Problem-based learning

To supplement your studies, and help "ground" some of the more apparently academic concepts in physiology, we will be considering a number of "cases". Some of these are real cases, some are constructed especially for this exercise. Occasionally we will mention a possible treatment regime, which you may well consider to be ill-advised, old fashioned or downright impracticable. This is deliberate, and the treatment regime will have been chosen because it highlights a particular problem.

Please do not assume that a clinical treatment suggested here is going to be the best course of action for one of your patients.

You will be discussing several of the cases in small groups, and we would like to suggest a particular technique for approaching the problems, which is very well tried, tested and researched.

Roles within the group

Each time your group meets to discuss a case, you will need to elect a "scribe" to document the proceedings on a flip chart or white board and summarise the main points. You will also need to elect a Chairman, whose job is to ensure that the process outlined below is actually followed, and followed carefully. The jobs of Chairman and scribe should be allocated to someone different at the beginning of each session, so that everybody has a chance of doing each job more than once.

Role of the Tutor

You will usually have a tutor observing the discussion. They are not there to give you physiological information, and they will not. They are simply there to facilitate the group process. They know the case well, and in some cases will have the answers to particular questions (e.g. the results of any blood tests which you might think necessary). It is important that you find the answers for yourselves, even though this might seem frustrating at times. If they think that you are going completely down a blind alley they may try to guide you back to the substance of the problem, but in most cases you will probably learn more from exploring leads which you find interesting. Remember we have no syllabus to speak of, we are simply trying to increase your breadth of understanding of physiology.

The "Seven Step Process"

  1. Clarify terms and concepts that are not clear in the written case study.
  2. Define the problem/problems. As concisely as you can given the information to hand
  3. Analyse the problem. Brainstorming - write down all the ideas that crop up, no matter how far fetched or implausible. It is a general rule not to comment about ideas during the brainstorming session - that comes later. You want as large a number of possibilities written down as possible.
  4. List the possible explanations that resulted from 3 above.
    This time sift through the possibilities systematically. Link concepts that fit together, try and see if there are relationships between ideas. Discard ideas only if they are totally insane (bearing in mind that penicillin came from a mistake....).
  5. Formulate learning objectives and set priorities.
    What will you need to find out before the next session in order to solve the problem? Is there anything that you think that you should know, which you have perhaps forgotten in the mists of time? Is there something that you never quite understood? Many problems will have more than one dimension, don't forget that, but make sure that at least some of your time will be spent on physiology!
  6. Look for additional information outside the group.
    You have the workbooks, your textbook, perhaps colleagues who are likely to be able to help. You can also contact Dr Terry L. Gleave (tlgleave@liverpool.ac.uk, or telephone for an appointment, 0151 794 5352) for help with specific questions - but please make sure that they are specific questions rather than "what is the right answer to this case study..."
  7. Report back (do NOT speak from notes), synthesise and test the information.
    Usually this will be at the next timetabled session, and will be the time when you gather everything together and realise how easy it was. Occasionally you will want to know further information, and will have another bite at the cherry before finalising your solution. If you feel that it would help, it is quite in order to meet your colleagues in the group outside "physiology time" you don't necessarily need a "tutor" with you.

Finally