Problem-Based Learning Modules
Problem-Based Learning case studies are divided into four modules, one in each preclinical semester. The first module comprises two case sequences of ten cases in total. Each of the following three modules comprises three sequences, each of six to eight cases. On completion of the study of each of these case sequences, an examination, in the style of the medical licensure boards, is given to test the students’ knowledge and understanding of the learning issue material that they elected to study in association with each case in the sequence.
The PBL cases are based upon real patient cases. The information concerning the patient will be progressively disclosed to the students, on their request, as they work through the case from patient presentation to diagnosis and case management, as detailed below.
The PBL Group Sessions
The study of each PBL case is generally completed in two group sessions. At the commencement of a PBL case study, all group members are given the age, gender and chief complaint of the patient. One student plays the role of patient and is given full details of the patient history. Another student plays the role of physician, interviewing the “patient” to obtain the history, and then obtaining the results of a physical examination from the facilitator. The student group, by now, should have drawn up a range of differential diagnoses — although, before they gain experience, this may be merely a list of possible affected body systems. They then proceed as a team, to decide what additional information is required in order to understand the patient’s problems, and request various further data from laboratory tests, or diagnostic procedures. The appropriate information is progressively disclosed by the facilitator in response to these requests. This information may be in the form of tabulated data from laboratory tests or, for example, a radiograph or an EKG. (To facilitate this process, early in the program the students are made familiar with diagnostic procedures and their applications, interpretation of EKGs, and radiological imaging, etc. PBL students also undertake courses in history taking and physical examination of patients throughout the preclinical years.)
Between the group sessions, students engage in independent study, individually or in groups, addressing the learning issue material assigned by the group, and seeking further insight into the case in order to bring new information back to the table for the next meeting.
When the group meets for its next session, one student briefly presents the patient case as one would on hospital rounds. In light of new information brought to the table, the students approach the case again, listing new ideas, and formulating new hypotheses and learning issues, as more case information unfolds, until the definitive diagnosis is reached. The students must be mindful that, whilst achieving the definitive diagnosis heralds the completion of the case study, this is not the primary purpose of the exercise, which is to employ the case as a vehicle for learning. The broader goals of the PBL modules are to learn and understand the medical sciences underlying the cases, and to appreciate their integrated relevance in the clinical situation. Consequently a rapid progression to diagnosis is not to be equated with success.
At the conclusion of each case, a final list of learning issues is agreed upon by the group and is submitted to the PBL administration. These learning issues (chapters or sections of required textbooks) define the material on which each PBL examination is constructed at the end of each set of PBL cases. The PBL examinations are written in the style of the medical boards, and comprise mostly multiple choice questions, with occasional sets of matching questions.
At the conclusion of each session, there is a brief, round-table wrap-up, when the students indicate what they have found to be valuable in the session, and at the conclusion of each case, students evaluate the case-study experience. On two occasions through the study of each set of cases, a more comprehensive, group oral evaluation occurs, when each member of the group evaluates the performance and contribution of every other member over the course of the preceding sessions.
All faculty members may be consulted outside PBL sessions, and supplementary enhancement may also be available, on request to the PBL director, through occasional workshops or enrichment sessions.
On the Erie and Seton Hill campuses, orientation workshops are also incorporated into the first PBL module in areas such as those listed below, whilst on the Bradenton campus these experiences are part of the PBL program.
- Laboratory Tests and Diagnostic Procedures
- Interpretation of EKG
Student Assessment in PBL Modules
In the PBL component of the program, there are two examinations in the first semester and three examinations per semester thereafter. Cases are studied in groups of up to eight. Each group of cases is followed by an examination that tests knowledge and understanding of the learning issues relating to every case in the group. A small, additional component of the student assessment is derived from evaluation of the students’ performance in PBL tutorial sessions.
Early Clinical Experience
From the first semester of the program, PBL students learn patient history evaluation and physical examination techniques in class, and gain clinical experience with standardized patients under the guidance of clinically experienced preceptors. They then apply this experience in clinical settings, such as physicians’ offices and hospitals, during preceptorships in year two, and later during clinical rotations in years three and four.
Osteopathic Principles and Practice
LECOM students study and are guided in the basic philosophy, principles and practice of osteopathic medicine throughout the preclinical program. This hands-on diagnosis and treatment provide the foundation of osteopathic, whole-person health care.
Although more than 60% of the pathway program is delivered by PBL, it is accepted that some aspects of medical education may require a different or modified approach. Consequently, other courses, such as those in the following list, involve more didactic or directed learning. Some are primarily lecture-based; others may involve computer-based, directed study.
- Anatomical Sciences (Gross Anatomy, Embryology and Histology)
- Introduction to Biostatistics and Research Methodology
- Geriatric Medicine
- Healthcare Management
- History and Physical examination
- Human Sexuality
- Medical Jurisprudence
- Medical Spanish
- Osteopathic Principles and Practice
- Preclinical Review
- Public Health and Preventative Medicine
The following topics also necessitate more personal, hands-on instruction.
- Advanced Cardiac Life Support
- Basic Life Support
- History and Physical Examination
- Ophthalmic Examination
- Osteopathic Manipulation
- Sensitive Patient Examination
- Standardized Patients/Skills Laboratory