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Donald R. Woods, "Problem-based Learning: resources to gain the most from PBL," D.R. Woods, Waterdown, ON, ISBN 0-9698725-2-6, revised 1996 A. How to.move toward PBL
A.1 Osterman feedback lecture, A-1
A.2 MPS-Osterman feedback lecture, A-4
A.3 Use feedback forms, A-11
A.4 Feedback forms, monitor, mark, A-13
A.5 Guided Design, A-16
A.6 Relaxed Guided Design, A-18
A.7 Socratic facilitation, tutor-directed case example, A-19
A.1 Osterman feedback lecture
For a description and some details see Woods (1991).
Before class:
1. Identify a topic section of your course that has about 3 to 6 h of lectures
and that ends with a homework assignment

2. Present the homework assignment first as the "big context problem".
3. Prepare the major themes of the reading material and divide it into 20
min section

4. Identify meaningful, short, 5 min problems for in-class work. These can
be simplified versions of a large assignment. For example, "Identify the
key issues in the task." "Plot three data points. (instead of 52)

5. Create the learning guide for each 1 h of lecture indicating the
Reading: to be done before the lecture
Bring to class: what they need in-class
Mini-lecture: outline the key ideas for the first 20 min "lecture"
Activity: In-class problem: pose the problem
Second mini-lecture: outline the key ideas for the second 20 min "Lecture"
For next day: outline what they need for the next day.
Example: Table A-1.
6. Create the transparencies for the mini-lectures.
Example: Table A-2.
7. Duplicate copies of the full set of learning guides and the transparencies
for all of the lectures. Hand this out 1 week before the series starts.
Describe the expectation that students learn before class and use the in-
class time to work together to apply and solve problems.

Present in class:
1. Pose the "Big context problem" first.
2. Raise the various issues the problem suggests and lead into the subject
of the first mini-lecture. Bring a timer set for 20 min because when you
lecture, it's too difficult to keep track of time.

3. After 20 min, ask pairs or groups of students to work on the problem.
(Anyone who didn't do the learning before class will now see that they are
unprepared. They will do the reading for next class. That's why you need
to try this experiment for at least 3 classes.)

4. During this time, you circulate so as to answer questions, see how well
the students understand and get "feedback" about the quality of their
learning so far.

5. After 5 min of students actively working cooperatively on the problem,
summarize, respond to what you have seen or to questions that are causing
difficulty so that after a total of 10 min on the activity you can.

6. Complete the next 20-min mini-lecture and end with the reminder of the
assignment for next day.

About the series of Feedback lectures
1. The big-context problem is used at the start of the activity; close out a
particular series with a return to use the subject knowledge to "solve" the
big-context problem.

2. Extensions of other types of problems you can now solving using the
knowledge.

1. This method helps you shift the learning to before the classroom activity
2. You get feedback about the quality of the learning from the activity
3. You can use your skills to help them with the problem solving
processing in-class.

4. This overcomes the 20 min boredom that always sets in after 20 min to
"lecture"

5. Students are active and cooperative
6. Involves opportunities for processing skills
7. It has elements of problem based because you pose the problem first.
This models the use of the problem to drive the learning. Granted, the
teacher structures the subject knowledge and what to learn and the
resources. However, there is now a global, problem context.

8. How to use HTGTM in this context? Very little.
9. Why do it? It brings in some of the fundamentals to improve learning; it
is a minor shift from the traditional lecture; my experience has been that it
is extremely effective (both in the quality of learning, and in the student
evaluations about the course).

For more:
See Woods, D.R. (1991) J of College Science Teaching 20, Mar/April 298.
Example preparation page: Table A-1Example transparencies: Table A-
2A.2 MPS-Osterman feedback lecture

This adds structure to the 10 minute Activity.
In the Osterman feedback lecture, the students bring their native problem
solving, interpersonal skills (or lack thereof), to the 10 minute Activity. We
can use this opportunity to start explicitly developing "process skills."

The term "explicitly develop" means:
1.We have/set learning objectives that describe the skills. (Examples are
given in Section D.3.)

2.We ask students to gather evidence to illustrate process in achieving the
goals/objectives.

