Problem Based Learning (PBL)

1. Problem Based Learning (PBL) Sylvia Parker, MS, RN November 28, 2012 University of Scranton Nsg 534: Strategies for Teaching Nursing Dr. Marian Farrell

2. Definition of PBL Problem based learning is defined in several ways, such as: Watering & Dochy (2005) described Problem based learning • An approach to learning that presents students with real life problems; • Students work in small groups to solved the “problem”. • As a result, the students develop improved critical thinking skills; • Learning process facilitated by educator (DeYoung, 2009).

3. Defined • PBL also defined as: • An educational process that centers learning around problems, unlike other courses that may be subject related and discrete (Bradshaw & Lowenstein, 2011), and • results from the process of working toward resolving a problem (Billings & Halstead, 2012).

4. PBL-Defined: Animated • http://www.youtube.com/watch?v=w-FQdaP240g&feature=related (YouTube, 2012)

5. Theoretical Framework Theoretical framework for PBL: • Has not originally been supported in literature. • Contextual learning, however, stated that PBL was superior as: students learn all content within context of problem, and recall information better, and be able to apply to real – life; clinical situations. • Colliver stated that this theory is too simple for the complexities associated with PBL. • Overall, one theory not adequate to support PBL.

6. Theoretical Framework • Other theories somewhat conspicuous to PBL, are: • Cooperative Learning Theory: Members dependent on other members of the group to reach goals; usually in small groups. • Self Determination Theory: Identifies more controlled and autonomous motivators that the learner finds enjoyable. • Control Theory: All behaviors based on 5 needs of freedom, including: freedom, power, love, fun, and survival (Bradshaw & Lowenstein, 2011).

7. Theorist -PBL Piaget (1896-1980): The theoretical framework for this strategy is based on the cognitive development theory, which indicates that goals are attained while coordination of individual feelings with feelings and views of others.

8. Theorist - PBL Vygotsky (1896-1934): Theorist Vygotsky, indicated that human development is dependent on human interaction. In this theory, Vygotsky states that human cognitive development is increased with human interaction, along with verbal discussion.

9. Theorist – PBL • David A. Kolb (1939- ) David Kolb is the inventor of “Kolb Learning Style” (Rose, C (2012). Theory: Experiential Learning, which states: -Concrete Experience (CE): Learn from actual experience. -Reflective Observation (RO): Learn/observing others. -Abstract Conceptualization: Create theories to explain what is seen. -Active Experimentation(AE): Use theories to solve problems. Kolb (1984) defines experience-based learning, an interchangeable term for PBL.

10. Kolb, Con’t • Kolb (1984) defines experience-based learning, an interchangeable term for PBL, • as a transformational learning process where knowledge is created through the • transformation of experience from concrete experience, abstract conceptualization, • reflective observation and active experimentation. The first two modes of the process are • considered grasping experiences while the other two modes are labeled as transforming • experiences. This continuum can be evolved and learners can learn at all times.

11. As proposed by Hughes Caplow, Donaldson, Kardash & Hosokawa (1997) problem based learning has multiple and overlapping theoretical foundations. The study discussed the medical school model of PBL and related the foundations of information processing theories, constructivist perspectives and co-operative learning. As illustrated in Figure 6 problem based learning is influenced by many theories, some of which overlap or are contested by theorists themselves. Theories-PBL • Models that have been used to illustrate Problem Based Learning include Interaction of various PBL theories; often not only one approach taught/used to teach. (Kylie Tootell & Denny McGeorge , University of New Castle)

12. History of PBL • Problem based learning was first devised and started in in the 1960’s at the McMaster University Medical School in This learning style was developed and implemented in response to the large amounts of information that was required to be learned, and that would quickly outdate.

13. Taxonomies Based on the Revised Bloom’s Taxonomy, implications for educating nurses includes 4 types of knowledge intended for students to learn, which can also be components of PBL: • Factual-To learn specific elements of lesson topic; • Conceptual-To analyze clinical data in practice; • Procedural-Teach general problem solving; • Metacognitive-Case study to teach sequential thinking/clinical reasoning (Su & Osisek, 2011)

14. PBL - Emphasis • Emphasis on: • Working in small groups; • Self-directed study of a “problem”; • Assistance of faculty tutor, rather than lecturer

15. Objective 1 • Learning Objective 1: Learners will understand differences between Type 1 & Type 2 Diabetes • Teaching Strategy: • Review Type 1 & 2 Diabetes materials that includes a poster review and other printed materials, as determined by the group. ; • Facilitator: Facilitator will assume the role of facilitator; answer questions, etc. • Learning outcome: Learn and demonstrated differences of Type 1 & Type 2 diabetes per patient care.

16. Learning Objective 2 • Objectives 2 : Learner will determine methods to teach patient the differences of diabetes types/patient type. • Teaching Strategy: PBL group will determine problem and appropriate process to: • Educate patient with Type 1 or Type 2 diabetes. • Facilitator will introduce patient education options, which may include 1:1 with Diabetes Educator or other methods, such as Diabetes Conversation Map. Learning Outcome: The student will learn various methods available in regards to patient diabetes teaching.

