March 15, 2008, by Teaching at Nottingham

Using problem-based learning to develop critical thinking skills

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Paul Garrrud: “Another benefit of the structure we have of working through a case in three group meetings, and obviously they do quite a lot of thinking and research out with those group meetings, is that it gives them an appreciation and some experience of clinical reasoning.

“From the patient who walks in about whom you know nothing, but they’re distressed, they’re red in the face, they’ve got orangey hair, or whatever it may be, and it could be anything that’s the problem, and how do you start tackling that?”

Jane (student): “What they’re trying to get us to do, I think, ultimately, is it’s not about the answer, anyway, it is about how you get there. And I find it difficult to believe that between us all that we’ve ever gone completely down the wrong track. That would seem really unlikely.”

Thomas (student): “We do keep each other – at each other – and check as well, like you say it’s so much easier to ask each other questions, sort of thing, so when you do think “Oh, I’m not sure that’s right,” everyone is quite open to doing it.”

Jane: “We do say that to one another, we did that today.”

Thomas: “Yeah, we say ‘I’m not quite sure about this, I think it’s this’.”

Group session

Students:“So she’s basically got high liver cirrhosis and hep C. Girl’s doing well. And she’s an alcoholic. Would you call her an alcoholic?”
“Yes.”
“She drinks everyday.”
“Yeah, well, quite a few people do, though, but that doesn’t make them alcoholic.”
“Well, we need to see if she can go without.”

Interview

Jonathan Ball: “I think the main difference that certainly I see is the fact that they’re more lateral-thinking. There certainly seems to be more problem solving, they can come to their own conclusions as to what’s going on in a case, just by bringing together the various subjects that they’ll bring together in any particular PBL session.

“Physiology, anatomy, biochemistry, and you don’t find that so often when you’ve taught those subjects separately, so it’s the integration of the subject.”

Jonathan Ball (School of Molecular Medical Sciences)
Paul Garrud (Graduate Entry Medicine & Health)
Jane Litchfield (Graduate Entry Medicine & Health)
Thomas Metson-Scott (Graduate Entry Medicine & Health)

Views on the students’ approach to learning, illustrated in extracts from the PBL sessions that are the focus of pre-clinical education on the Graduate Entry Medicine & Health course. This video was originally published as part of PESL’s Teaching at Nottingham collection. Produced March 2008.

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