To help you know better the rationale behind PBL, how to design a PBL experience, and how students actually feel about PBL, I interviewed scholars, teachers and students who have practical experiences with PBL. Well, central to problem-based learning or PBL is its ontological and epistemological stance. Drawing on social constructivism, PBL adopts a process approach to knowledge. PBL theorists stress the centrality of constructing flexible knowledge. This goes beyond learning facts, but rather integrates knowledge across multiple domains. Such knowledge is coherently organized around deep principles in a domain in order to support long-term retention. In contrast to direct transmission approaches which value information delivery and knowledge consumption, PBL values information management and knowledge co-construction. One of the original rationales for PBL in medical education was to deal with the exponential growth in information. This, one can argue, is even more cogent today in our information-rich era. Through PBL students work in groups to develop skills to access, critique, interpret, synthesize, and apply relevant knowledge, originally to health sciences' clinical context, but now across many applied fields in higher education. OK, so when we're thinking about the curriculum level across the years of a program, then we're talking about creating domains that are vertical and then at the year level horizontally, we map learning issues, in PBL we call the topics learning issues. We map those to the domains and then choose to integrate them, so that one PBL problem is drawing upon knowledge from multiple domains. So managing the curriculum, coordinating this level of integration, requires a lot of staff commitment. So you need to bring staff out of their disciplinary silos, have them sit down, map the content across the curriculum, and then choose how they're going to integrate particular aspects of that knowledge, as I said horizontally, within a problem. For a successful PBL actually we need to have a good curriculum design. Therefore, each PBL, actually we need a PBL problem giving a nice template, giving instructions to facilitators and then integrate it into the curriculum overall. Then we need to arrange a PBL tutorial. It will start with a tutorial one which the students would discuss about PBL problem under the guidance of facilitator and then they identify the running issues. After that then we need to arrange some activities. The facilitator is just learning of course, OK, the student center learning is the key. But then they still need some facilitation, but we can arrange some information-giving sessions. It can be some kind of, a presentation by experts, it can be activities where they can go over with this or observing demonstrations, taking care of the exercise. Then after this, OK, a learning process, OK. The next element actually is the time when the students will be able to consolidate that learning and present it to facilitators so they can know how much they learn. And after that, OK, then we need to have some assessment of the learning outcomes. And then this process actually has to be repeated for different problems so that we will cover the full range of topics that we want to cover in the curriculum. I think it's important that for the curriculum design we need to bring in different disciplines. Then you have to decide on what other important topics that they want the students to learn. And then these key topics have to be integrated in the design of a PBL curriculum, and also in designing the PBL problem so that each problem actually will involve multiple disciplines, rather than on a very narrow topic because PBL actually is a market, a real world type of learning situation in which in real world we use these disciplines. People have to encounter different topics at the same time and there's no limitation on where the source comes from, a source of information comes from because they can explore different disciplines. And then in the process of the implementation actually the facilitators who are usually the teachers from different disciplines actually learn. Both the students they need to understand the situation and apply their knowledge in a more interdisciplinary setting. And then this also helps for the interdisciplinary collaboration with teaching and also in the later assessment of the students. Actually, you can assess the two aspects of the students' performance that we need to assess. One is to process it so that we assess whether the students are able to learn under the PBL type of learning environment and process. The other is that we want to assess the student learning outcomes. So usually for the process actually then we will give our students a problem and then to work through, and then the facilitator or the examiner in this situation will try to have a minimal intervention so that they can observe the student and process the discussion and interaction. And then we need to put down explicitly what are the aspects that we want to assess. For example the student's ability to explore the problem, ability to explain their ideas, their ability to discuss or to accept people's different views. So we need to specify what aspects of the process we want access and also get a very clear assessment criteria and different grading. And then that is done for each individual student, because even though PBL is carried out in a group but then the performance of individual members of the group may vary because in the assessment we want to give them individual feedback. We want to give them individual assessment on their performance. And then the other aspect of assessment is on the outcome, the learning outcomes. Because we want to know how much or how deep a student can learn. And then because the PBL's