17. Learning Objective 3 Learning Objective 3: Learner will develop methods to evaluate effectiveness of patient’s learning progress. Teaching method: Determine process to evaluate the effectiveness of teachings provided to patient, such as communication, age, ethnicity, socioeconomic and other issues when the patient is evaluated. Facilitator will monitor effective evaluation methods/tools developed by the PBL group . Learning Outcome: The student will develop various processes to effectively evaluate patient diabetes education.

18. Other Teaching Strategies • Other teaching strategies, to encourage student critical can include (as appropriate): • Lecture; • Socratic questioning; • Humor; • Games; • Imagery; • Portfolio (at end of learning exercise); • Role Play; • Concept Mapping (document/track thought processes). • (PP/Class-2012)

19. PBL-Video • http://www.youtube.com/watch?v=GlZFEVxfg3k • You Tube, 2012

20. Role of Faculty-PBL • Faculty may/may not be subject experts; although combination of content and process expertise is preferred; • Others feel that faculty should be involved with subject of which they are most comfortable/knowledgeable; • Faculty require training in PBL to acquire more facilitative roles, although, according to Hitchcock and Mylona (2000) there are limited training opportunities to teach staff ways to effectively assume the facilitator role as a PBL teacher (Bradshaw & Lowenstein, 2011).

21. Student PBL Exercise • Small Group Case Study: • Diabetes Education /(Patient) • 68 y.o. African American male; • Lives alone; • States unable to complete glucose test, as prescribed; • States unable to take meds due to financial issues; • Unable to communicate/understand “basic” issues/T1 and T2 Diabetes (states the hospital nurse taught him about diabetes, “one afternoon” the day he was discharged”.

22. Student PBL Exercise Event/Problem 1: Discuss and develop process to identify effective/available diabetes education sources for the patient. What does he need to know as a newly diagnosed diabetic patient? with timeframes. Event/Problem 2: Discuss and develop process to effectively initiate diabetic teaching for this patient, with timeframes. Event/Problem 3: Develop/discuss process to evaluate and follow-up, with time-frames (Tuncer, 2007).

23. Evaluation • The problem based learning exercise will be evaluated as follows: • Did the PBL group obtain clarity on Type 1 & 2 diabetes? • Did the learning group work effectively to address the identified patient needs (diabetes education)? • Did the learning group develop effective/realistic methods to communicate with the patient? • Were the processes devised by the group to address the problems realistic?

24. PBL-Discussion • As proposed by Hughes Caplow, Donaldson, Kardash & Hosokawa (1997) problem based learning has multiple and overlapping theoretical foundations. The study discussed the medical school model of PBL and related the foundations of information processing theories, constructivist perspectives and co-operative learning. As previously stated, problem based learning is influenced by many theories, some of which overlap or are contested by theorists themselves.

25. Conclusion • Problem based learning has been found to be effective in nursing education, where simulation may be included with learning activities. However, care should be take that this learning method maybe stressful for some students who are more accustomed to “tradition” learning styles. Therefore, care should be taken to recognize the student who may experience difficulty, with supports put into place to assist this student to have a smoother transition (Bradshaw & Lowenstein, 2011).

26. Recommendations • Problem based learning may be considered as a consistent method of teaching/learning for nursing education, as a means to develop critical thinking skills. • The instructor, however, may need to determine if this method is practical for all nursing students in a given class, as certain students may not be comfortable with this method and fall behind in their learning.

27. PBL-NursingVideo • http://www.youtube.com/watch?v=GlZFEVxfg3k

28. Learning via PBL • The Motivation to Learn Begins with a Problem • In a problem-based learning (PBL) model, students engage complex, challenging problems and collaboratively work toward their resolution. PBL is about students connecting disciplinary knowledge to real-world problems—the motivation to solve a problem becomes the motivation to learn (PBL@UD).

29. Finally!! Per Captain Jack Sparrow…

30. The End! • Questions??? • Thank you!!

31. References Bradshaw, M.; Lowenstein, A (2011). Problem based learning. Innovative Teaching Strategies in Nursing and Related Health Professions, 5th Ed.; pp 137-144. DeYoung, S (2009). Activity based teaching strategies. Teaching Strategies for Nurse Educators, 2nd. Ed.; pp 151 – 155 & 226 – 232. Rose, C (2012). Communities of practice. Sandahl, S. (2009). Collaborative testing as a learning strategy in nursing education: a review of the literature. Nursing Education Perspectives, 30 (3). Su, M.W; Osisek (2011). The revised bloom’s taxonomy: implications for educating nurses. The Journal of Continuing Education in Nursing, 42(7). Tuncer, D (2007). American diabetes association … to transform diabetes education. American Diabetes Association.

32. References • You Tube 2012: Problem based learning-brief introduction. • You Tube 2012: PBL with Nursing Students • Google: Captain Jack Sparrow/Problem Photo