3.We assess their progress.
4.We assess their skill.
5.We should legitimize this by including this in the course outline, in the
calendar description and by including questions about it on the final exam
(or whatever other assessment method we use).

Students will appreciate this because:
1.They know the value of these skills; having the skills will help them
obtain summer jobs or good placement experience.

2.Adding the structure (especially items 2, 3 and 4) will develop their
confidence that they have these skills.

Example explicit activity to include:
1. TAPPS: talk aloud pairs problem solving. A description of a longer
workshop is given in Table 3-2 as MPS 1 and by Woods (1984). Use the
ideas given in this article and have one person listen (in the pair of
students) as the other person talks aloud while solving a content-
independent problem. Ask both to reflect and complete feedback forms.
Time: 10 min. The next session, reverse roles and repeat. In the third
session, ask/reflect about the feedback forms; introduce the importance of
monitoring. The fourth session, repeat using subject-rich problems plus
concern for accuracy. The fifth session, repeat using subject-rich problems
with accuracy. Submit the evidence sheets together with a 1-page

reflection/assessment. Example problems in Pharmacy given in Table A-3;
in Nursing, Table A-4; in Engineering, Table A-5. For more, see Section
C.3.

2. Strategy: TAPPS plus strategy board. A description of a longer
workshop is given in Table 3-2 as MPS 4 and by Woods (1985), and
HTGTM p 3-23. Use the ideas given in that article; ask one person to talk
aloud and move a marker to identify the stage they are working on. The
other person, in the pair, listens. Use it first in a content-independent
Terry Sleuth detective story (HTGTM p. 3-26). Extend to add monitoring
and to use Terry Sleuth problems in the context of your subject discipline.
Examples are given in Tables A-6, A-7 and A-8 for Pharmacy, Nursing
and Engineering, respectively. For more see Section B.3.

3. Hypothesis generation and creativity. A longer workshop is described in
Table 3-2 as MPS 7 and by Woods (1986). Use components of it in the 10
min Activity.

4. Group skills: described in HTGTM p. 5-19. The first 10 min Activity
focuses on the feedback form [HTGTM p. 5-9] and the terminology. The
second session, create a group of 4 to 5 with individual observers who use
the feedback form. Ask group to do a task; then the group assesses their
progress. Finally have observers give feedback to their individual clients.
This is described in Table 3-2 as MPS 27-28 and by Woods (1989) and
Section B.5.

References
Woods, D.R. (1984) MPS Awareness workshop, J. of College Science
Teaching, 13, 470.

Woods, D.R. (1985a) MPS Strategy workshop, J. of College Science
Teaching, 14, May, 523-525.

Woods, D.R. (1986) MPS Creativity workshop, J. of College Science
Teaching, 15, Feb, 410.

Woods, D.R. (1989) MPS Group skills workshop, J. of College Science
Teaching, 19, Nov, 109.

Table A-3 TAPPS for Pharmacy
Pharmacy 240
Some drugs need to be refrigerated at 2 -10oC; some kept in a cool place at
10 - 15oC while others can be stored elsewhere at temperatures that might
exceed 15oC. Which of the following must be refrigerated?

1. adrenaline injection
2.influenza injection
3.benzylpenicillin sodium
4.procaine penicillin injection
5.phenoxymethylpenicillin tablets (Penicillin V)
6.chloramphenicol eye drops
7.typhoid vaccine
8.streptase (streptokinase and streptodornase powder)
9.insulin injection
10.other
Pharmacy 231 (created with the help of Suzi Woods)
Which of the following, if any, would be used to treat hypertension:
1.timolol
3.phenobarbitol
4.oxymorphone
5.propranolol
6.epinephrine
****************
Pharmacy 232 (created with the help of Suzi Woods)
Some of the following drugs vasodilate (V); some prevent clotting (C);
some are á blockers (B) and some may be none of the above (N). Classify
each of the following as to the category with the symbols V, C, B, or N.

1.ASA _____
2.prazosin ____
3.heparin ____
4.hydralazine ____
5.digoxin ____
6. captopril ____
7.propranolol ____
8. phenoxybenzamine ____
9.epinephrine ____
10. yohimbine ____
*****************Pharmacy 233 (created with the help of Suzi Woods)
Which of the following would be prescribed for problems related directly
to the cardiac-vascular system?