aim actually is we want to encourage higher order of learning. So even though the format of the assessment can be similar to the traditional ways, in the written form or in an oral examination, the way that we ask the questions can we be slightly different, in that we don't ask questions on just a factual record at the level, we start, we go up the higher level of the Bloom's taxonomy, you start with the understanding and then it also assess whether they are able to explain the situation. Application may be a bit of landscape depends on how deep you want to ask. But then in the question actually we would like the questions to allow for multiple type of question- answers, and integrate answers. So the questions, the different path of the questions actually needs to be integration, integrated, and because the learning is integrated means that within the same question we asked them for information from different disciplines, and then the students are allowed to answer, put an answer, give integrated information from different disciplines. It means that the one who makes assessment or who marks the answer script needs to allow for answers that may not be just in that teacher's own specialty. And the format can be written form or can be oral examination, or it can be another type of assessment, for example ask them to do some exercise or some performances. It depends on what aspect of learning that we want students to learn. I think it is hard, I mean because on one side as a teacher we oftentimes want to help the students to learn, but on the other hand at a certain point you really have to let the student to explore themselves. And sometimes when you see them go astray or when they are making mistakes you feel almost immediately you want to jump out and help. But I think to really help students to develop their own problem-solving skills the teachers sometimes will have to sit back. First of all the teacher can create the opportunities by asking questions or writing good clinical cases to stimulate the student to think. And then the attitude of the teacher is also important. Teachers should be more open to mistakes. So even if the students are making a mistake, if he or she doesn't jump out immediately and say oh this is wrong, but sometimes the reason is because sometimes students will actually find out that they are making a mistake themselves and then correct themselves. And it's OK to let the student know that it's OK to make mistakes. Because as I said they can correct the mistakes themselves and sometimes they learn from their mistakes. So mistakes are alright, and sometimes one strategy I use is sometimes I ask questions that I myself don't even know the answer. And then to explore the problems with the student along with the students and through that process the student can actually get to see how a somewhat more experienced person in the field can approach the problem. So once again it's just telling the student it's OK to not know something, it's sometimes OK to be wrong. And it is a enjoyable process to explore a problem. I think technology is a, is a tool in PBL. And just like any other tool if you use it correctly it can help the process, but if you use it incorrectly it can actually harm the process. Sometimes technologies are helpful but not all times. And therefore I think technology, like the mobile devices students are using to look up information is good, but I would try to limit the use on looking for specific information like definition, data, journal papers, statistics, or informative pictures, illustrations, soundbites, videos to illustrate certain procedures or pathological processes. But beyond that point I oftentimes encourage students, OK, put down your, put down your tablets, notebook computer, and start thinking about the information you have in hands, and start the discussion process among the students in a group. And then if students continue to hang on to their mobile devices it can actually be a, it can actually slow down the process of the discussion and problem solving. So I think technology, the use of technologies is good when you use it appropriately, but the key thing, the key issue for a PBL facilitator is to know when to use it and when not to use it, how to select the information, but selecting information takes time. One of the obstacles that technology, or mobile devices, poses as an obstacle in PBL is when the students are looking at the tablets and mobile devices, looking through all the search results, it actually distract them from taking part in the discussion process. And you will see, you'll actually see all the students looking at their computers during the PBL discussion and they just become very quiet, they don't take part in the discussion, they are actually looking for information instead of problem solving. And I think there's a difference between the two. Information alone doesn't mean learning. And, but of course without information it's very difficult to start a discussion that is based on evidence and facts. So limited degree of use of technology to look up information is good, but once you reach a certain extent I think the facilitator has to encourage the student to take part in a constructive discussion instead of just a continuous competition in the search for information. It is, it is very different and it does require a little bit of a mindset change, because often when you are an expert in a particular area you have a certain passion about it and it's something that you really want to get across. And all of a sudden in PBL you're not allowed to do that. You're meant to be holding back a bit and you're there watching the students explore this and develop themselves, and that can be quite painful because it's, it can be slow to watch. But what you're doing is you're seeing in