curriculum research

Proposal abstract: Case-based learning in undergraduate physiotherapy education

Abstract for a project I submitted earlier this week for ethics clearance. During 2012 – 2014 we converted one of our modules that runs in the 2nd, 3rd and 4th year levels from a lecture-based format to a case-based learning format. We are now hoping to have a closer look at whether or not the CBL approach led to any changes in teaching and learning behaviours in staff and students.

Case-based learning (CBL) is a teaching method that makes use of clinical narratives to create an authentic learning activity in which students navigate their way through complex patient scenarios. The use of CBL in a health professions undergraduate curriculum attempts to convey a multidimensional representation of the context, participants and reality of a clinical situation, allowing students to explore these concepts in the classroom. While the implementation of CBL has a sound theoretical basis, as well as a strong evidence base for use in health professions education, there are challenges in its effective use that are not easily resolved. However, if it can be shown that the approach leads to changes in teaching and learning practice, which enhance student learning, providing additional resources to resolve the challenges can be more strongly justified. This project therefore aims to determine staff members’ and students’ perceptions of CBL as a teaching method, and to find out how it influenced their teaching and learning behaviours.

This study will make use of a mixed method research design in which the experiences and perceptions of student and staff members are used to determine whether or not there was a change in their teaching and learning practice. Qualitative and quantitative data will be gathered using a survey of all students in the population, focus group discussions of students and in-depth interviews of all staff in the department. The survey will determine if the design of the CBL approach led to a change in what the students did. The focus group discussions will gather data on the nature of the changes and the underlying rationale for those changes. The interviews with lecturers will be conducted in order to delve more deeply into whether or not lecturers’ teaching behaviours changed, and again, to explore the underlying rationale of those changes.

The survey will make use of a self-developed questionnaire that will gather quantitative data using Likert scales and other closed-ended questions. The survey will be sent to all 3rd and 4th year students in the 2015 academic year. The same students will be invited to participate in the focus groups, and the researchers will make use of purposive sampling to allocate volunteers into two focus groups in each year level. All lecturers in the department (n=10) will be invited to participate in the in-depth interviews, including those who were not directly involved in the implementation of CBL. In addition, we will also invite ex-staff members who were involved in the process, as well as postgraduate students who assisted with student facilitation.

Qualitative data will be gathered during the focus groups and interviews. This data will be interpreted via the theoretical frameworks used in the design of the CBL cases. The focus group discussions and interviews will be conducted in English and recorded using a digital audio recorder. The audio files will be sent for verbatim transcription and the anonymised, transcribed documents will then be sent to participants for verification. The transcripts will be analysed thematically, coding the data into categories of emerging themes. Trustworthiness of the analysis will be determined through member checking and peer debriefing and participants will be given the opportunity to comment on whether or not the data was interpreted according to what they meant. The transcribed verbatim draft will be given to colleagues who were not involved in the study for comment.

curriculum learning

Case-based learning


It is useful to think of case-based learning (CBL) as a teaching method that uses a set of events unfolding over time to stimulate an activity (Shulman, 1992). In clinical education cases make use of clinical narratives to create an authentic learning activity. CBL represents an approach to unstructured learning that can nonetheless be scaffolded in the sense that students choose the details of what they want to explore, while the case designer chooses the broad themes that must be covered. It is therefore an attempt to convey a balanced, multidimensional representation of the context, participants and reality of a clinical situation.

Cases are based on complex clinical situations or problems that should aim to stimulate discussion and collaborative groupwork among students (Flynn & Klein, 2001). They usually involve the interactive, student-centred exploration of those problems while being guided by facilitators. Since the cases are complex, students must analyse them as they try to resolve problems and answer questions that have no single, or simple, correct answer.

Case-based learning reduces the likelihood of students constructing inert knowledge that is decontextualised from how that knowledge will be used in the real world. If the case is an accurate representation of what can be expected in the real world, then the knowledge produced is more likely to be of use when they encounter similar events in the clinical context.

Benefits of CBL

CBL offers the following advantages (David, 1954; Flynn & Klein, 2001; Herreid, 1997; Lombardi, 2007):

  • It provides students with authentic situations in which to explore and apply a range of behaviors and information that can strengthen the learning of knowledge that transfers between different situations.
  • When students participate in the analysis and discussion of alternative solutions they come to better understand difficult or complicated issues and analyse them more effectively.
  • The emphasis on the process of decision making requires students to synthesise information from a variety of disciplines and subject areas.
  • Students can use the case as a base from which to launch their own, personally meaningful investigations into a topic or theme.
  • New technologies and resources can be integrated in order to solve problems. The use of images, video, audio and collaborative writing platforms can enhance the case, increasing the authentic context that promotes deep learning.
  • Cases can help students develop multiple perspectives, as opposed to hearing about patient management from only one point of view (usually the lecturer’s). Cases emphasise the value of interdisciplinary and collaborative approaches, skills that are increasingly important in health care systems.
  • In the process of finding solutions and making decisions through collaborative group work, students must sort out factual data, apply analytic tools, discuss issues, reflect on their experiences, and draw conclusions that can be related to new situations. Through this, they develop analytic, collaborative, and communication skills that are essential for the clinical context.
  • Cases provide students with the opportunity to see how to apply theory in practice. This can lead to graduating students who are more engaged, interested, and involved in the clinical environment.
  • CBL develops students’ skills in group learning, public speaking, and critical thinking.
  • Cases can be used effectively with both large and small classes or groups.

In summary, the benefits of using CBL in the classroom can lead to the development of knowledge that is not decontextualised, as well as skills that are relevant for working as part of multidisciplinary clinical teams.

Theoretical foundations of CBL

Collins (1988, pg. 2) described the idea of “learning knowledge and skills in contexts that reflect the way they will be used in real life”, as situated learning and cognition. When decontextualised material is presented to students (as it is during a lecture), they have difficulty deciding how to integrate that knowledge into their practice i.e. to bridge the gap between the classroom and clinical spaces. Being able to use information effectively requires that students learn it in the same, or similar, contexts as those in which they will be expected to use it. When knowledge and context are separated, knowledge is seen by learners as a product of education, rather than a tool to be used within dynamic, real-world situations. Authentic learning positions the task as the central focus for authentic activity, and is grounded in the situated cognition model (Brown et al, 1989; Herrington, Oliver & Reeves, 2003). In other words, meaningful learning will only take place when it happens in the same social and physical context in which it is to be used.

In addition, to situated learning and authentic learning, CBL also draws on elements of constructivism, in which students actively work to construct their own meaning from the learning opportunities presented to them. No matter what the intention of the teacher is, if students do not engage with the learning experience, they will have difficulty integrating the concepts that the teacher is presenting (Prideux, 2005). Social constructivism builds on this concept still further, and suggests that meaningful knowledge is only developed through discourse with a more knowledgeable other (Vygotsky, 1978). The teacher (or more experienced peer) helps guide the student through the zone of proximal development, the conceptual distance between what the student can do alone and what they can only do with the assistance of another (Vygotsky, 1978).

It is clear then, that CBL as a teaching and learning method has significant theoretical support, offering more than a practical framework for the design of classroom activities. It is an approach that helps students develop the ability to apply abstract concepts and ideas to clinical situations, in an authentic context that leads to personally meaningful learning.

