INTEGRATIVE PROBLEM BASED LEARNING

Edward C. Klatt MD* and Andrew F. Payer PhD, Florida State University College of Medicine, Tallahassee FL 32306, U.S.A.

PURPOSE: We describe a strategy utilizing nuances of problem based learning that reduces faculty time commitment and keeps students engaged with high-level clinical reasoning for mastery of more learning objectives.

METHODS: Six PBL modules were developed for a 2^nd year pathology course. Each 4 hour module had a case with a family of 2 to 5 patients, whose different but often related medical conditions required students to work with expanded differential diagnosis sets and cover more course objectives. Each 4^th hour of a module was a combined group wrap-up session conducted by one facilitator with all students present, and called upon randomly to discuss the case. Facilitator preparation session time was reduced by 1 hour. Each module began with a quiz covering objectives in that section of the course, scored individually.

RESULTS: Students kept track of multiple patients with multiple problems, like real medical practice, and determined how patient interactions affected outcomes, reinforcing clinical reasoning. 70% more objectives were covered than in single patient PBL cases. Wrap-ups kept students more engaged and confirmed key objectives. Overall faculty facilitator time was reduced by 33% compared to traditional PBL sessions of similar length because of reduced facilitator preparation and small group participation time. Quizzes promoted individual student preparation, with performance similar to quiz scores for the entire course.

CONCLUSION: Integrative PBL encouraged student preparation, engagement, achieving objectives, and clinical reasoning, while reducing overall faculty time.