The tutorial process

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The tutorial process

• Anne Baroffio, PhD,
• Unit of Development and Research
• in Medical Education
• University of Geneva - Faculty of Medicine

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Instructional approaches in an integrated
curriculum

• Problem-based small group tutorials
• Lectures
• Forums/ Discussions
• Seminars
• Practical laboratory sessions
• Practice-based learning

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Objectives of PBL

• analysis et synthesis of problems
• acquisition of basic medical sciences knowledge
• collaborative learning
• integration of disciplines
• self-directed learning
• small group functioning

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The process of PBL at a glance
Problem analysis
Tutorial 1
Learning objectives
Self study
Problem explanation
Tutorial 2
Evaluation
learning
group
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Question

• Based on the PBL process and on your experience
  in the simulation of yesterday, what should a
  tutor do ?

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What should a PBL tutor do?
process

• Know the process of PBL
• Understand the problem content
• Be committed to student-directed learning
• Generate a non-threatening environment
• Promote discussion and critical thinking
• Willing to make constructive evaluation of
  student and group performance

cognitive
group functioning
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The 8 steps of PBL
1. CLARIFY unknown terms in the problem.
2. DEFINE the problem
5. FORMULATE your learning objectives
3. ANALYZE the problem
4. DISCUSS AND ORGANIZE your explanations
6. SELF-DIRECTED LEARNING
7. SHARE and APPLY the new knowledge in
explaining the problem
8. EVALUATE the group learning and process
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Tutor
Traditional Tutorial
Students
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Tutor
PBL Tutorial
Students
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Students functions

• Group leader
• Manages PBL steps
• Watches the time
• Manages the group functioning
• Secretary
• Keeps track of the discussion
• Blackboard, flip-chart,
• Scribe
• Records consensus ideas on paper

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• PROBLEM SIMULATION
• SMALL GROUP EXERCISE

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Simulation Mister Karr

• Mr Karr, a taxi-driver, had this morning a
  violent dispute with another car-driver. Some
  minutes later, he feels an intense constrictive
  pain in the chest irradiating to the left
  shoulder and the left arm. As the pain is still
  present some 30 minutes later, one of his
  colleagues calls the emergency centre of the city
  for an ambulance.
• When he arrives at the emergency centre
  of the hospital, the patient is agitated,
  sweating, nauseous, and stills complaints of
  chest pain. His blood pressure is 170/100 mm Hg
  and the pulse is 84/min regular. The auscultation
  of the heart and the chest are normal. The EKG
  shows typical signs of acute myocardial infarct
  (Pardees waves). A blood test is performed to
  measure the level of his cardiac enzymes and the
  appropriate treatment is quickly started.
• Mr Karr asks Hey doc, what is a
  myocardial infarct and why do you need to take my
  blood for analysis?

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Simulation Mister Karr

• Mr Karr, a taxi-driver, had this morning a
  violent dispute with another car-driver. Some
  minutes later, he feels an intense constrictive
  pain in the chest irradiating to the left
  shoulder and the left arm. As the pain is still
  present some 30 minutes later, one of his
  colleagues calls the emergency centre of the city
  for an ambulance.
• When he arrives at the emergency centre
  of the hospital, the patient is agitated,
  sweating, nauseous, and stills complaints of
  chest pain. His blood pressure is 170/100 mm Hg
  and the pulse is 84/min regular. The auscultation
  of the heart and the chest are normal. The EKG
  shows typical signs of acute myocardial infarct
  (Pardees waves). A blood test is performed to
  measure the level of his cardiac enzymes and the
  appropriate treatment is quickly started.
• Mr Karr asks Hey doc, what is a
  myocardial infarct and why do you need to take my
  blood for analysis?

• Small group exercise
• Time 1 hour
• Run across the steps of the first tutorial with
  your tutor
• Come back with a diagram explaining the problem

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• DEBRIEFING

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Rationale and Cognitive Bases for Active Learning

• Nu Viet Vu PhD
• Unit of Development and Research in Medical
  Education
• University of Geneva - Faculty of Medicine

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• INFORMATION
• TEACHER LEARNER
• ACTIVE
• Schmidt, HG. Foundations of problem-based
  learning some explanatory notes. Medical
  Education, 1993, 27422-432.

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Conditions facilitating learning

• Prior Knowledge

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Playing chess
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Playing chess

• What do you remember having seen?

