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Explore impacts of neoliberal policies on rural health, using Problem-Based Learning to understand challenges and solutions for aging populations and limited resources.
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Applying problem based learning to studying rural health care provision Dr Sarah Lovell
The Problem • Neoliberal restructuring and urbanisation are among the process of change producing unique health pressures for rural regions • Specifically: • Populations are ageing more rapidly in rural areas • Closure of rural hospitals • Expectation the voluntary sector will ‘fill the gap’ left by the withdrawal of state funding • Volunteers are also ageing • Limited support for ageing in place
Learning Outcomes • Identify the changing demographics and health care needs of rural populations • Understand the implications of rural health service restructuring • Demonstrate how theories of change may be applied to a rural case study
Pedagogical Inspiration • Problem-Based Learning (PBL) an approach widely used in medical schools internationally • Students work in groups to work through a process of setting goals and identifying ‘triggers’ • Learning ‘triggers’ lead to further self-directed study; on returning to the group further discussion allows students to learn from each other • Team work and problem solving are amongst the skills learned through PBL • The approach is rated well by students who experience control over the learning process • A level of competence in the subject area for problem solving to be an effective mode of learning
PBL Tutorial Process • Step 1 Clarify terms and concepts not readily comprehensible • Step 2 Define the problem • Step 3 Analyse the problem • Step 4 Review steps 2 and 3 and arrange explanations into tentative solutions • Step 5 Formulate learning objectives • Step 6 Private study (all students gather information related to each learning objective) • Step 7 Group synthesises and tests newly acquired information
Field trip preparation • Constraints: 40 students, one day field trip, group-based work. • Preparation: background lecture, students provided with key readings on the following topics • What are the implications of population ageing for rural health care provision? • How has health care restructuring changed the landscape of care in rural places? • How has the process of deinstitutionalisation impacted Hanmer Springs? • Working in groups, students choose one of the above topics, carry out background readings, supplementary research and devise questions for key informants giving them insight into the case study
Discussion • Student learning is evaluated through group presentations where they are asked to demonstrate linkages between theory and the case study • Challenges: Group work, freeloaders and lack of community feedback • Problem-based learning requires students set their own learning goals and instigate problem-solving themselves • Challenges: the short time frame and lack of prior knowledge of the topic compromises this process • The field trip is an effective solution for student demand to engage in real world problem solving and lecturers prioritising acquiring content knowledge