The Use of Problem Based Learning Method in Turkey’s Medical Schools

Öz

Introduction and purpose: Problem-based Learning (PBL) is a student-centred active educational method based on students’ use of their prior knowledge, determination and learning of needed learning objectives, elaboration and discussion of knowledge in the course of a work aiming to solve health problems. The implementation of PBL in medical education was first initiated at McMaster University in 1969 and its use spread gradually. Dokuz Eylul University School of Medicine initiated the use of PBL in 1997 as the first time in Turkey and the PBL program was later adopted by Pamukkale University School of Medicine, Ondokuz University School of Medicine and Ankara University School of Medicine. In these schools the PBL method is located at the centre of the educational program and implemented systematically. In recent years, an increasing trend to use the PBL method in the existing educational programs is observed in other schools of medicine. Method: In December 2007, a questionnaire was sent to 44 schools of medicine in Turkey to determine the frequency of use of Problem-based Learning method and to evaluate the similarities and differences in the implementation of PBL in different schools and answers from 40 schools were evaluated. Findings: Among 40 participating schools, the school using and not using the PBL method in their educational program respectively were as follows 18 (45.0%) and 22 (55.0%). When the findings of PBL method implementing schools were analyzed based on the aspects of the year/years in which PBL is used, characteristics of the curriculum, PBL tools and implementations and properties of PBL tutors; it was observed that certain implementations were in accordance with the PBL philosophy and principles, while others had different types of implementation. Conclusion: In the light of data obtained from this study, it was thought that the development of platforms to discuss PBL implementations in detail, to share experiences and to evaluate the outcomes of different implementations would be beneficial.

Anahtar Kelimeler

• Problem based learning, educational program, tutors

TÜRKİYE’DE TIP FAKÜLTELERİNDE PROBLEME DAYALI ÖĞRENİM YÖNTEMİ KULLANIMI

Öz

Amaç: Probleme Dayalı Öğrenim (PDÖ) bir senaryo temelinde saptanan sağlık sorunlarının çözümlenmesine yönelik çalışma sürecinde öğrencilerin önceki bilgilerini kullanmaları, gereksinim duydukları öğrenme konularını belirlemeleri, öğrenmeleri, bilgiyi işlemeleri, tartışmaları temeline dayanan öğrenci merkezli aktif bir eğitim yöntemidir. PDÖ tıp eğitiminde ilk kez 1969 yılında McMaster Üniversitesi’nde uygulanmaya başlanmış ve giderek yaygınlaşmıştır. Türkiye’de ilk kez 1997 yılında Dokuz Eylül Üniversitesi Tıp Fakültesi PDÖ programını uygulamaya başlamış ve izleyen yıllarda Pamukkale Üniversitesi Tıp Fakültesi, Ondokuz Mayıs Üniversitesi Tıp Fakültesi ve Ankara Üniversitesi Tıp Fakültesi PDÖ programı uygulamasına geçmiştir. Bu fakültelerde PDÖ yöntemi eğitim programının merkezinde yer almakta ve sistematik olarak uygulanmaktadır. Son yıllarda diğer tıp fakültelerinde de mevcut eğitim programının içinde PDÖ yöntemini kullanma konusunda artan bir eğilim gözlenmektedir. Gereç ve Yöntem: Türkiye’de tıp fakültelerinde Probleme Dayalı Öğrenim yöntemi kullanım sıklığının belirlenmesi ve fakültelerin PDÖ uygulamaları arasındaki farklılık ve benzerliklerin gözden geçirilerek değerlendirilmesi amacıyla Aralık 2007’de öğrenci alan 44 tıp fakültesine anket formları gönderilmiş ve 40 fakülteden gelen yanıtlar değerlendirilmiştir. Bulgular: Araştırmaya katılan 40 fakültenin 18’i ( %45.0) eğitim programında PDÖ yöntemini kullandığını, 22’si (%55.0) ise kullanmadığını belirtmiştir. PDÖ yöntemi kullanan fakültelere ait bulgular PDÖ’nün hangi dönem/dönemlerde kullanıldığı, müfredat özellikleri, PDÖ gereç ve uygulamalarına ve eğitim yönlendiricilerine ilişkin özellikler açısından incelendiğinde, PDÖ felsefesi ve ilkelerine uyumlu uygulamalar yanı sıra farklı uygulamaların da olduğu gözlenmiştir. Sonuç: Bu çalışmadan elde edilen verilerin ışığında ülkemizdeki PDÖ uygulamalarının ayrıntılı bir şekilde tartışılıp, deneyimlerin paylaşılabileceği ve farklı uygulamaların etkilerinin değerlendirileceği ortamların sağlanmasının yarar sağlayacağı düşünülmektedir.

