Problem Based Learning in the Era of Wikipedia & Google

Problem Based Learning in the Era of Wikipedia & Google Amin Azzam, MD, MA University of California, Berkeley & San Francisco Dennis Valenzeno, PhD University of Kansas School of Medicine, Wichita A. Azzam. D. Valenzeno. IAMSE Conference 2014

Outline “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Who we are Amin Azzam, MD, MA • University of California, Berkeley & San Francisco • Here are my current role-responsibilities Dennis Valenzeno, PhD • University of Kansas School of Medicine, Wichita • Here are my current role-responsibilities “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Who you are • Name • Institution • Role • Name at least one thing you hope to get out of today’s workshop “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Reflections on info explosion Volume Originally from Rosenfeld & Moreville: “Information Architecture.” as reproduced at: http://blog.famakinwa.net/content/information-explosion 1992 Internet explosion Milestones in Content Growth 1900 London library (500,000 volumes) 1884 First mechanical typesetter 1480 Vatican library (1500 volumes) 1450 Information Architects arrive Guttenberg’s hand press 500 Monks copy books by hand 1994 SGML developed 3000 BC Earliest written record 1970 Dewey Decimal System 1876 Time Alexandria Library includes 120 scroll bibliography Assyrian king organizes tablets by subject 330 BC Milestones in Content Organization 660 BC “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Reflections on info explosion Originally from Peter Diamandis: “Abundance: The Future is Better Than You Think.” as reproduced at: http://awealthofcommonsense.com/future-better-think/ “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Reflections on info explosion Exabytes: Documenting the ‘digital age’ and huge growth in computing capacity “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Reflections on info explosion Volume 1992 Internet explosion Content Growth 1900 London library (500,000 volumes) 1884 First mechanical typesetter This is you dear medical science educator! 1480 Vatican library (1500 volumes) 1450 Information Architects arrive Guttenberg’s hand press 500 Monks copy books by hand 1994 SGML developed 3000 BC Earliest written record 1970 Dewey Decimal System 1876 Time Alexandria Library includes 120 scroll bibliography Assyrian king organizes tablets by subject 330 BC 660 BC Content Organization “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Break out groups: what to do? “Me too– what’s an educator to do?” “I’m overwhelmed.” “I suppose we can’t just keep doing the same old thing and expect it to keep working.” “You’re right– times change, so should we.” “Do you think we should tell the audience what we think they should do?” “No, of course not! In true PBL fashion we should have them tackle the problem!” “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Break out groups: task • Discuss educator and educational strategies that might be useful in the modern information era • Identify a scribe at each group to capture your wonderful ideas • Identify a person willing to “report-back” when we re-convene as a large group • Let’s see how much you can accomplish in 15 minutes! “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Break out groups: report back “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

PBLDefined: Elements 1 & 2 Definitional Element Our Clarification 1. • Students should be organized into small groups with a “tutor.” • In contrast to large lecture-based groups. 2. • In contrast to instructor-centered teaching. • Learning must be student-centered. “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

PBL Defined: Elements 3 & 4 Definitional Element Our Clarification 3. • The “tutor” must act as a facilitator or guide. • As opposed to a knowledge or content expert. 4. • Problems based in the practical world must be presented at the beginning of the learning process. • In contrast to front-loading a curriculum with the “basic foundations” before encountering “real” problems. “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

PBL Defined: Elements 5 & 6 Definitional Element Our Clarification 5. Problems should serve as tools for acquisition of knowledge and problem-solving skills. • As opposed to merely learning the “correct answer” to this specific problem only. 6. • As contrasted with “educator directed” • (e.g. a syllabus is educator directed). • Content knowledge should be acquired via self-directed learning. “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Variation in use of PBL in pre-clerkship medical school years “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Variation in use of PBL in pre-clerkship medical school years Though the majority of US medical schools used PBL, they did so as a relatively small percentage of their students’ curricular experiences. “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

putting this in a united states western regional context Workshop at AAMC WGEA Regional Meeting 2009. “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

The six core elements of pbl • Students should be organized into small groups with a tutor. • Learning must be student-centered. • The tutor must act as a facilitator or guide. • Problems based in the practical world must be presented at the beginning of the learning process. • The problems should serve as a tool for the acquisition of both knowledge and general problem-solving skills. • Content knowledge should be acquired via self-directed learning. “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Barriers & opportunities Barriers • insert Opportunities • insert “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Our local contexts “Let’s start with you, Dennis.” “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

University of KANSAS + = Since 1905 Kansas City (175) Salina (8) Clinical campus since 1975 Expanded to 4-years in 2011 (28/~70) Jayhawk Doc A “Jaydoc” “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Ku School of medicine curriculumall 3 campuses Break Break Break Break 1st Year • Years 1 and 2 • Organ-System Based Curriculum • Interactive TV lectures; local faculty for small groups • Years 3 and 4 • Disciplinary sequence of clerkships and electives • Taught separately on each campus • coordinated, same goals and assessment Cardio - pulmonary 8 weeks Ren/Endo 4 weeks GI/Nutr 4 weeks Infl/Imm 4 weeks Gen/Neo 4 weeks Repro/Sex 4 weeks Foundations 8 weeks • Where is PBL in this curriculum? • Small groups • basic science oriented case studies • histopath labs • anatomy labs • clinical skills / standardized patients • PBL 2nd Year Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Step 1 Tests Tests Board Prep Infect Dis 8 weeks Integrate/Consolidate 8 weeks Blood 4 weeks Mus/Skel 4 weeks Brain & Behavior 8 weeks • Current PBL • development of clinical reasoning • 6-7 PBL cases per year • 2 meetings per case • variable, but significant, faculty direction 3rd Year Pediatrics 6 weeks Surgery 8 weeks Internal Medicine 8 weeks Ob/Gyn 6 weeks Family Medicine 8 weeks Psych 4 weeks Neuro 4 weeks Geriatrics 4 weeks 4th Year Pub Hlth 4 weeks Electives 16 weeks Crit Care 4 weeks Rural 4 weeks Subintern 4 weeks

