October 20, 2011

Today’s Case: Problem-Based Learning

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One of things that people in the veterinary profession ask me when I tell them I go to Cornell is, “So how do you like that problem-based learning?” Problem (or case)-based learning is a teaching style in which students are put into small seven-to-eight-person groups called tutor groups with one instructor (the “tutor”) and work their way together through a clinical case page by page. The first page might introduce the case — for example, a seven-year-old female spayed Labrador Retriever hasn’t eaten or defecated for the past two days. The group spends some time discussing this page and writing down important facts, hypotheses, questions, etc. on a whiteboard (like in House!). During this process, several “learning issues” come up — things that the group isn’t clear on and will need to research. For example, what is the path of food down the gastrointestinal tract and where might there be a blockage? You’re not allowed to flip to the next page in the case until the previous page has been thoroughly discussed, and we usually go through four to six pages in each two-hour session. At the end of the session, we go home and research the learning issues and spend a good amount of time talking about them at the beginning of the next session before getting back to the case. The tutor simply acts as a facilitator, making sure that the group stays on the right track and answering simple questions.I’m sure you can see the appeal of this system — instead of sitting in an auditorium for two hours being lectured about the anatomy of the G.I. tract, you learn the anatomy by exploring it on your own in a practical context. Vet school curricula range from using problem-based learning almost exclusively to not using problem-based learning at all. Cornell supplements problem-based learning with traditional lectures, but my impression is that it uses more problem-based learning than most other vet schools that mix the two techniques. Problem-based learning is important enough in Cornell’s curriculum that people ask questions like the one I opened this column with, and during the welcome weekend accepted students are put into mock tutor groups so that they can figure out if they think they can learn effectively with problem-based learning.In practice, I don’t know if problem-based learning lives up to all of its hype. There are a few issues inherent in it that would be extremely difficult to work out. The one that you hear about the most is incompatibility between group members, but I haven’t actually seen that one happen.  Everyone (both in my group and from what I’ve heard about other groups) respects each other enough that they’re able to work well together. The tutors rotate every couple of weeks, and the teaching styles of the different instructors can actually be more jarring to the group dynamic than the group members themselves. The biggest problem I’ve found is that the resources available to solve the learning issues we come home with at the end of the day are too broad. There aren’t assigned course books, just “suggested references,” so you never really know how much detail to go into with your research or even where to start. Essentially, you’re taking 100 extremely high-functioning students and putting them in a library and telling them to know everything about a topic. You want to look at everything but at the same time can spend hours looking at just one book.I know it seems a little odd that I’m complaining about having too many resources. But when it comes down to it, you only have a few hours to get the work done and a million other things that you definitively know you need to study, and this is where the beauty of problem-based learning gets lost a little bit. Instead of taking the time to sit down and really understand what you’re researching, it’s easy to say, “Oh I’m just going to look this up now and then sit down to really understand it after we’ve talked about it in tutor group and I know what’s important.”At the same time, I’m sure educational psychologists would tell you that just the process of going through books and looking things up has a positive impact on your ability to retain information, especially when you then get to talk about those things in tutor group and hear about them in lecture and dissect them in lab. And tutor group is a fun process — we get to learn how to think like real veterinarians from day one, if nothing else. But I don’t think it’s the problem-based learning that makes Cornell’s program so strong, even though that’s implied sometimes. You can learn well here even if you don’t like problem-based learning, because really it’s the remarkable faculty and the integrated curriculum that drive the program.

Nikhita Parandekar ’11 is a first-year veterinary student in the Cornell College of Veterinary Medicine. She may be reached at nparandekar@cornellsun.com. Hoof in Mouth appears alternate Fridays this semester.

Original Author: Nikhita Parandekar