real time how students are assimilating and acquiring this knowledge and working out its relevance. So in a way you get feedback and enjoyment that's richer because you're actually seeing how they've acquired the knowledge and how they're thinking about it, whereas normally when you stand up and you're doing a lecture or presentation and it's a monologue, you have no idea whether the students have understood anything of your presentation. You think, oh I've done a great job, I spoke well, I had pretty slides, and this went well and that went well, but at the end of the session, you know, maybe 40-60% of the students followed everything that you were saying and others were getting lost. Whereas in PBL you can really see what's happening in the moment. So there's got to be a mindset change about that role that you're playing, and the old adages that you're no longer the sage on the stage you're the guide on the side. And I think another way of helping you to transition, and this is an easier one to do, and that's simply asking your faculty or whoever is running some PBL, can I sit in on one of our established facilitators who's gotten good feedback to see how they do it, because then you can actually have a visual role model to get an idea about what's happening, and then maybe after a period of time if there's certain, you know, insecurities or uncertainties that you are, still not sure if you're doing it right, then I would see whether somebody can sit in on your session and give you some direct feedback about how you're doing. But normally I think people adapt to it quite well, quite well. I mean in other types of curriculum they basically use formal lectures and then you've got tutorials. So the learning is quite passive, you just receive the thing what they told you. But then in PBL we are like beginners of everything, we are the plain white paper. So we have to like fill in ourself and on the progress then we had to do a searching on ourself, and we can like do more searching on the thing that interests ourself. And if you're interested in something then you go deeply into that thing and then you will be more familiar and you are more willing to learn. And in formal lectures like they just give you everything, you just spoon feed it, and then no matter you like it or not you just like take it all. And sometimes that could be real painful. But for PBL you can pick the thing, I mean in general you still have to cover all the things, but then you can like, when you're choosing the learning usually you can pick that one that actually interests you and then you go deeply, and you will be the expert in that issue, and I think that is one thing I like PBL the most. The most important thing? How to learn by yourself. Yeah you have to, and I think it's like you're developing these learning skills by yourself because it's not easy to start a brand new concept from the very beginning all by yourself. Although we do have the scene-based session and PBL practice, but the most important part is, and the most maybe difficult, like the most difficult part is actually to like select the right information, the correct information, what are important, what are not, and to collect them, make your own notes that you can use into too. To connect different pieces of information together and then use your reasoning to make judgments and conclusions. To take the initiative, to be productive. So like in T1 we really have to be proactive and take the initiative to speak to voice out. It really like boost your confidence, if you speak more, you practice more, you will be, you'll be more confident in giving speeches. So you have been acting as a very special role in this discussion, which is the chairperson. So what is the most important thing you learn from being a chairperson in this kind of tutorial. To be considerate. Because some people like really have different backgrounds, like some people have a degrees, some people actually finished their PhD, and some people like have master degree, so those people were really dominating the discussion. But for those people that, some of them didn't really have biology background in their high school, and they can't really speak anything. I mean they have nothing inside. And so I think to be a chairperson you really have to like consider those people who have no basic background and then you can like initiate them to talk more, like what they are saying whether you think that is right or wrong, kind of thing. I think for PBL one of the most challenging aspects is that we don't know, we're not sure about what we should know, like the learning outcomes are not very clearly defined. Sometimes we don't know how deep we should investigate into this topic and how broadly. I remember when I was a first year it was difficult for me to speak in front of people because I was never used to give my own opinion as well, especially in politics you have to give a lot of your own opinions. And in PBL you were very encouraged to do that as well. So that was one of my main issues I think at the beginning. So by beginning you mean the first year? Yeah the first year when I, my first year when I used PBL. I think I would say it's to catch up. I mean... Catch up with? Catch up with everything, I mean because we do have students who don't have a biology background which means you have to learn more because other people have, the student with first degree or with the biological background, they actually have learned a lot of things beforehand. So as a student who don't have this background you have to like learn more by yourself so as to keep up with the pace. By now I hope you have your answers to all the questions asked earlier. If you have interest in exploring deeper PBL, please read the relevant articles recommended in this course.