Ku School of medicine curriculumall 3 campuses Break Break Break Break 1st Year • After 10 years of an organ-system based • curriculum where are we headed? • 3 year study of modern medical education • Carnegie reports: Flexner, 1910, Cooke, Irby and O’Brien, 2010 • Multiple campus visits • Full accreditation renewal • Principles for new curriculum • Clinical case focus • Adult learning • Active learning • Expert guidance • Technology • Pilot course running this summer with 7 students Cardio - pulmonary 8 weeks Ren/Endo 4 weeks GI/Nutr 4 weeks Infl/Imm 4 weeks Gen/Neo 4 weeks Repro/Sex 4 weeks Foundations 8 weeks 2nd Year Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Tests Step 1 Tests Tests Tests Board Prep Infect Dis 8 weeks Integrate/Consolidate 8 weeks Blood 4 weeks Mus/Skel 4 weeks Brain & Behavior 8 weeks 3rd Year Pediatrics 6 weeks Surgery 8 weeks Internal Medicine 8 weeks Ob/Gyn 6 weeks Family Medicine 8 weeks Psych 4 weeks Neuro 4 weeks Geriatrics 4 weeks 4th Year Pub Hlth 4 weeks Electives 16 weeks Crit Care 4 weeks Rural 4 weeks Subintern 4 weeks

Our local contexts “Over to you, Amin.” “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

University of california 3 years 2 years Masters’ degree + “Clerkship” years of medical school + = Happy Graduate MD, MS “Pre-clerkship” years of medical school “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Break Break Break Break Break 1st Year 3rd Year 2nd Year PBL Core Experiences PBL Core Experiences PBL Core Experiences PBL PBL Core Experiences PBL Core Experiences Anatomy & JUMPstart Individually scheduled time Individually scheduled time Clinical Skills Experiences Clinical Skills Experiences Clinical Skills Experiences Clinical Skills Clinical Skills Experiences Clinical Skills Experiences HMS Masters Thesis HMS Masters Thesis HMS Masters Thesis Masters HMS Masters Thesis HMS Masters Thesis Assessment Assessment Assessment Assessment Assessment Assessment Assessment Assessment Assessment Assessment Assessment UC Berkeley – UCSF Joint Medical Program (JMP)Pre-clerkship medical school roadmap • Contextually-Integrated Case-Based Curriculum (CICBC) • Covers the equivalent of the “foundational sciences” • Entirely Problem-Based Learning (PBL) • No required lectures! • Clinical Skills Patient Care Curriculum (CSPCC) • Covers the equivalent of “intro to doctoring” courses • Culminates with an Observed Structured Clinical Exam (OSCE) to ensure readiness for clerkships • Master’s Thesis • Spans the entire 3 years (not just 2) • Includes general training in research skills & longitudinal mentoring • Required and elective UC Berkeley coursework • Culminates with a research thesis • The M.S. is an academic degree in Health and Medical Sciences awarded by UC Berkeley Clerkship Rotations begin at UCSF USMLE self study

Break Break Break Break Break 2nd Year 3rd Year 1st Year PBL Core Experiences PBL Core Experiences PBL Core Experiences PBL PBL Core Experiences PBL Core Experiences Anatomy & JUMPstart Individually scheduled time Individually scheduled time Clinical Skills Experiences Clinical Skills Experiences Clinical Skills Experiences Clinical Skills Clinical Skills Experiences Clinical Skills Experiences HMS Masters Thesis HMS Masters Thesis HMS Masters Thesis Masters HMS Masters Thesis HMS Masters Thesis Assessment Assessment Assessment Assessment Assessment Assessment Assessment Assessment Assessment Assessment Assessment UC Berkeley – UCSF Joint Medical Program (JMP)Pre-clerkship medical school roadmap • After 10 years of an entirely PBL-based • pre-clerkship medical school curriculum: • This really does work– students are incredibly creative and talented teachers! • It is wise to prepare students for this radically-different notion of an entirely collaboratively and student-led curricular structure • There can be amazing synergy between students’ individual strengths and areas for growth • Handoffs between outgoing and incoming faculty tutors are highly valuable • The most “poisonous” element is when individual students “check out” • Group tension is inevitable over the long journey(s) • One must carefully respect student autonomy and ownership of the process • One must also maintain a safe space for students to learn • Other curricular models may feel “threatened” by the information era, but we feel it only enriches our students’ capacities to fully engage the power of PBL! “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014 Clerkship Rotations begin at UCSF USMLE self study

Questions & answers What questions can we try to answer? “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

reflections Let’s review your original goals for this workshop and see if we addressed them “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Where do YOU go from here? Self-directed Learning: • Did you get what you wanted out of today’s workshop? • Is there anything else you want to look up soon? Index card next step activity! • Side 1: What do you hope to accomplish 3 months from today? • Side 2: What mailing address would you like us to send this index card to 3 months from now? Image from http://lenpenzo.com “Problem-Based Learning in the era of Google & Wikipedia” A. Azzam. D. Valenzeno. IAMSE Conference 2014

Problem Based Learning in the Era of Wikipedia & Google amin_azzam@berkeley.edu Amin Azzam, MD, MA University of California, Berkeley & San Francisco Dennis Valenzeno, PhD University of Kansas School of Medicine, Wichita dvalenzeno@kumc.edu A. Azzam. D. Valenzeno. IAMSE Conference 2014

Problem Based Learning in the Era of Wikipedia & Google