Common characteristics of cases

While cases can cover a broad range of topics, patients, conditions and environments, most effective cases have the following generic characteristics (adapted from Dolmans et al., 2009; Flynn & Klein, 2001; Herried, 1997; Wasserman, 1994):

  • Content should be closely aligned with one or more of the overall learning objectives for the course or module.
  • They tell a story and focus on a current issue that arouses interest. It should draw the reader into the story and enhance interest in the subject matter, helping to sustain discussion about possible solutions and encourage students to explore alternatives. The ending of the narrative could be open-ended, allowing students to develop their own conclusions.
  • It should be well-written and appropriate for the level of the students and could include direct quotes, using the characters’ dialogue to tell the story. It should be compelling and create empathy with characters, aiming not only to make it more engaging but because the attributes of the characters can influence the decisions that students make.
  • Include situations that students know about or are likely to face, therefore making it worth their while to complete. The content should adapt well to their prior knowledge and contain cues that stimulate them to use that knowledge.
  • Stimulate self-directed learning by encouraging students to generate their own learning outcomes and conduct literature searches in order to answer research questions that they come up with themselves.
  • Should provoke conflict and force decision-making, clearly presenting the dilemma but not resolving it. Include conflict or ambiguity so that students do not agree on the outcome, encouraging compromise and decision-making.
  • Collaboration and cooperation should be encouraged, rather than competition.
  • The case should be short. It is easier to hold someone’s attention for brief periods than long ones.

Designing effective cases

Before beginning to design the case, it’s important to determine what the objectives of the case will be. Begin by explicitly stating the purpose of the case and what specific knowledge and skills you’re trying to develop in the students (Dent & Harden, 2005). Provide some background for the case by inserting it into a larger health system context, which serves to inform students why they are going to be working on this particular case and why it is appropriate for them as part of their training. By making it more relevant, they are more likely to actively engage with it. Learning outcomes might need to be changed in order to reflect the idea that the knowledge gained should be used as a tool as part of a process, rather than an end in itself. In other words, it’s not enough to know a series of facts, but rather how those facts can be applied to solve real-world clinical problems. Designing authentic tasks is challenging, and readers are encouraged to review Authentic Learning as a framework to guide this process (Herrington, Oliver & Reeves, 2003).

It is useful to design cases that based on actual patients, which serves to increase its authenticity, as well as leaving less room for error (Marks & Humphrey-Murto, 2005). Place less emphasis on the volume of content to be covered and spend more time designing cases that facilitate the development of critical thinking and clinical reasoning. Pay attention to preparing resources for the case, including artefacts like policy documents, X-rays, referral letters, research papers, readings from textbooks, images of real patients, and videos. The range of materials is enormous and depends on the level of the students, complexity of the case, the creativity of the case designer and objectives of the module. These resources should be as authentic as possible in order to reduce the cognitive dissonance experienced by students when the classroom context is logically inconsistent with reality.

It should be noted that the key to success is the quality of the small group discussion, which is an integral aspect of CBL (Christensen 1987; Flynn & Klein, 2001; Wetley, 1989). Without the discourse associated with exploring new territory, students will not have the opportunity to analyse, generate and evaluate solutions, solve problems, or make decisions. These are the types of learning activities that give students an active role in the learning process, thereby helping them to develop and improve their higher-order thinking abilities. The content of cases and the process of discussion are therefore inseparable in CBL and designers should ensure that reasonable time is allocated for this activity.

Generic content, or content that is relevant across a wide range of contexts, should be included in multiple cases in order to show students the different ways it can be used. For example, hypertension is a concept that is relevant for a range of cases that could involve heart disease, amputation, stroke and maternal health. The same is true of professional ethics, which can be explored across a diverse range of cases. In this way, the student is introduced to the idea that information can be used in many different ways, and that knowing the facts is less important than knowing how those facts can be used to solve problems in different contexts.

Finally, a multi-disciplinary team approach is recommended when designing cases. This has several advantages, including the increased likelihood of catching errors, more creativity, better resources, the inclusion of domain-specific expertise and ultimately, a more authentic case.

Preparing students for CBL

If this is the first time students are faced with CBL they will most likely have a few concerns. These can include the fact that they will be more responsible for their learning, the realisation that they are covering less content than friends from other classes or institutions (who are not using CBL), and general anxiety because the approach is new to them. These concerns can be addressed by discussing with them (as many times as necessary) the benefits of using CBL. You can also use one session to guide them through the process of completing a case, possibly with a topic that isn’t formally included in the course, to take the pressure off of getting the “right” answer.

While we may like to think that our students are capable of working collaboratively in groups, we often find that they work cooperatively as individuals. They split the work into smaller chunks and then assign those chunks to people in the group with one person taking responsibility for combining all the pieces at the end. The problem with this is that no single member of the group actively works on the project as a whole. Even the person who combines it all is only acting as an editor, giving a consistent aesthetic and voice to the content. Without actively engaging with all of it throughout the process, this form of cooperative groupwork has little value in CBL. Therefore, students will have to be taught and guided through a process of collaborative groupwork, including how to allocate roles, what those roles should be, how to negotiate group norms, setting consequences for failure to comply with group norms, resolving conflict, reporting what is learned back to the group and a host of other skills necessary for effective groupwork.

Designers should aim to create a space in the module for students to share and discuss their concerns, helping them to resolve any issues that arise. As they become more experienced with working in groups students will begin resolving their own problems.

Working through a case

Working through a case usually involves the following problem-based approach, although the specific steps used will likely be an adaptation of this. The following structure (or some variation of it) is usually used by groups when working through a case.

  1. One person reads the case out loud for the group.
  2. The group members identify words and phrases they don’t understand.
  3. They confirm what they do understand, and ensure that they all have the same understanding.
  4. Identify the clinical or functional problems (depending on the objectives of the case) that may arise as a result of the information presented.
  5. Brainstorm possible causes of the problems, taking on board every suggestion no matter how unlikely. This needs to be a safe space for students to be OK with sharing openly and without judgment.
  6. Structuring and hypothesis: students begin to systematically and logically explore relationships between concepts, narrowing down possible causes of the problems identified. They should create a list of statements that look something like “We believe that….because of….”
  7. Generate research questions in order to fill in the gaps in understanding and to “prove” the statements that they have made.
  8. Conduct research in order to find evidence to support (or refute) the statements.
  9. Finish with a set of notes that: i) Define words and phrases relevant to the case. ii) Present problems the patient is likely to have, possibly using the International Classification of Function (ICF), or another outcome measure that they would be expected to use in the clinical context. iii) Highlight relationships between clinical presentation and functional problems, supported by evidence. iv) Document the appropriate assessment and management of the patient. v) Note that the items presented above would vary significantly depending on the type of case, and the learning outcomes described at the outset.
  10. At the next session, each member of the small groups present to each other within the small groups. The purpose of this is to consolidate what has been learned, clarify important concepts and identify how the group is going to move forward (if the case is still not complete).
  11. At the end of each week each small group presents to the larger group. This gives them the opportunity to evaluate their own work in relation to the work of others, to make sure that all of the major concepts are included in their case notes, and the opportunity to learn and practice their presentation skills. Students could also be expected to evaluate other groups’ work.
  12. Note that students may begin moving between steps as they develop their clinical reasoning skills, which is only a problem if the process becomes one of unthinking, rote behaviour, in which case completing the activity will not have the desired impact on critical thinking.

In addition to the more detailed steps listed above, students could also use a simpler, six step IDEALS approach when working through a case:

  1. Identify the problem (What is the real question we are facing?)
  2. Define the context (What are the facts that frame this problem?)
  3. Enumerate the choices (What are the plausible actions?)
  4. Analyse the options (What is the best course of action?)
  5. List reasons explicitly (why is this the best course of action?)
  6. Self-correct (What did we miss?)

Using the questions above, they begin to get a sense of the case and what it is about as well as situating themselves and their prior knowledge within that context. They identify the basic concepts and questions that will serve as a basis for progressing through the rest of the case. This approach helps to create a broad outline for the case before delving into the more complex aspects. For very simple cases students can also be guided by the following questions:

  • What do I know that will help me to solve this problem?
  • What do I think I know that I’m uncertain of?
  • What don’t I know that I need to learn more about?

