexts 9 . In Year 5, they have one‐to‐one attachments to clinicians and continue to attend group tutorials, but now use real patients as triggers for PBL 10 …”