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Cited by 37Problem and Project Based LearningInnovations in Medical EducationBiomedical and Engineering Education

A model of clinical problem‐based learning for clinical attachments in medicine

Macallan, Derek C, Kent, Andrew, Holmes, Sandra C, Farmer, Elizabeth A, McCrorie, Peter·2009·Medical Education
DOI 10.1111/j.1365-2923.2009.03406.x
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Abstract

Context Problem‐based learning (PBL) has been widely adopted in medical curricula for early‐years training, but its use during clinical attachments has not been extensively explored. Objectives This study aimed to develop and evaluate a new model, ‘clinical problem‐based learning’ (CPBL), to promote learning skills, attitudes and knowledge during clinical attachments. Methods The CPBL model takes the principles of PBL and applies them to learning during clinical attachments. Real patient encounters are guided by a list of broadly defined case types to ensure curriculum coverage. By discussing history taking and examination in the context of differential diagnosis and problem listing, students generate learning objectives relating to clinical skills, disease mechanisms and clinical management. These are explored through self‐directed learning before the second tutorial, in which the tutor takes the role of ‘expert’, demonstrating how learned material translates into clinical practice. We evaluated which components contributed most to the success of the model using semi‐structured questionnaires, focus groups and a consensus (Delphi process) method. Results Students found CPBL a positive learning experience. Identification of suitable cases for discussion was readily achieved, although follow‐up was sometimes difficult. The tutor’s level of expertise and a non‐threatening learning environment, conducive to student questioning, were highly rated contributors to successful CPBL. Comments reinforced the view that CPBL is a parallel teaching approach that helps structure the teaching week, but does not replace traditional bedside teaching. Conclusions Clinical problem‐based learning was well received in clinical placements. Key elements were the learning interval, the involvement of expert tutors and a non‐threatening learning environment.

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Authors
Macallan, D. C., Kent, A., Holmes, S. C., Farmer, E. A., & McCrorie, P.
Affiliations
  • University of London (GB)
  • St George's, University of London (GB)
  • University of Wollongong (AU)
Corresponding author
Macallan, Derek C
ORCID
Macallan, Derek C
Venue
Medical Education
Publisher
Wiley
Published
2009-07-20
Volume
43
Issue
8
Pages
799-807
ISSN
  • 0308-0110 (ISSN-L)
  • 1365-2923
DOI
10.1111/j.1365-2923.2009.03406.x
OpenAlex
W2102707291
Cited by
37
References
29
Citations by year
2025: 1 · 2024: 1 · 2022: 2 · 2021: 2 · 2020: 5 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 1 · 2012: 5
FWCI
14.05
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Medical Education (publishedVersion)
  • PubMed (publishedVersion)
  • Research Online (University of Wollongong) (submittedVersion)
Topics
  • Social Sciences › Education › Problem and Project Based Learning
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Physical Sciences › Engineering › Biomedical Engineering › Biomedical and Engineering Education
Keywords
problem-based learning, clinical attachment, clinical practicum, medical history, physical examination, differential diagnosis, self-directed learning, learning environment, student attitudes, curriculum development
MeSH terms
Clinical Competence, Curriculum, Education, Medical, Undergraduate, Educational Measurement, United Kingdom, Humans, Statistics as Topic, Students, Medical, Problem-Based Learning

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