A typical case is designed to be integrated with small group learning. However, it is also possible to create shorter, less complex cases that can be resolved independently as part of self-study. Note that students will need to be quite motivated to work through cases alone and the facilitator should still be available for short discussion and guidance. Remember that cases are a type of formative learning experience, where the process of working through the case is more important than the final product i.e the completed case.

Cases can also be distributed to students before or after a lecture, so that they can prepare for the work ahead, or to consolidate what has been covered. In these situations, the case would more likely contain more information, and leave fewer gaps because the objective is less about stimulating critical thinking, and more about revising content in an authentic, clinical context.

The role of the facilitator

Different facilitators take on different roles during the CBL process. They are, at various stages students, listeners, analysts, questioners, paraphrasers and lecturers, and it is important to recognise that this can have a significant impact on the students’ experience. Try to avoid having the facilitator take on the “teacher” role too often, providing students with the answers to all of their questions. The “all-knowing” facilitator who is the inquisitor, judge and jury can be seen as trying to extract wisdom from the student “victim”. In its worst form it can be a version of “I’ve got a secret, and you have to guess it.” But, in its best form it can bring about an intellectual awakening as insights emerge from a complex case.

The facilitator should aim to stay on the sidelines as the students take over the analysis but can begin the discussion by simply saying, “Well, what do you think about the case?” From then on, they may simply ensure that some semblance of order is kept and that all students in the group get to voice their views. They should also try to avoid being too far on the periphery and not providing students with the structure they need to not feel lost. Highlight the fact that they don’t have all the answers and that they are co-learners in the classroom.

The facilitator should aim to guide the discussion but not control it, which requires the confidence to give up control. This is the only way to get students to actively construct their own learning experiences by asking questions, gathering information, testing hypotheses, and convincing others of their findings. During this process, facilitators should work with the groups in order to make sure that students have not left out important concepts as they progress through the case.

It is important that the facilitator withholds personal or professional judgments and opinions during discussions. They need to guide the discussion in a way that generates as many different issues, perceptions and solutions as possible, which will be limited if they project their own opinions into the discussion. Using the basic questions, “who, what, why, when and where” helps to engage the students in the activity. Facilitators must also summarise the main concepts and ask questions that help students identify issues and stay on track, but that also do not lead them to a specific conclusion. Facilitating student discussion may appear to be simple but in reality it requires skill in helping students explore and discuss the case in ways that maximises their learning opportunities.

The facilitator’s work can be divided into two broad general categories: setting up the learning environment and facilitating discussion and exploration (Blackmon, Hong & Choi, 2007). They should provide the context for the class and the depth to which students should explore questions. They can also decide which questions are prioritised and which ones can be answered via different methods e.g. lectures, essays, or assignments. It is worth noting that CBL may not be appropriate for every aspect of the curriculum.

Finally, the facilitator needs to add additional information and be able to direct students to resources that are appropriate to the topic (Blackmon, Hong & Choi, 2007). Most practitioners of the discussion method prefer a middle ground, with the facilitator providing an introduction, directed but not dominating questioning, highlighting the essential issues, and an appropriate summary (Welty, 1989).

The role of the student

Although some teachers will assign cases as the basis for individual work, many would argue that discussion in groups is at the core of the CBL approach. The group discussion in CBL can be an effective and motivating method of learning if students are well-prepared and given time for both individual preparation and group discussion (Flynn & Klein, 2001). You might even say that the student’s role is as important as that of the facilitator. Students who take their “jobs” seriously in CBL will prepare in advance by reading through the cases and describing the issues, perceptions, and possible courses of action. They could also review relevant materials in advance if the case is presented early enough.

In addition to preparation the successful student will continually evaluate the proposed solutions and reflect on what is learned and what still needs to be learned. In this process of evaluating and reflecting, they are able to take more responsibility for, and control of, their own learning. Finally, the student must commit to working collaboratively with their peers. Even students who reported disliking groupwork were more satisfied with their learning experience than those who worked alone (Flynn & Klein, 2001). While working through cases, students should aim to:

  • Engage with the characters and circumstances of the story
  • Identify and define the problems as they perceive them
  • Connect the meaning of the story to the clinical and professional context
  • Bring their own prior knowledge and principles to bear on the problem
  • Highlight relevant points and questions, and defend their positions
  • Formulate strategies to analyse the data and to generate possible solutions
  • Work with others to develop a collaborative solution to the problem

Case-based assessment

Initially, assessment and performance evaluation in CBL may seem daunting, as it can be more subjective than other methods and some teachers may be uncomfortable with that. However, with careful planning and preparation, assessment in CBL can be done efficiently, effectively and fairly. Students might also be uncomfortable with assessment, especially those who are accustomed to multiple choice or other forms of assessment that have clear right and wrong answers. This is one reason why the learning objectives need to be established at the beginning, and referred to regularly. Once those are clear and students understand what is expected of them, they should be able to keep track of their own progress and play a greater role in regulating their learning (Wasserman,1994).

The following questions should be considered when deciding how to evaluate a case (Schneider, 2010):

  • What parts of the process need to be assessed?
  • What parts can be graded as a group?
  • What can be submitted for individual assessment?
  • What are the time constraints for the grading?
  • How do you balance grading workload with the need to externally motivate student performance?
  • How will you ensure that the students actually know the content?

Assessing a student who has used a CBL approach can make use of something called key-feature approach questioning (Schuwirth & van der Vleuten, 2005). In this context, the assessor can use short cases that are followed by a limited number of questions aimed at addressing specific decisions that the student must make. Ensure that all of the information necessary to answer the question is presented in the case; not only medical information, but contextual information as well. Ensure that the questions are directly linked to the case, so that the correct answer is based on the students’ ability to integrate all of the relevant information in the case i.e. students should not be able to answer the question without comprehending the case. Ensure the question elicits important decisions where an incorrect decision would lead to incorrect management of the patient.

Teachers and students may both find scoring rubrics helpful, as these can help to establish a clear picture of successful behaviour or work quality, removing subjectivity and some of the ambiguity inherent in using CBL. Cases and group performance can also be assessed with case presentations, which are conducted at the completion of a case. Facilitators and other students can challenge the approaches and outcomes of the case, using a rubric that is distributed to students well before the presentations.


Case-based learning provides opportunities for the richer, deeper exploration of concepts and ideas in clinically-orientated teaching and learning. Students are able to develop experience in analysing ideas and applying concepts to solve problems, rather than simply acquiring abstract knowledge. It also requires students to engage with one another and their environment and facilitate the development of a wide range of social and cognitive skills. Case-based learning requires careful preparation and skilled facilitation on the part of teachers, as they aim to guide students towards personal learning, as opposed to providing them with content. Assessing student learning and evaluating their performance requires more than the traditional multiple choice or short-answer tests. Clear learning objectives, performance standards and relevant criteria can help enable teachers use a more holistic approach in order to better tailor the learning activities to students’ needs. Case-based learning is a valuable teaching and learning method that aims to develop contextualised knowledge and skills that will help students succeed in the clinical context.