1. imuran
2.heparin
3.diazepam
4.meperidine
5.propranolol
6.prazosin
7.vigabatrin
8.azathioprine
Pharmacy 234 (created with the help of Suzi Woods)
What is common to most of the following and which do not belong to the
largest common group:

1.lidocain
2.phenobarbitol
3.digoxin
4.diazepam
5.potassium bromide
6.vigabatrin
7.meperidine
****************
Pharmacy 235 (created with the help of Suzi Woods)
What is unique about this collection of drugs:
1.calciparine
2.valium
3.lanoxin
4.diazepam
5.azathioprine
6.heparin calcium
7.digoxin
8. imuran
Table A-4 TAPPS for Nursing
A patient has 150 meq/L sodium level in his blood. Which of the following
evidence is consistent with this information:

a. ruddy complexion
b. heart rate 70
c. chronic cough
d. perspiring on a relatively cool day
e. nervous and agitated
f. argumentative with clear logic
g. comatose
h. other (specify)
A patient has a haematocrit of 0.60. Which of the following evidence is
consistent with this information:

a. pale complexion
b. heart rate 110
c. chronic cough
d. normal reading
e. mopping her brow
f. nicotine stains on the first two digits of her left hand
g. complains of dizziness
h. breathing is slow and deep
i. pupils are slow to respond to bright light
j. other (specify)
Table A-5 TAPPS for Engineering
Table A-6 Terry Sleuth for Pharmacy
440: Terry Sleuth and the Case of Mr. Smith (created based on Dunn et al.
(1985) and with the help of Nancy Koppert)

JoAnne perused the recent newsletter which contains an article about
forgeries. The article warns pharmacists about possible forged
prescriptions that are being presented to obtain drugs of abuse. Recently,
forged prescriptions had appeared for a patient using the name Karl or
Robert Smith. Furthermore, Smith, of the Queen's Road trailer park, had
tried to obtain prescriptions for morphine from two pharmacies on the
same day. "Ahah" she thought, "I had better watch out for that. It is
common knowledge that I keep a large stock of Morphine, Codeine and
valium." She glanced up and noted her long time friend but retired
pharmacist/detective Terry Sleuth. She called Terry over and pointed out
the notice."Look at all the stuff we have to worry about these days."
Terry greeted her and looked at the notice. Further conversation was
curtailed because JoAnne went to the counter to attend to Mrs. Franchuk.
JoAnne turned and looked through the "cool storage". She turned in
frustration."There should be some Procain penicillin injection here. It
was restocked last week. But I don't see it." Terry scanned the shelves.
Benzylpenicillin sodium, adrenaline, Streptase, Penicillin V tablets. but
no Procaine penicillin injection. Terry commented, "Don't you have a new
assistant? Perhaps, she stored it in the refrigerator, even though it need
only be stored in a cool place."

JoAnne turned, opened the refrigerator and then beamed at Terry."Here
it is. Thanks for solving that one!"

While Joanne was completing the prescription for Mrs. Franchuk, a
stranger approached the prescription counter. He was tall, dark, about 35;
his tanned skin and poise suggested self-confidence and work outdoors.

Despite that poise there seemed to be a nervousness as he flicked his eyes
around the Pharmacy. When Mrs. Franchuk chatted her way out of the
store, he passed his prescription to JoAnne. She read it, paused, excused
herself, and then went to the back to phone. Worry seemed to encompass
her brow. She then came over to Terry. As gently as if she was handling a
timebomb she set down the prescription on the counter. It was written for
Mr. Phil Smith and signed by Dr. Kershaw. She added."I know Kershaw,
this is his signature, I phoned his office. Kershaw is in emergency, all the
receptionist could do at this time is to confirm that Phil Smith is a patient
of Kershaw; although she doesn't recall Smith being in for an appointment
recently.

The prescription was for 2 x 200 mL bottle of Codeine Phosphate, 60
Valium Tablets 5 mg, Streptase (a million units) and Ventolin inhaler.
JoAnne recalled that Streptase was a powder mix of streptokinase and
streptodornase used for anticlotting. In the UK she recalled it was called
Varidase.