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Conditions facilitating learning

• Prior knowledge
• Activation

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A test exercise(Adapted from Brandsford
Johnson, 1972)

•   A newspaper is better than a magazine. A
  seashore is a better place than the street. At
  first, it is better to run than to walk. You may
  have to try several times. It takes some skill
  but its easy to learn. Even young children can
  enjoy it. Once successful, complications are
  minimal. Birds seldom get too close. Rain,
  however, soaks very fast. Too many people doing
  the same thing can also cause problems. One needs
  lots of room. If there are no complications , it
  can be very peaceful. A rock will serve as an
  anchor. If things break loose from it, however,
  you will not get a second chance 

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A test exercise

• What do you remember having read?

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Flying a kite(Adapted from Brandsford Johnson,
1972)

•   A newspaper is better than a magazine. A
  seashore is a better place than the street. At
  first, it is better to run than to walk. You may
  have to try several times. It takes some skill
  but its easy to learn. Even young children can
  enjoy it. Once successful, complications are
  minimal. Birds seldom get too close. Rain,
  however, soaks very fast. Too many people doing
  the same thing can also cause problems. One needs
  lots of room. If there are no complications , it
  can be very peaceful. A rock will serve as an
  anchor. If things break loose from it, however,
  you will not get a second chance 

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Conditions facilitating learning

• Prior Knowledge
• Activation
• Elaboration
• Structuration

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Elaboration, Structuration  Paired Associates 

• Dog Bicycle
• Lake Cross
• Shoes Leaves
• Car Cigarette
• Bag Wheel
• Stone Tree
• Statue Telephone
• Class Flower
• Cloud Pin

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 Paired Associates 

Leaves
Shoes
Wheel
Bag
Telephone
Statue
Cloud
Pin
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Conditions facilitating learning

• Prior Knowledge
• Activation
• Elaboration
• Structuration
• Organization (Knowledge representation)

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Structuration, organizationFrom Geneva to
Strasbourg

• Flights Departure Destination
• 201 Amsterdam Paris
• 202 Amsterdam Genève
• 206 Paris Amsterdam
• 235 Genève Amsterdam
• 140 Bruxelles Paris
• 141 Bruxelles Genève
• 143 Paris Bruxelles
• 511 Paris Zurich
• 512 Paris Strasbourg
• 513 Zurich Paris
• 514 Strasbourg Paris
• 644 Zurich Bruxelles
• 645 Bruxelles Zurich

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From Geneva to Strasbourg Structuration,
organization - diagram

• Amsterdam

• Bruxelles

• Strasbourg

• Paris

• Zurich

• Genève

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Learners representation of the digestive system
Elaboration, Structuration, Organization
Adapted from André Giordan
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Diagram representation of Mr. Karr
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Conditions facilitating learning

• Prior Knowledge
• Activation
• Elaboration
• Structuration
• Organization (Knowledge representation)
• Context

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Context

• Specific Knowledge
• Context
• Analysis and Problem
• Solving Strategies

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Needham Begg study (1991)

• Group 1 Read the problem and the solution
• (success 60)
• Group 2 Resolve the problem and receive
  appropriate feedback
• (success 90)

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Conditions facilitating learning

• Prior Knowledge
• Activation
• Elaboration
• Structuration
• Organization (Knowledge representation)
• Context
• Transfer

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Transfer (Gick Holyoak, 1983)

• Group 1 Read the problem - Was given solutions
• Group 2 Read the problem - Attempt to
  problem-solve
• Group 3 Read the problem - Attempt to
  problem-solve - Was given solutions

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Transfer (Gick Holyoak, 1983)

• Group 1 Read the problem - Was given solutions
• No transfer - 10 success
• Group 2 Read the problem - Attempt to
  problem-solve
• Spontaneous transfer 30 success
• Group 3 Read the problem - Attempt to
  problem-solve - Was given solutions
• Informed transfer 75 success

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Conditions facilitating learning and within
context of a problem a summary

• Define/ explain phenomena
• Discuss/organize proposed explanations
• Formulate/ read on learning objectives
• Integrate/synthesize new acquired knowledge to
  explain the problem

• Activate prior knowledge
• Elaborate/structure/ organize prior knowledge
• Self-evaluate/learn in self-directed manner
• Elaborate/structure new knowledge with prior
  knowledge

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Conditions facilitating learning

• Prior Knowledge
• Activation
• Elaboration
• Structuration
• Organization (Knowledge representation)
• Context
• Transfer

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