References and Resources

  • Association of American Medical Colleges (1984). Physicians for the 21st century: Report of the project panel on the general professional education of the physicians and college preparation for medicine. Journal of Medical Education, 59, part 2:1-208.
  • Blackmon, M., Hong, Y., & Choi, I.. (2007). Case-based learning. In M. Orey (Ed.), Emerging perspectives on learning, teaching, and technology.
  • Christensen, C. R. (1987). Teaching and the case method. Boston: Harvard Business School Press.
  • Collins, A. (1988). Cognitive apprenticeship and instructional technology. Technical Report No. 6899. BBN Labs Inc., Cambridge, MA.
  • David, D.K. (1954). Forward In McNair, M.P. (Ed.), The case method at the Harvard business school. New York: McGraw-Hill (p.viii).
  • Dolmans, D., Snellen-Balendong, H., Wolfhagen, I., & van der Vleuten, C.P.M. (2009). Seven principles of effective case design for a problem-based curriculum. Medical Teacher, 19(3), 185-189.
  • Flynn, A & Klein J, (2001). The influence of discussion groups in a case-based learning environment. Educational Technology Research & Development, 49(3), 71-86.
  • Herreid, C.F. (1997). What makes a good case? Some basic rules of good storytelling help teachers generate excitement in the classroom.
  • Herrington, J., Oliver, R. & Reeves, T.C. (2003). Patterns of engagement in authentic online learning environments. Australian Journal of Educational Technology, 19(1), 59-71.
  • Lombardi, M.M. (2007). Authentic learning for the 21st century: An overview. Educause learning initiative, Diana G. Oblinger (Ed.).
  • Marks, M & Humphrey-Murto, S. (2005). Performance assessment. In Dent, J.A. & Harden, R.M. (Eds). A practical guide for medical teachers. Elsevier.
  • Prideux, D. (2005). Integrated learning. In Dent, J.A. & Harden, R.M. (Eds). A practical guide for medical teachers. Elsevier.
  • Regehr, G. & Norman, G.R. (1996). Issues in cognitive psychology: Implications for professional education. Academic Medicine, 71(9), 988-1001.
  • Schneider, D.K. (2010). Case-based learning. Edutech wiki. Schuwirth, L.W.T., Blackmore, D.B. Mom, E.M.A., van den Wildenberg, F., Stoffers, H.E.J.H., van der Vleuten, C.P.M. (1999). How to write short cases for assessing problem-solving skills. Medical Teacher, 21, 144-150.
  • Schuwirth, L.W.T. & van der Vleuten, C.P.M. (2005). Written assessments. In Dent, J.A. & Harden, R.M. (Eds). A practical guide for medical teachers. Elsevier.
  • Seely-Brown, J., Collins, A., & Duguid, P. (1989). Situated cognition and the culture of learning. Educational Researcher, 18(1), 32-42.
  • Shulman, J. (1992). Case methods in teacher education. New York: Teachers College Press.
  • Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press.
  • Washington University in St. Louis (n.d.). Teaching with discussions. The Teaching Center, accessed 11 January, 2013 at
  • Washington University in St. Louis (n.d.). Asking questions to improve learning. The Teaching Center, accessed 11 January, 2013 at
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  • Weltey, W. (1989). Discussion method teaching: A practical guide. Change, July/August, 40-49.
curriculum learning physiotherapy

Theoretical underpinnings of PBL

Schmidt, H.G. (1993). Foundations of problem-based learning: Some explanatory notes. Medical Education, 27: 422-432.

This paper presents the theoretical premises that underlie decisions to use PBL as part of an approach to develop critical thinking. A key premise is that knowledge cannot be transferred, as in a lecture. The learner has to “master it”. An important aspect of learning is that the topic being studied must actually be understood.

The paper identifies 6 fundamental principles of learning derived from cognitive neuroscience and educational psychology, which show how this understanding can be achieved.

  1. Prior knowledge of a subject is the most important determinant of the nature and amount of new information that can be processed. The amount of prior knowledge available determines the extent to which something new can be learned. Cases must therefore be iterative i.e. they must build on what came before. This is either in the form of sections within cases, where each new section is scaffolded onto what came before, or in the form of cases that build on previous cases.
  2. The availability of relevant prior knowledge is a necessary condition for understanding and remembering new information. This prior knowledge needs to be activated by cues in the context in which the current information is being studied. Cases must therefore offer cues that cause prior knowledge to be activated. This is the reason for the “What do I already know”? question.
  3. Knowledge is structured and the way in which it is structured in memory makes it more or less accessible. “Knowledge” is stored as a relationship between two or more concepts. This is known as a semantic network and it allows us to impose a structure on what would otherwise be an undifferentiated mass of isolated facts. Facilitators should therefore always ask students to represent their knowledge and understanding as a relationship between concepts e.g. “This is the way it is because of the way this other thing is”. The way that students present their understanding allows us to “see” their misunderstanding, which helps facilitators guide them towards a more accurate knowledge structure. Semantic networks are therefore not necessarily accurate representations of reality but they provide a means by which we can understand the world. The depth and accuracy of this understanding is a function of the quality of the semantic networks we have. We should therefore not think of the semantic network as “book knowledge” i.e. a set of facts. Rather, it is a reflection of a person’s experiences, views and ideas. One of the problems in the clinical environment is that knowledge learned in the classroom (“book knowledge” -> isolated facts) is that there are few opportunities for students to develop the semantic network that establishes relationships between concepts / facts.
  4. Storing information in memory and retrieving it can be improved when, during learning, elaboration of the material takes place. “Elaboration” is to actively establish and expand on the relationship between concepts. This process creates multiple “retrieval paths” to understanding. The more “paths” exist, the more likely it is that a concept will be retrieved. Facilitators should therefore aim to question students’ on their reasoning behind articulated statements e.g. “Explain to me why you think that technique is appropriate for this patient”?
  5. The ability to activate knowledge in long-term memory and make it available for use depends on contextual cues. Learning about topics in the context in which they are likely to be needed increases knowledge retention. Information that is intentionally learned and incidental information about context are simultaneously stored in memory. This is called the “contextual dependency of learning”. Cases and their discussion should therefore be conducted using the language and culture of the profession as tools to guide and scaffold the process. Students must present findings and articulate understanding to each other and facilitators as if they were on the ward.
  6. To be motivated to learn, prolongs the amount of processing time put in, and therefore improves achievement. In other words, someone who feels the urge to learn will be better prepared to spend more time on learning than someone who feels less inclined. Facilitators should therefore spend time developing students’ curiosity and motivation to learn, as part of a general approach to developing lifelong learners. Avoid simply “getting the task done”. Rather try to get students to develop an active and focused curiosity on the topic. When group work is aimed at stimulating interest and engagement, students are more likely to follow up with their own research. Group discussion aimed at clarifying one’s own point of view and being confronted with other perspectives stimulates focused curiosity.

Problem-based learning is therefore an approach to teaching and learning where students work together in small groups, with guidance from a facilitator, and try to solve problems (in our context, clinical cases).

In order to activate prior knowledge, the clinical problem must first be discussed by the students without them having “the answers”, or reference to the literature. The goals of this preliminary discussion are:

  1. To mobilise the knowledge that they already have available.
  2. To help elaborate on that knowledge i.e. to establish conceptual relationships.
  3. To contextualise the available knowledge within the current case.
  4. To engage the students’ curiosity to find out more.

It is clear therefore, that students should not have the facts given to them (e.g. with a lecture) prior to discussion of the case in their small groups. They should also be discouraged from simply identifying and allocating research questions to cover individually. The discussion is an essential aspect of the process, based on established theories of learning that aim to drive understanding.

If the clinical case is well-designed, students will begin to identify areas where they lack understanding and will soon begin to ask questions that need answers before they can proceed. The questions that are derived after the discussion will help them to find information that will therefore build on prior knowledge.

Upon returning to their groups with the new information, obtained by finding answers to questions derived in the first discussion, students then share and discuss their new information, which helps to structure the new knowledge in new semantic networks. Central to this process is the idea that while thinking, studying and talking about the clinical case, students are building a context-sensitive cognitive structure, which may help them to understand more complex clinical problems that they encounter later.