Anahtar Kelimeler

• Probleme dayalı öğrenim, eğitim programı, eğitim yönlendiricisi

Kaynakça

1. Barrows HS. A specific, problem-based, self-directed learning method designed to teach medical problem solving skills, and enhance knowledge retention and recall. In HG Schmidt & ML De Volder (Eds). Tutorials in problem-based learning. Assen: Van Gorcum. 1984.
2. Schmidt HG. Problem-based learning: rationale and description. Medical Education 1983; 17: 11- 16.
3. Dolmans HJM, De Grave W, Wolfhagen IHAP, Van der Vleuten CPM. Problem-based learning. Future challenges for educational practice and research. Medical Education 2005; 39: 732-741.
4. Newman M. Problem Based Learning. Higher Education Academy Imaginative Curriculum Guide. http://www.heacademy.ac.uk/assets/York/documents/resources/resourcedatabase/id362_Imaginative _Curriculum_Guide_Problem_Based_Learning.rtf . Erişim tarihi: Mart 2008.
5. Schmidt HG. Foundations of problem-based learning: some explanatory notes. Medical Education 1993; 27: 422-432.
6. Dolmans DHJM, Snellen-Balendong H, Wolfhagen IHAP, Van der Vleuten CPM. Seven principles of effective case design for a problem-based curriculum. Medical Teacher. 1997; 19 (3): 185-189.
7. Davis MH, Harden RM. Problem-based Learning: A practical guide. AMEE Medical Education Guide No.15. Medical Teacher 1999; 21 (2): 130-141.
8. Wood D. ABC of learning and teaching in medicine. Problem based learning. British Medical Journal 2003; 326: 328-330.

9. Finucane PM, Johnson SM, Prideaux DJ. Problem-based learning: its rationale and efficacy. The Medical Journal of Australia 1998; 168: 445-448.
10. Koh GCH, Khoo HE, Wong ML, Koh D. The effects of problem-based learning during medical school on physician competeny: a systematic review. Canadian Medical Association Journal 2008; 178(1): 34-41.
11. Norman G. Problem-based learning makes a difference. But why? Canadian Medical Association Journal 2008;178(1): 61-62.
12. Azer S. Navigating Problem-based Learning. Marrickville, N.S.W. : Elsevier Australia, 2008.
13. Wetzel MS. Developing the role of the tutor/facilitator. Postgraduate Medical Journal 1996; 72: 474–477.
14. Distlehorst LH, Dawson E, Robbs RS, Barrows HS. Problem-based learning outcomes: The glass half-full. Academic Medicine 2005; 80(3); 294-299.
15. Musal B, Akalın E, Kılıç O, Esen A, Alıcı E. Dokuz Eylül Üniversitesi Tıp Fakültesi Probleme Dayalı Öğrenim Programı, süreçleri ve eğitim yönlendiricilerinin rolü. Tıp Eğitimi Dünyası, 2002; 9: 39-49.
16. Boushuizen HPA, Snellen-Balendong HAM, de Grave WS, Stalenhoef-Halling BF, van der Lugt P. Design of patient-cases for problem-based learning: An example of a curriculum revision. In he Klein (Ed). Problem solving with cases and simulations. Watheam MA: Bentley College Press; 1990.
17. Fyrenius A, Bergdahl B, Silen C. Lectures in problem-based learning-Why, when and how? An example of interactive lecturing that stimulates meaningful learning. Medical Teacher 2005; 27 (1): 61-65.
18. Van Berkel H, Dolmans DHJM. The influence of tutoring competencies on problems, group functioning and student achievement in problem-based learning. Medical Education 2006; 40: 730- 736.
19. Azer S. Twelve tips for creating trigger images for problem-based learning cases. Medical Teacher 2007; 29: 93-97.
20. Veale P. Prospective comparison of student-generated learning issues and resources accessed in a problem-based learning course. Medical Teacher 2007; 29: 377-382.
21. Mennin S, Gordan P, Majoor G, Osman HAS. Position paper on problem-based learning. Education for Health 2003; 16 (1): 98-113.
22. Schmidt HG, Moust JHC. What makes a tutor effective ? A structural-equations modeling approach to learning in problem-based curricula. Academic Medicine 1995; 70(8): 708-714.
23. Neville AJ. The problem-based learning tutor: Teacher? Facilitator? Evaluator? Medical Teacher 1999; 21 (4): 393-401.
24. Mclean M, Wyk VJ. Twelve tips for recruiting and retaining facilitators in a problem-based learning programme. Medical Teacher 2006; 28 (8): 675-679.
25. Jung B, Tryssenaar J, Wilkins S. Becoming a tutor: exploring the learning experiences and needs of novice tutors in a PBL programme. Medical Teacher 2005; 27 (7): 606-612.
26. Musal B, Abacıoğlu H, Dicle O, Akalın E, Sarıoğlu S, Esen A. Faculty Development Programs in Dokuz Eylül School of Medicine: In the Process of Curriculum Change from Traditional to PBL. Med Educ Online (serial online) 2002: 7: 2.