Mr. Smith's well-cultured voice interrupted their thoughts. "Could I
please have the prescription filled. I am a little pressed for time. I'm
catching an 11 o'clock flight overseas on business. I was lucky I caught Dr
Kershaw on his way to some emergency. I just would hate to be in the
Philippines without that medication."

JoAnne looked at Terry. Terry said."I don't think you should fill that
prescription." Why?

Table A-7 Terry Sleuth and Nursing
Case 320 Terry Sleuth and the Case of the Questionable Holter Monitor
(developed with the help of M. Lea and D. Patton)

Jane looked puzzled, "Ah - Terry would you mind coming over and
looking at the tracing from a Holter monitor," she called out as Terry
walked past the office. Terry was pleased to see a challenging new problem
and this sounded like one just from the tone of Jane's voice.

Terry looked at the output recording and scanned it. It all seemed to be the
normal set of blips except for the place where Jane pointed where the trace
was absolutely flat. "See there; not even a wiggle!" The darn machine
must be acting up again. Remember last week when Mr. James was
hooked up to it, the whole last 5 hours was straight like this. He said that

the monitor slipped off his shoulder and hit the concrete. They were
supposed to repair it before they hooked it up to Mrs. Kaplinski.

Terry looked at the trace again. Terry was a little puzzled. "Tell me more
about Mrs. Kaplinski."

"Well," said Jane, "she's a 21 year old secretary who has complained of
fainting spells, dizziness and weakness. She says it is not related to any
stress, but she is a little vague about that. She did mention that she's very
frightened of hospitals and needles, and that she has fainting spells when
blood is drawn."

"Hmm," said Terry. "Did you ask about any family emotional problems
like suicide?"

"No," Jane responded. "I felt that I had sufficient information so I
referred her to Dr. Smitzer, the neurologist on Ward 7. He's not the
greatest, but he was the only one in at that time. He diagnosed a possible
convulsive disorder."

"Did he tell you the basis of his decision?" asked Terry.
"No, you know him; if we asked he would think we were questioning his
competence."

"So, next you hooked Mrs. Kaplinski up to the Holter monitor?" asked
Terry.

"No. We gave her a complete physical and here are the records," replied
Jane.

Terry scanned what might be the most pertinent data and saw:
Hct:33.2
Hgb:14.6
WBC:11.2
Glucose:48
"Rinnng." "Excuse me Terry while I answer the phone. Hello, Stebbing
speaking." The conversation lasted a short while. Then Jane hung up,
turned to Terry and said, "that was the lab; they were trying to do a 2 h
P.C. on Mrs. Kaplinski when she became ashen pale, lost consciousness
and convulsed." Jane continued, "too bad that stupid Holter monitor
doesn't work."

Terry looked carefully at Jane and said.
What did Terry say?
Table A-8 Terry Sleuth and Chemical/Mechanical/Civil Engineering
A.3 Use feedback forms
Make the implicit explicit by using feedback forms. Table A-9 offers
various levels of reflection you might ask students to do. For the use of
feedback forms only, use column 2 of Table A-9. Identify the process skills
that you wish to reflect on. Select the appropriate feedback form from
HTGTM and ask the students to complete the form whenever it is
appropriate.

Example A-1
Chantelle wants to apply a little more focus on developing the student's
"lifetime learning skills." She feels she can allow perhaps 5 minutes per
tutorial. She is willing to try feedback forms. Now what?

An Answer
From Table A-9, Chantelle notes that she might try an "awareness" and
"skill" checklist. From HTGTM, in Feedback forms following p A-2, she
considers only the section on Self-directed, interdependent learning. The
description is:

aware of the educational fundamentals and uses these to teach others, sets
explicit learning objectives that have measurable criteria to identify
achievement and that are achievable with the resources available,
considers a wide range of learning resources, and willingly draws on peers
as resources, agonizes through the difficult parts of the subject [instead of
skipping these and hoping they are not pertinent], creates forms of
evidence to show accomplishment and applies these to both the knowledge
learning and the process used."

Chantelle realizes that she must spend some time ensuring that the
students understand this description. She asks the students to discuss with
each other the meaning of the terms in this description and pose any
questions for clarification. The group then discusses and clarifies the
meaning.

In the next session, she asks students to rate their own awareness and skill
in the process as described above.