Conclusion The problem-based approach to teaching and learning is premised on 6 fundamental theories of learning that are derived from cognitive neuroscience and educational psychology. These principles include:

  1. Activating prior knowledge (basing current tasks on previous ones)
  2. Elaborating prior knowledge (forming relationships between concepts)
  3. Discussing problems in small groups (constructing semantic networks)
  4. Designing problems that are contextually relevant (solve problems in classroom that are cognitively similar to other spaces e.g. clinical)
  5. Fostering curiosity (so that students are internally motivated to spend more time on tasks)
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Posted to Diigo 03/23/2012

    • I also told students why we were doing this (something that isn’t done often enough in classrooms, in my opinion–why do some still insist on keeping what they want students to learn a big secret, making students stumble around trying to figure it out all in the name of “it’s good for them?”) by writing some “I can” statements for problem-solving
    • I can solve problems by:

      • analyzing given information to determine what you need to know
      • doing research and collecting resources using technology
      • stating the problem in clear language
      • mapping out the problem to arrive at a solution
      • proposing a logical solution to the problem based on evidence gathered during your research, and supporting that solution by citing evidence from your research
  • However, I must still focus on my content area objectives
  • after a few days of processing the initial information given to them in the case report and letter, I sent them another letter from the good doctor which stated the specific “science stuff” they needed to include in their presentation
  • We then added more questions to their “Need to Know” list, and continued the research
  • Our next steps are to plan out their presentations (which is the solution to their problem) and practice them in class before giving them in class
  • Don’t use a case that is easily find-able on the internet
  • Make your problem more than just about finding a “right” answer
  •  Also, the inherent real-world “messiness” of my problem  lies not in the solution itself but in making the connections between the science concepts and the little girl’s symptoms in order to form a coherent and concise explanation
  • Have students practice making connections between concepts
  • students are used to the “memorize, repeat, forget” model of schooling and need practice with upper-level thinking skills
  •  Bottom line–if your students don’t know how to think the way you want them to, you have to have them practice that thinking
  • Just throwing them out into the thinking pool without any training (or even any floaties to help them) is setting yourself and your students up for frustration rather than learning
  • Provide students with activities to help them learn your curricular goals.
  • in order to guide them and help them focus their research, I wrote some learning activities
  • But don’t let students get so lost in the content forest that the content trees are all they see
  • review the problem statement every day
  • Don’t let them get so deep into the memorizing content zone that they lose sight of the problem they’re supposed to be solving
  • Unlearn talking at students and learn to ask them question after question
  • I am also driving my students nuts with my questions, because now I am not the supreme answer-giver and master science-explainer
  • it puts the burden of thinking back on the student

conference education learning research technology

HELTASA conference, 2011 – day 2


Explaining, naming and crossing border in Southern African higher education
Prof Piet Naude

This was one of the most challenging presentations I’ve ever listened to. I didn’t agree with a lot of what Prof Naude said, but he made me question my own beliefs and biases.

Ontology: language is the house of reality (language shapes reality)
In political discourse, language precedes actual violent acts. In Rwanda, people called each other “cockroaches”, and it’s much easier to kill a cockroach than to kill a human being.

Crossing interpretive borders in higher education:

  • Utilitarianism: views universities as vehicles for the promotion of sectarian interests e.g. religious, political, economic → doctrines dictate the boundaries of science and denies the search for truth without fear nor favour (religious language abundant in university e.g. professor, sabatical, rector). University as a vehicle to continue the doctrine or belief e.g. when universities in South Africa advanced the notion of Apartheid in different fields (biology, politics, religion, etc.). “Truth” would be based on doctrine.
  • Scientism: views “real knowledge” on the basis of empiricist, quantitative assumptions and a correspondent theory of truth. Science is the future, Humanities is the past. Some scientists are blind to the social construction of scientific paradigms. Blind to the link between science and the power or use of science. Blind to the complexity of personal and societal development.
  • Liberalism: rests on presumed a-contextual and unversalist assumptions about the human person, rationality and knowledge whist actually reflecting post-Enlightenment, Western thinking. “Professional training is vicious”. I think therefore I am vs. ubuntu = I am who I am because of who we all are. “Vicious ideological nature of Western scientific thinking”. Are there non-empirical forms of validation that are equally valid as scientific ones? Are all forms of non-Western knowledge subject to verfication by Western evaluation practices?

If universities don’t exist for the public good, they become playgrounds for the rich. Commercial language can change the direction of education e.g. when a “vice chancellor” becomes a “CEO”

Crossing 5 metaphorical boundaries

  • Centre – periphery: where you are born will determine your ability to succeed in the world / geographical (in)justice
  • Conceptual – technical / applied (epistemic justice). People who work with their hands are not as “smart” as people who can “think”. In South Africa, we need a greater emphasis on technical / applied knowledge. More colleges, fewer universities.
  • Uniformity (globalism) – plurarility (glo-cality) (cultural justice): where everyone wears jeans, watches BBC and speaks English. Emphasise a system where I can function at a global level but remain true to my local context. What is the impact on language / culture of the homogenising effect of university?
  • Anthropocentrism – cosmocentric thinking (ecological justice): it’s a problem when science and technology seeks only to improve the lot of human beings at the expense of everything else.
  • Past / present – future (noogenic justice): the world is in a mess, we need to prepare students to improve the future. Challenge students to imagine a future that does not exist, and give them the knowledge and skills to create it.


Perceptions of PBL group effectiveness in a diverse pharmacy student population
Lindi Mabope

Study set out to evaluate student perceptions of differences in plenary vs small group work in a PBL context

4th years have better experiences with groups than 3rd years

Some students prepare only what THEY need to present in plenary sessions, whereas small groups mean that students must prepare better and more broadly

Students generally feel that the plenary sessions aren’t a “good way of learning”

Most students agree that working in small groups helps develop tolerance for language and cultural difference

Most students agreed that small group working helped them to work effectively

Cases in small groups helped students to clarify areas of difficulty

PBL seemed to work well across a diverse student group, perceptions were generally positive

Confusing / difficult conceptual work required the development of certain attributes e.g. communication, self-directed learning, tolerance

Some students found the small groupwork sessions frustrating and challening

Groups demand a large investment in time and energy, from students and staff

Problems must be resolved very early on

Continuous monitoring and evaluation of the PBL process is essential

Facilitators must pay regular attention of the changing needs of the students (students change and develop as part of the process, as do their needs, so facilitators must be aware of the changes and change the programme accordingly)

Use the positive benefits of diversity, rather than merely work around it (how can student diversity actually feed into the programme, encourage students to bring themselves into the cases, share their own life experiences in order to enrich the module)

Supporting and enabling PG success: building strategies for empowerment, emotional resilience and conceptual critical work
Gina Wisker

What are the links between students’ development and experiences: ontology (their sense of being in the world) and epistemology (how they construct knowledge)
Why do students undertake doctorates and what happens during their studies to help / hinder them?

Conceptual threshold crossing (Meyer & Land): the moments when you know that you’re being cleverer than you thought you were 🙂

What can staff do to enhance and safeguard research student wellbeing and nudge conceptual threshold crossing?

Building emotional resilience and wellbeing

Students kept learning journals for a duration of 3 years and included interviews during that period

“Troublesome encounters” (Morris & Wisker, 2011)

Doctoral learning journeys are multi-dimensional:

  • Meeting course requirements (instrumental)
  • Professional dimension
  • Intellectual / cognitive development
  • Ontological (how does it change the person?)
  • Personal / emotional

How do doctoral students signify their awareness of working conceptually?

