Steven Pearce

RN, MSc, BA (Hons), Dip Ed.

Anna Jones RN, MSc, BN.

Problem Based Learning - Definition Problem based learning

is a form of educational practice whereby the student is presented with a problem which then acts as a catalyst for learning.

PBL is a popular approach to learning in health care.

It aims to develop problem-solving skills and foster team-working.

PBL differs from the lecture or the “talk and chalk” model in that the students themselves direct their own learning and the tutor acts as a facilitator or guide

PBL: Its use within Critical Care Education.

PBL used within the clinical area

More structured application within academic setting

Accredited learning

Develop critical thinking skills essential for critical care working

Cardiff University, Critical Care and PBL Introduced to support the

development of a new critical care nursing module, at BSc (level 6 HeFCW)

An alternative mode of learning and teaching that draws on the problem based nature of critical care nursing

Had previously been applied to undergraduate nursing within the University of Wales College of Medicine (UWCM) – merged with Cardiff University

The aim of the BSc. (Honours) pathway in critical care nursing was to develop a caring patient focused, inquiring and flexible nurse, who can analyse and engage in practice development, reflecting the level of patient need rather than being determined by the clinical environment.

Buckinghamshire New University, Critical Care and PBL. Within the Intensive Care module and Acute

Respiratory Care module, PBL was introduced as a specific element

An alternative learning mode in addition to the traditional methods approach to teaching

PBL was applied to assist with group cohesion due to the multiple units/ students that recruit to the modules

PBL also influenced learning and teaching due to the multicultural nature of the student body

So what does PBL look like?

Trigger Questions: A Critical Care Example The patient’s history:

George Thomas, a 58 year gentleman. He is a list case admission for aorto bifemoral bypass. Day 5 post operative a collection is noted on the right hand side of the abdominal wound, excised and drained of pus. Day 6 George’s condition deteriorates with increased temperature, tachycardia and he begins to cough up sputum. His oxygen saturations drop with bilateral crackles in lung bases. Seen by surgical registrar who makes a provisional diagnosis of pneumonia.

Trigger questions:

Discuss the political and professional care content to include the origination of the DoH (2001) and WAG (2006) levels of patient classification.

Discuss Outreach and MEWS, and the related professional implications.

George has become dehydrated and requires fluid management. Discuss the rationale, implications and nursing interventions when administering:

Colloid

Crystalloids

Trigger Questions: A Respiratory Care Example

Trigger questions: Discuss end of life issues in

relation to patients with a long term chronic respiratory disease

Take into account the principles of breaking bad news and the role of the nurse.

Considering professional and political drivers, as well as Tom’s past medical history, including the events of his recent hospital admission, discuss the options available to help Tom live as independently as possible back in the community.

Qualitative Evaluations: Bucks New University:

‘It relies on everyone pulling their own weight’

‘Sometimes difficult to establish good communication within PBL group’

‘Gives you the independence of working at your own pace’

‘Makes you look at the patient from different aspects’

‘Allows you to discuss problems and not just accept facts’

‘Students can spot their lack of knowledge and focus their work on it’

‘More interactive and creative way of learning’.

Cardiff University:

‘Triggers took time -distracted from focus of other learning needs’

‘Bit more taught lectures would have been appreciated’

‘Course could have taught much more’

‘Enjoyable - researching focused topics’/ ‘Enjoyed the triggers – made me go away and gather info rather than just being taught in class’

‘Better way of learning’/ ‘Lots of self directed learning – good’/ ‘Learning needs met’

‘Found it very helpful with regards to my work as a critical care nurse’.

Benefits and limitations: Benefits:

Teaches additional skills such as presentation skills

Develops team working within education

Social skills development

Triggers reflect real life situations – preparation for practice.

Limitations:

Resource intensive

Student perceptions of PBL versus traditional teaching methods

Use within post-registration courses limited

Conclusion and future development Financial and political drivers

will in future decrease study leave, therefore need to equip nurses with self directed learning modes – ‘learning how to learn’

Incorporation into more programmes and modules at all levels of education

Education within the UK moving towards all graduate workforce, therefore need to support nurses’ learning

Thank you – any questions? Diolch yn fawr – unrhyw gwestiynnau?