Time must be spent ensuring that all students are clear as to the
dimensions of the skill being considered. Chantelle does a nice job here.
She does not lecture at them. She poses the problem to them and let's them
identify what they need to know.

Example A-2
In the next session, Rene rates his awareness as 10 and his skill as 10.
Although Chantelle is working with tutorless groups (so that she is not
present in Rene's group) based on her general observations she would rate
Rene as 6/10 on awareness and 4/10 on skill. What does she do now?

An Answer:
Using the forms in isolation without asking them to hand them in with
evidence means that the students have been empowered to do the task yet
are not held accountable. The key, missing ingredient is evidence.
Chantelle might respond to Rene as follows:

"Rene, I am delighted that you rate yourself highly on both awareness and
skill. What evidence would you supply to an independent observer that
you are aware and skilled with, for example.

"considers a wide variety of learning resources"?"
At this stage Rene probably would respond "I'm not sure, I just know."
"Let me help you then, could you supply a list of the resources you
considered in preparation for the last "teach" session. Would the list
include a range of different sources? or one book? who did you consult?
and so on. I'm sure you can think of imaginative ways of generating
evidence of your awareness and skill. What can I do to help you gather
that evidence?"

Chantelle correctly focuses on evidence and positively shows a willingness
to help Rene collect the kinds of data that will quantify "intuitive feelings"
both by her and by Rene.

Table A-9 Successive levels of feedback and monitoring
Level 2: complete specific Level 3: form
Level 1: complete
given in Section F-2
everyday life other
supplied to substantiate the than your PBL group. claim. see Section F-2.
Awareness and skill HTGTM, self-monitoring page journal
Change & stress form following p A- stress. plus worksheet See completed once per 2 in HTGTM.
Opportunity Table 1-6, p. week. An Example is
1-11; HTGTM
given in Section F-4.
successive problems HTGTM, 12-item
or cases the students checklist for problem
awareness and skill. structured so ask them to Use a scale of 0 to Table 5-1., p. 5-9:
HTGTM, four dimension
interpretation of the as described in Section 5.3-6, p. 5-11, HTGTM.
p. 5-13; HTGTM or use
form in Section F-5.
HTGTM. Team to
Table 7-3, p. 7-15,
HTGTM. Ask all
you whenever you contribute to the "teach meeting." HTGTM; self, peer or
tutor complete this.
A.4 Feedback forms, monitor, mark
Here we add more structure to the approach described in Section A.3.
Columns 3 and 4 in Table A-9 summarize Levels 2 and 3 for this approach.
Forms are completed by peers, self or tutor.

Monitoring
These are given to the student who reflects on this evidence, draws
conclusions and sets goals for improvement. Over a period of time, varying
from 1 week to 10 weeks, the student

- reflects on the application of the skill in different contexts: other PBL
experiences, other courses and in everyday life. S/he gathers evidence to
support claims about the use of the skill.

- sets goals for improvement, establishes criteria and the forms of evidence
s/he wishes to gather. Then, over a prolonged period of time, s/he gathers
the evidence, reflects on it and makes claims about accomplishment.

- students summarize the results. Sample forms are given in Table A-10
and illustrated in the example in Section F-5.

The tutor assesses the student's summary report based on completeness,
quality of the evidence, consistency in interpreting the evidence objectively
and relating the criteria-evidence to the objectives. An example feedback
form is given in Table A-11.

Table A-10 Example forms to guide the reflective journal writingTable A-
11 Example tutor's marking guide for the journals

A.5 Guided Design
Guided design is an extremely powerful approach. It is relatively easy to
implement; it can be used in large classes with tutorless groups. Wales,
Nardi and Stager (1994) describe it as follows

"Students working in teams of four to six are guided one step at a time
through each of the decision-making operations by a set of printed
"instructions" and "feedback" pages prepared in advance by the teacher.

Each student receives a copy of the instruction, which explains the
operation about to be performed and asks the student to complete it. When
the students are ready, the teacher checks their ideas and approves of what
they have done or suggests some additional ideas to consider. When the
teacher is satisfied with the work, each student is given a copy of the
printed feedback, which describes what a typical student group might be
expected to do. If the feedback is well written and the students in the class
have done an appropriate amount of thinking, the two results should be in
close agreement. This combination of feedback from members of the
group, from the teacher, and from the printed material helps students
develop the reflective thinking skills that they need. The printed material
also helps ensure that similar skills will be developed in multisection
courses taught be different instructors."