How do supervisors recognise students’ conceptual grasp of research (this applies equally well to UGs conceptual grasp of the discipline)

Conceptual crossing is evidenced by:

  • Troublesome knowledge
  • Movements on from stuck places through liminal spaces into new understanding
  • Transformations (Meyer & Land)

Ontological change: seeing the self and the world differently and you can’t go back
Epistemological contribution: making new contributions to understanding and meaning

You have to find your own way, otherwise it’s a mechanistic process

Threshold concepts are:

  • Transformative: developing an academic identity
  • Irreversible: when you change how you perceive the world, you can’t go back
  • Integrative: forming relationships between what seemed previously to be disparate ideas
  • Troublesome knowledge: dealing with complexity

Learning moments that may indicate threshold crossings:

  • Coming up with research questions
  • Determining relationships between existing theory and own work
  • Device methods and engage with methods
  • Deal with surprises and mistakes
  • Analsyse and interpret data

There needs to be a number of conceptual leaps, otherwise the thesis is a box-ticking exercise

Make sure that the doctoral project has boundaries. The work is part of a greater whole, and the more focused the work, the easier it is to define the boundaries

Research is a journey (risks, surprises, deviations, even though it looks mapped), but a thesis is a building (ordered, coherent, organised, linked)

Constructive, intellectually challenging relationships

Student wellbeing is essential for postgraduate success:

  • Academic
  • Personal
  • Financial

There are factors in the learning environment that pose challenges to student wellbeing

What are the wellbeing issues for our research students?

Negative impacts cripples creativity and encourages you to take the path of least resistance, where the project is more about a qualification and less about innovation

Important to switch off from the process and engage in the world in different ways, as a coping strategy when experiencing difficulty


Crossing borders between face-to-face and online learning: the evaluation of an online tutoring initiative
Sanet Snoer

Collaborative learning has as its main feature a structure that encourages students to talk

Created an online module because student numbers increased, shortages of venues and tutors, timetable clashes, changing student profile and needs

Blended approach could help with logistical problems, expose students to a new way of learning, more challenging activities, develop wide variety of skills

Uses Gilly Salmon’s model for teaching and learning online as a point of departure, provides scaffolding to take students through a process of familiarising students with the environment

Students’ perceptions of online components were generally positive. However, students reported challenges with effective textual communication and typing, time management (which seems odd, since blended learning seeks to help with time issues), self-expression, understanding of concepts that are read rather than heard, poor familiarity with computers and the internet → disadvantage, feedback is immediate with face-to-face, relationships → face-to-face is a more personal interaction

Used Community of Inquiry framework to develop good online teaching practices (see Kleimola & Leppisaari, 2008 for breakdown of different “presences”)


  • Needs to be agreement about turnaround time for feedback from facilitators
  • Purpose of each activity should be clear
  • Understand the benefits of the activities
  • Must model effective online behaviour
  • Communicate expecations clearly
  • Promote the mind shift that needs to take place
  • Create a non-threatening environment
  • Don’t assume students are familiar with the environment
  • Explain the role of face-to-face and online activities

Was there integration of online and offline activities? Used real-world examples to develop conversation around activities


Students’ learning satisfaction from a blended learning environment for physiology
Saramarie Eagleton

What aspects of technology provide benefits / advantages to the learning process. NOT whether technology is inherently good or bad


How collaborative groupwork affects students’ writing
Shena Lamb-du Plessis, Laetitia Radder

Aim was to get the students to write in as many different ways, and as regularly as possible during the course

Used group journal reflections and group progress reports

Peer feedback is valuable when students know from the start that they will be sharing their work with others

Developing a writing identity means pushing students to think for themselves and to imagine themselves as writers

A process of developing and clarifying thoughts by sharing them with an audience

Groupwork can shape the meaning of the work

Group dialogue helped to define / outline the writing requirements

Students felt that personal expression validated their viewpoints

Helped to develop self-confidence when they realised that others shared their experiences

Must introduce conflict management strategies, orient students to role allocation, discuss writing tasks to restructure meaning


Exploring the tension between institutional learning management systems and emergent technologies: staff perspectives at the Cape Peninsula University of Technology
Daniela Gachago, Eunice Ivala, Agne Chigona

What are “emerging technologies” and can they disrupt teaching practice?

The impact of technologies in education falls short of the rhetoric:

  • They are used to support and improve current teaching practices
  • Teachers and students use a limited range of technologies
  • Used to reproduce existing practice, as opposed to transforming practice
  • Supports passive, teacher-centred and didactic instruction

Need to redefine e-learning: “can no longer be viewed as a purely institutionally based or narrowly defined set of activities” (HEFCE paper, 2009, 5). Difficult because institutions are reluctant to give up their power and control

There is a shift of the locus on control:

  • Control moves to students and lecturers
  • Transfer of authority of knowledge and ownership of technology

Type I technologies replicate existing practices, Type II technologies allow students and lecturers to do things that they couldn’t do before

In complex-adaptive domains, knowledge doesn’t provide prospective predictability but rather, retrospective coherence. Learning should be self-organised and collaborative (Williams, Karousou, Macness, 2011)

“Hard” technologies: constraining and limiting, stifles creativity e.g. LMS
“Soft” technologies: freedom to play

Soft technologies require skill and artistry. It’s not just what you do but how you do it.

Qualities of disruptive technologies (Meyer, 2010):

  • Student-centred
  • Designed to offer options, motivate students, provide connections to the lives, jobs and communities of students
  • Capitalise on willingness of students to experiment and fail, to improve, and to keep at problems until solutions are crafted

Laurillard (2002, 141): We’re playing with digital tools but with an approach still born in the transmission model. There is no progress therefore, in how we teach, despite what is possible with the new technology

Laurillard’s conversational framework: there’s no escape from the need for dialogue, there is a constant exchange between teacher and student:

  • Discursive
  • Interactive
  • Adaptive
  • Reflective

Laurillard (2002). Rethinking university teaching.

No one approach is better than the other. We need to have a mix of approaches to get the maximum benefit of using different tools

“It’s a way of doing life. It’s not about computers. It’s not about mobile learning. It’s just learning – it’s just life”


Analysing teaching and learning at five comprehensive universities
Sioux McKenna

What are the mechanisms in the world that exist in order for us to have the experiences that we do?

Move beyond the statistics of higher education, and ask what must the institution be like in order for this to be (im)possible?

What is the role of Culture (ideas), Structure (process), and Agency (people)?

Most institutions continue to reflect their individual histories as rural/urban, disadvantaged/advantaged, traditional/university of technology. There seemed to be little cohesion in terms of what it means to be a comprehensive university.

Comprehensive universities emphasise the management discourse that focuses on the “complexity to be managed” rather than a “knowledge discourse” i.e. what is knowledge / research, etc.

There are implications for academic identify and research output

“Powerful ways of knowing”

Often students are constructed as deficits i.e. they are deficit in language, life skills, motivation, etc.

assessment assignments curriculum learning research students teaching workshop

Problem based learning: transitioning to an online / hybrid learning environment

A few weeks ago I attended a short presentation by Prof. Meena Iyer from Missouri University. Prof. Iyer spoke about how she moved her PBL module from using a traditional, mainly face-to-face approach, to an online / hybrid approach. Here are my notes.


“All life is problem solving” – Karl Popper

How do we get students to think like professionals in the field?
How do we foster group interaction in online spaces?
How do I assess learning in online spaces?

PBL addresses the content issue, as well as enhancing critical thinking through the collaborative solving of authentic, real-world problems


  • PBL → solving problems is the tool, learning is the goal
  • Traditional → content is the tool, problem solving is the goal

PBL is all unstructured (but it can be scaffolded), and there’s not necessarily a right/wrong answer

Six steps to problem solving (IDEALS):

  • Identify the problem (What is the real question we are facing?)
  • Define the context (What are the facts that frame this problem?)
  • Enumerate the choices (What are the plausible actions?)
  • Analyse the options (What is the best course of action?)
  • List reasons explicitly (why is this the best course of action?)
  • Self-correct (What did we miss?)

