Small Group Learning (SGL): a PBL-based approach to teaching & learning in an integrated curriculum for a Graduate Entry Programme in Medicine

Background: Problem-Based-Learning (PBL) has emerged as a useful tool in reforming higher education and in modernizing undergraduate medical education. It is a learning process which is driven by problems from which students, split in small groups, identify and pursue their own learning needs and then reapply what they have learned to specified problems. The students go through the process following “The Seven Steps” as described by Schmidt in 1983. “True” PBL is synonymous with a problem-based curriculum, representing a comprehensive curricular strategy. In the Graduate Entry Programme in Medicine in UCC, we have introduced SGL, based on the methodology of PBL, as a central part of an integrated curriculum.Aim: To evaluate the learning benefits of SGL, using a PBL methodology, in an integrated curriculum for a Graduate Entry Programme in Medicine.Design: Forty-three graduate students, coming from different backgrounds, who started the Graduate Entry Programme in Medicine in UCC, received two days’ training in the methodology of PBL prior to commencing twice-weekly small group learning sessions. In particular, the roles of the Group Leader (GL) and Reporter were clearly defined and the importance of participation in the group highlighted. During the first session, the students used “triggers” from a clinical scenario to define their own learning needs; subsequently they did independent, self-directed study before returning to the group to discuss and refine their acquired knowledge in the second session. Assessment forms were given to the students and the facilitators at the end of the second session every week. Each GL was asked to identify2the Learning Outcomes of the clinical case and to provide a multiple choice Evaluation of the Process covering the case, the resources, and the dynamics of the group. The Facilitators were asked to provide multiple choice feedback on the roles of the leader, the role of the reporter, overall participation, and the provision of new information by the students.Results: All completed GL forms (six groups, four cases per group) indicated that the clinical cases were recognised as being related to other learning activities, the resources were adequate, and the groups worked well. There was some variability in the responses related to the cases. While no group identified a case as being “too simple”, one group felt that one case was “too complex”. Interestingly, this case was also identified as having lower “real-life” value than the others, due to the perceived rarity of the case under consideration. The facilitators uniformly rated the role of the leader and reporter highly, as well as citing good participation and input.Conclusion: PBL as a method for SGL has been implemented effectively in the integrated curriculum of the Graduate Entry Programme in Medicine. Two days’ training was adequate to bring the performance of all student groups to a “good” level, as rated by the facilitators. The performance of the leaders and reporters was also rated “good.” The PBL approach helped the students to identify the relationship between the clinical cases and their other learning activities. In summary, PBL has been used to promote efficient knowledge handling and transfer in a stimulating pre-clinical context.Acknowledgment: We acknowledge the contributions of the following facilitators: Drs. Ahmed Ahmeda, Elizabeth Brint, Ruaidhri Carmody, Patricia Chalmers, Dylan Evans, Patrick Henn, Niall Hyland, Gerard O'Keeffe, Siobhán O'Mahony, and Mark Rae.