Problem Sets allow for multiple competency acquisition in first year neuroscience course

Abstract

Self-directed learning (SDL) is an expected element of medical education programs. LCME standard 6.3 requires that students engage in all the following components of SDL as a unified sequence: identify, analyze, and synthesize information relevant to their learning needs, assess the credibility of information sources, share the information with their peers and supervisors, and receive feedback on their information-seeking skills. A classic tradeoff of problem-based learning (PBL) and lecture oriented pedagogies lies between life-long learning skills and content coverage. Problem sets were developed to ensure coverage of learning objectives while allowing students to engage in SDL as defined by the LCME. The neuroscience curriculum for first year medical students at the Medical College of Georgia was restructured to include problem sets in place of lectures related to special senses, somatosensory, motor systems and mental health. The purpose o f this study was to document whether problem sets provided students effective engagement in SDL, and to determine if medical knowledge competency suffered as a result of this shift in pedagogical strategy. Small groups of four students met to evaluate, solve, and discuss each problem set in a series of three meetings. Students were provided learning objectives, cases, and associated discussion and supporting questions. Students initiated a problem set by reviewing learning objectives and cases, identifying individual learning needs, and developing an individual inquiry strategy. During the subsequent meeting, students shared information learned and discussed responses to discussion questions. The final meeting involved a discussion of the problem sets between two groups with a faculty facilitator. Groups were randomly assigned discussion questions and students took turns presenting their findings. Over the course of four problem sets, each student presented findings for two discussion questions. Faculty facilitators used rubrics to assess student competency in all SDL domains. To document student engagement in SDL, data from student assessments were tabulated. To determine whet her medical knowledge was negatively affected by replacing lectures with SDL, student performance on 19 test items mapped to learning objectives covered in problem sets was compared with the same test items mapped to learning objectives covered in lecture in the previous year. Students scored 4.8 ±± 0.5 out of 5 on their ability to identify and analyze information relevant to learning needs, 4.6 ±± 0.6 out of 5 on their ability to use credible sources, and 4.7 ±± 0.6 out of 5 on their ability to effectively communicate information. A two-tailed t-test of percentage correct for all test items indicated no statistically significant differences in student performance on test items mapped to learning objectives (84.4±±10.4 % [lectures] vs. 85.7±±11.5[SDL], p=.71, d=.12). This study shows that students effectively engaged in SDL using problem sets without negatively impacting coverage of medical knowledge. More study is needed to determine if SDL skills improved as a result of problem sets. Future steps include assessment of long term retention of medical knowledge resulting from SDL vs. lecture. In conclusion, problem sets as a pedagogical approach achieved multiple competency-based objectives by providing students an opportunity to develop life-long learning skills and acquire medical knowledge.