The problem should be authentic and appealing (a mystery to solve)
Clearly outline expectations for each step of the process

Why move from face-to-face to online?

  • In F2F, you can only move forward at the speed of the slowest learner
  • Significant time requirements for F2F
  • Identify…can be anonymous online → fewer preconceived biases among students


  • How do you transition F2F to online
  • What tools are appropriate / feasible / viable / affordable?
  • How do you do collaborative work when everyone is online at different times?


  • Cases are presented in multiple formats / media
  • Introductory week to familiarise students with online environment. In addition to learning the content and critical thinking, students also have to learn about PBL
  • Scenarios are released in 2 stages over a 2 week period
  • Scenarios are accompanied by a set of probing questions to stimulate discussion
  • Teacher provides support during the discussions
  • Students must also design their own case
  • Assessment is based on content and depth
  • Wiki used for question / answer. Each student must answer each of the questions, each answer must be different i.e. must add to what has already been added (this means that the question can’t just be a knowledge question)
  • Discussion boards are used for students to dissect the cases (All and Group)
  • Each group assesses their own knowledge base, and define what the gaps are, and therefore what they need to find out (who provides the links to the resources, or can students use any resources?)
  • At least 3 posts per student, including: Summarise and question one citation; Answer another students’ question; Follow up any discussion on their own posts
  • Reading assignment: written, critial appraisal of a published article relevant to the case study. This summary must be posted online.

Important for students to learn how to share information in supportive environments


  • What parts of the process need to be assessed?
  • What parts can be graded as a group?
  • What needs to be submitted for individual assessment?
  • What are the time constraints for the grading?
  • How do you balance grading workload with the need to externally motivate student performance?
  • There is also a syllabus quiz to ensure the students actually know the content


  • Make the problem compelling
  • Outline expectations
  • The problem analysis should relate to the professoinal field
  • As student proficiency develops, withdraw support
  • Use learning issues to encourage EBP
  • Ensure that solution development is based on critical appraisal


  • Barrows, HS (1996). Problem based learning in medicine and beyond: a brief overview. New directions for teaching and learning
  • Barrows HS & Tamblyn, RM (1980). Problem based learning: an approach to medicla education. New York, Springer Pub. Co.
  • Hmelo-Silver, C (2004). Problem based learning: what and how do students learn? Educational Psychology Review, 16(3)



Posted to Diigo 08/21/2011

    • “ ‘Thunks’ are deceptively tricky little questions that ‘make your brain go ouch!’

      Ian’s examples of ‘Thunks’ include:

      • ‘Is a broken down car parked?’
      • ‘If you read a newspaper in the newsagents without paying for it, is it stealing?’
      • ‘Do all polo’s taste the same?’
      • ‘Can you be proud of someone you have never met?’
      • ‘Is a hole a thing?’
    • Active Learning-I ask students to use their prior experiences (interests, hobbies, coursework) in a service learning project for my class, using what they know, and connections they have been able to make, to benefit others. They propose their own projects.

      This idea has all 5 components:
      a. Incorporating peer feedback into a course.
      b. By giving students the opportunity to learn how to give feedback to classmates’ works-in-progress, this motivates students to perform at the same or higher level or their peers in a non-threatening way.
      c. It is also an activity which reinforces learning of the subject matter (active & challenging).
      d. It can create a sense of support and community because the students are helping each other improve their own works (and grades!)
      e. And peer feedback allows students to gain an appreciation for classmates’ efforts and a glimpse of the instructor or professor’s role.

    • When students are stressed by the lesson, find a way to show how you (the teacher) messed up learning the topic
    • First day of class: When introducing class & trying to establish rapport, have the students say where they see themselves in 3 to 5 years
    • I give several smaller “low-risk” assignments in addition to “high-risk” mid-terms and finals
    • Share with my students some of my personal stories as a student, my stories and failures
    • I teach a 3rd year/level class and on the first day of a particular subject, in this case hydraulics, I give them an exam of what they should know from 1st year. I eventually let them take it home to complete it on their own
    • review some student work in class in front of the class, inviting student input. It challenges many students to work harder on their own work
    • I give an exam which I grade and return as soon as feasible to the students. I identify the learning outcomes that most students missed and offer students another test that focuses ONLY on those learning outcomes using different test items. They know they have a chance to improve their exam grades with the subsequent test score.

    • apply newly acquired knowledge to themselves or someone they are familiar with
    • In many sciences, students are concerned about memorizing information (ex. Periodic Table). I tell them that we never used to memorize an atlas, but we learn how to use it as a tool/reference
    • At the end of each lecture topic, students hand it a slip of paper with two items: “Got it”-what they understood and “don’t get it”-what they don’t understand. Once a week, results are posted on Moodle and explanations given for the “don’t get it” items
    • Collaborative learning: I found that students learn better and smooth out their rough edges when they combine conflicting analysis to produce a bounded unit of learning
    • When composing homework assignments, I combine questions of varying difficulty. I ultimately include a problem or two beyond the difficulty required for my course and offer extra credit for solving these problems. The number of students that choose to step up to the challenge is so incredibly refreshing and motivating
    • Have students take responsibility for their learning by applying lesson concepts to their occupations, field of expertise, and personal experience
    • The student gets to choose a topic they feel they could teach the class (for 15 minutes), they become the expert with certain guidelines to follow. Motivation—they are the “star” for 15 minutes. Active learning—they research. Task—they choose the topic. Community—they all practice with each other to get feedback before their 15 minute presentation. Holistic—they learn all types of things; respect, confidence, professionalism, body language, etc.
    • In a writing course, students receive each others drafts throughout the semester and one by one the whole class peer reviews the drafts. Students learn from other student papers and gain critical feedback on their own paper. In other words, every paper is read by every student, and every student must provide feedback.
    • Start each class with a “hook”—something that is contextual and related to the day’s concepts—provides relevancy and captures interest and involvement
    • I engage students to choose a concept from the course and teach a segment of the class.
    • Take students’ pictures 1st day of class and memorize their names. Call students by name from the 2nd class on. Use their names frequently. This instills community and aids in engagement because students cannot hide
    • Allow students to text you with questions
    • I am a student—I am tired (flight came in late). I am hungry (I missed lunch), I can’t concentrate (my daughter keeps texting me). How will you engage me? Tell me a story, a story with characters facing shocking/new or interesting challenges. Then ask me about it, allowing me to be a little grumpy, but encouraging me to continue to participate and reward my efforts. I will cheer up and feel transformed by your class session
    • “Self-correcting exams”: Students are able to alter test answers after the fact—through additional research/working with other students—and resubmit exam responses for additional partial credit.
      • Can the Ethics oral exam use a similar approach? After the exam students go and write a short reflective essay on what was discussed during the exam?
    • Clarify how knowledge that is being taught is important to students’ future work and/or life. Students will value only what they believe they need to know and will use in work/life
    • Problem based learning in groups. Assigning a facilitator in the group and then pick an idea that there isn’t a right answer. You can use concept mapping. First, students present the problem. Second, they find resources and list them. Third, they investigate solutions to the problem and list them. Fourth, they identify the three best solutions. Last, they pick the best one and provide the reason
    • I ask my students (every week), why are you here? I note week one and compare it with the final week. Typical observation: growing ambition.

