the Bell - St. Martin's Episcopal School

6
In support of
Problem Based Learning
What has been will be again,
what has been done will be done again;
there is nothing new under the sun.
(Ecclesiastes 1:9).
Surely even the Greeks knew that their educational theories
and styles were already ancient when they first employed them.
The small forum on an Athenian hilltop with Socrates eternally
asking questions was almost certainly only a very early recorded
example of what had passed for education in the even more
ancient societies. So it is nothing new to discuss problem based
learning. It has been with us from antiquity, but it is certainly
experiencing a much needed revival within the broad frame of
educational philosophies.
For me, problem based education occurs within the context
of medical education, but it is practical, relevant, and applicable
in most fields of educational activity. Specifically, many medical
institutions are introducing first year medical students to problem
based learning to assure a prompt integration of even early and
rudimentary medical learning into the whole process of assembling
and analyzing data, proposing diagnoses, testing and treatment.
When one meets with a group of freshman medical students
to undertake this task, the daunting problems of problem based
learning are immediately apparent. It is slow, very time consuming,
teacher or instructor intensive, and therefore a rather costly
form of education. However, the great advantages are equally
apparent: learning builds on previous learning and experience;
inference, reasoning, judgment are heavily used, emphasized
and rewarded when they lead to correct decisions and solutions;
common sense is highly valued; research to assure that inference
and reasoning are based on facts if known is de riguer; and the
learner achieves a great sense of accomplishment in knowing
that he has taken a major role in his own educational process.
An example: the student is only in the first quarter of medical
training, but a first unit of problem based learning presents a
young male with pallor, tachypnea, lethargy, and tachycardia.
First, does the student already know these terms (the patient is
white, short of breath, tires easily, and has a rapid heart rate)? If
not we are building medical vocabulary. Surely even a rudimentary
knowledge of the human condition would suggest anemia
to most. Now we are off: why is he anemic, how would we prove
it, what might cause it, how do we treat it? Those are the questions
the students must answer to solve the problem. The answer
should be sought individually, together within the group, through
research, study, or even recourse to perhaps older and wiser
minds.
Problem based learning cannot be used as an exclusive tool,
but it is powerful when used adjunctively. Let me close with an
anecdote based on the protocol above. In the actual description
introducing our “anemic” patient, he was described as pallid.
Some of the first year students were a little unsure of the meaning.
To reinforce the learning point, I directed the students to an
entirely different field of study and asked all to find within one
week a line of poetry “Perched upon a pallid bust of Pallas”.
When the week had passed, the group spokesman informed
me that the obvious use of alliteration had lead them immediately
to the works of Edgar Allan Poe, enabling them to correctly
identify this as a line from The Raven. I was greatly gratified with
their correctness and the deductive reasoning that had lead to
the solution. However, as the hour ended the same young student
sheepishly admitted that Google had actually supplied the answer
within seconds. But the great revelation of this problem solving
was that one can drop one word successively from that line,
reserving only the word pallid to the last, and Google will continue
to correctly suggest that you are seeking a line of poetry from
Poe’s poem, The Raven.
The lesson(s): Problem based learning works; not one of
those students will ever equivocate about the meaning of pallid
again. They found the answer, they learned the lesson, and they
solved the problem using the ever more powerful research tools
of the modern world. And it is obvious the teacher was taught,
too.
Robert M. Arensman, M.D.
Chicago, Illinois, November 2009
Member of St. Martin’s Board of Visitors and Parent of Alumni