    • Motivation and Value: I get my students to stop thinking like a student, rather think like a teacher (or a professional in their field) to see the value of the activities and assignments in the course
    • People respond to genuine concern for their well-being
    • Active Learning: I occasionally divide the assigned chapter up among the students, and give everyone 10 minutes to come up with a 1 minute presentation to the class. The students have at least read a few pages, and they talk to each other instead of listening to me
    • When a student engages in course dialogue, I write a note thanking them as their classmates and I enjoyed their participation and how important their questions and comments are to educators and their students. I also include that I hope they continue to share in all courses. This helps encourage participation, especially from those who seldom do
    • Recognize and sustain the “cool” in everyone and challenge the students to move from “pretend cool” to “cool.”
    • Remove fear/anxiety and increase expectations of success by: allowing students to redo/resubmit work or problems for regarding/assessment. They work and learn from their mistakes, but are not punished for their mistakes.
    • Living Concept Maps: During a case study, have the students in groups of 4-5, actively create a concept map as the case study is unfolding—adapting and changing it as new data becomes available. At the end, share the concept maps and see how different/similar they are and explore those.
    • the selection and use of technologies for teaching and learning is driven as much by context and values and beliefs as by hard scientific evidence or rigorous theory
    • There are deep philosophical, technical and pragmatic challenges in trying to provide a model or set of models flexible but practical enough to handle the huge range of factors involved
    • theories and beliefs about education will influence strongly the choice and use of different technologies
    • it is a mistake to focus solely on the educational characteristics of technologies. There are social, organizational, cost and accessibility issues also to be considered
    • what is best done face-to-face and what online, and in what contexts? What is the role of the human teacher, and can/should/will he/she be replaced by technology?
education health PhD teaching workshop

Developing cases for Problem-Based Learning

Workshop on the development of case-based studies

Facilitators: Dr. Ethel Stanley, Dr. Margaret Waterman

Part of my PhD will be to look at alternative approaches to clinical education, including uses cases in problem-based learning (PBL). My specific interest is in the use of emerging technology to design and teach with those cases in small groups. Unfortunately I was only able to attend the first half of the workshop, and didn’t get the opportunity to develop my own case.

Here are my notes from the workshop:

Biology is an important topic for everyone to understand, as it impacts on every major health-related decision that has to be made, so we used biological case studies as working examples

Students must be able to ask good questions in order to solve their own problems in preparation for the types of adult learning (androgogy, as opposed to pedagogy) behaviour we’d expect to see in practice. Memorising content isn’t a good strategy for learning how to solve problems like “Why is this patient walking in a way that is different from “normal”?”

A lecture is a good method to deliver content, but is a poor method for active learning around problem solving

Case-based learning (CBL) is a good way to explore realistically complex situations

Begin by introducing a problem with no expectation that the student can solve the problem. Use that as a springboard to explore their ability to develop good research questions

CBL requires the confidence from teachers to give up control, but giving up control is the only way to get students to actively construct their own learning experiences by asking questions, gathering information, testing hypotheses, and convince others of their findings

Structure for working through a basic case

  • Define the boundaries / outline of the case
  • What do you already know (group knowledge, as well as information that can be obtained from the case study) / what do you still need to know (this can be used as a basis for a short lecture) in order to answer the question
  • Choose the most important questions to explore
  • Get into small groups and discuss / share information, knowledge, assumptions
  • Go away and try to answer the questions that were generated
  • Come back and only then get the teachers objectives
  • Then go away again and refine the questions and information collected

Why use cases?

  • To initiate investigations
  • To use new technologies and resources to solve problems
  • Develop local and international / global perspectives
  • Emphasise the value of interdisciplinary and collaborative approaches
  • Structure student assessment through student products
  • Support diverse objectives within a shared workspace (would be interesting to investigate the possibility of using a wiki to develop and build on cases using this approach)

Used Gapminder to demonstrate alternative ways of visually representing data while working through a case study. See Hans Rosling (founder of Gapminder) on the Joy of Statistics, and his TED presentations.

The teacher can set the context of the class, and the depth to which students should explore questions, by using an appropriate framework / case. Can also decide which questions are prioritised, and which ones can be answered via different methods e.g. lecture, essay, assignment, etc.

Highlight the fact that, as the teacher, you don’t have all the answers and that you’re a co-learner in the classroom. Students should understand that the teacher isn’t a font of all knowledge on the subject, and that it’s acceptable and appropriate for the teacher to have to also do research on the topic

twitter feed

Twitter Weekly Updates for 2010-02-15

  • @ryantracey Agreed. The process, rather than the certificate, should be emphasised #
  • RT @wesleylynch: Video comparing iphone and nexus – Can’t imagine how the iPhone will survive, Android is already better #
  • RT @psychemedia: Are Higher Degrees a waste of time for most people? IT professionals are hardly “most people” #
  • University finds free online classes don’t hurt enrollment #
  • Mobile Learning Principles – interesting, but unrealistic in a developing country. “Mobile” does not = smartphone #
  • Presenting while people are twittering, an increasingly common backchannel. Be aware of it and use it if possible #
  • Presentation Zen: The “Lessig Method” of presentation. Great resource on improving your presentation skills #
  • About “P”! « Plearn Blog. This post raises some interesting questions about the challenges of using PLEs #
  • Crazy Goats. I don’t usually share this sort of thing, but this pretty amazing #
  • Learning technologies in engineering education. For anyone interested in integrating “distance” with “practical” #
  • Think ‘Network Structure’ not ‘Networking’. I always thought “networking” was too haphazard to bother with #
  • Clifton beach earlier today. I think I like it here #
  • @davidworth Hi David, thanks for the blog plug #
  • @sharingnicely: go around institutional pushback when policy is unfriendly to OER #OCW #
  • @dkeats: free content enables students to use scarce financial resources to acquire tech instead, which grants access to vastly more content #
  • Butcher: the curricular framework must drive development of OER – content comes after learning #OCW #
  • Neil Butcher from OERAfrica: OER can’t work without institutional support #OCW #
  • Why is copyright in OER even an issue? Copyright applies equally to OER and non-OER #OCW #
  • If you think of a degree as a learning experience, rather than a certificate, formal accreditation is less important. See P2PU #OCW #
  • Is there a difference between OER and #OCW I’m wary of the emphasis on content as a means of changing teaching practice #
  • @dkeats Improvement in quality is always important, isn’t it? No-one is aiming for mediocrity #
  • OCW workshop at UWC today, OCW board present incl. MIT OCW, should be a good day, quite proud its happening here #
  • RT @cristinacost: RT @gconole: Sarah Knight on JISC elearning prog including excellent eff. practice pubs #
  • RT @c4lpt: MicroECoP – Uisng microblogging to enhance communication within Communities of Practice #microecop #
  • Making the Pop Quiz More Positive. I like the change of mindset that the post suggests, pop quizzes aren’t punishment #
  • @cristinacost Looks good, you’re further along with your project than I am with mine, I might have to come to you for advice 🙂 #
  • Problem-Based Learning: A Quick Review « Teaching Professor. Nice, short summary of why PBL is a Good Thing #
  • @cristinacost What’s your interest in Buddypress? I recently set up WPMU/BP platform for physio dept social network to explore CoP #
  • Microblogging to enhance communication within communities of practice #microecop #
  • There’s a war goin’ on here, donchaknow? Retro copyright posters at EdTechPost #
  • Post by Howard Rheingold on crap detection on the internet should be required reading for everyone online #
  • Scroll down for the 5 C’s of Engagement on Postrank’s “What it is” page. Is it useful for building social presence? #
  • Great post on 3 strategies to manage information: Aggregate, Filter and Connect. The last one is hard (for me anyway) #
  • Great post on the importance of not only filtering information, but using it meaningfully #
  • Siemens’ post on moving from educational reform within the system, to a “no boundaries” approach #
  • Web 3.0 and Its Relevance for Instruction – interesting article on how a next generation web could be used in education #
  • Freedom helps kids learn more « Education Soon #

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