The printed instructions and feedback constrain the student approach
and, to some extent, control the ownership of the learning. Students are
not allowed to deviate far from the preset pattern. Ideas for relaxing this
limitation is are given in Sections A-9 and A-10.

This "limitation" is indeed one of the great strengths of this approach. It
provides the tutor with the degree of quality control and monitoring that
allays instructor's fears that the students are "learning the wrong things"
or are "not learning the right things." Guided Design is an excellent way to
get started.

Since it takes so much effort to create the printed instructions and
feedback sheets, try to locate modules and materials from those who have
already developed them. Table A-12 lists some of the resources.

References
Colvin, S.T., D.A. Kilmer and J.E. Smith (1972)"Guided Design in
environmental education," Engineering Education, 62, 907-908.

Cox, Cheryl and A. Ponting, Pharmacy, University of Alberta, Edmonton,
AB T6G 2N8. personal communication; series of 18+ case problems
worked up for PBL following the generalized Guided Design format.

Jang, R. and S.W. Solad (1990) "Teaching Pharmacy Student Problem-
solving: theory and present status," Am. J. Pharm. Education, 54, 161-166.

Pawlak, S.M., N.G. Popovich, J.W. Blank and J.D. Russell (1989)
"Development and validation of Guided Design Scenarios for problem-
solving instruction," Am. J. Pharm. Education, 53, 7-16.

Popovich, N.G. (1995) Purdue University, Lafayette, IN 47907-1335. Nick
has developed several dozen Guided Design modules in the context of
pharmacy.

Wales, C.E., R.A. Stager and T.R. Long (1974) "Guided Design," West
Publishing Company,

Wales, C.E., A. Nardi and R. Stager (1993) "Emphasizing Critical
Thinking and problem Solving," Chapter 8 in "Educating Professionals:
responding to new expectations for competence and accountability,"
L.Curry, J.F. Wergin and Associates, ed., Jossey Bass, San Francisco, CA.

Wales, C.E. and R.N. Hageman (1979) "Guided Design Systems approach
in Nursing Education," J. Nursing Education, 18 38-45.

Woods, D.R. (1984) "Guided Design as a Major Resource," J. College
Science Teaching, 14, Nov, 136.

Table A-12 Some "Guided Design" problems
Pawlak et al. (1989) Cox and Ponting, Jang and Solad (1990), A.6 Relaxed Guided Design
Guided Design starts with a problem. It provides structure for the problem
solving processing. The structure is more a "problem solving" application
to the problem "what do I need to know to solve this problem?" In many
ways it mirrors the eight steps of: (HTGTM p. 6-1)

1. Explore the problem, create hypotheses, identify issues. Elaborate.
2. Identify what you know already that is pertinent.
3. Identify what you do not know.
4. As a group, prioritize the learning needs, set learning goals and
objectives, and allocate resources. Members identify which tasks they will
do.

5. Individual self-study and preparation.6. Return to group, share the new
knowledge effectively so that all the group learn the information.

7. Apply the knowledge to solve the problem.
8. Assess the new knowledge, the problem solution and the effectiveness of
the process used. Reflect on the process. Elaborate on the problem.

Thus, in relaxing the formality of all the paper shuffling back and forth, in
relaxing the need for the detailed preparation of the feedback forms,
identify those parts of Guided Design that you can relax. First, you need to

pose the problem. The rest is a question of using imaginative ways to
monitor the group's progress; so that they are assured that they are on
task, and so that you have similar assurances. The advantages of starting
with the traditional, detailed feedback Guided Design is that you provide
everyone with a template for problem solving and working your way
through the process. Table A-13 gives some options for relaxing the
formality of the feedback in Guided Design.

Table A-13 Some options for relaxing Guided Design
step. Use the Guided Design "Thinking about Thinking" template. tutor collects the input from all verbally See Section A.7
provides an interesting way that the tutor Debrief the groups after the case is completed; or have the groups debrief each other. Popovich (1995) uses this approach. A.7 Socratic facilitated, tutor-directed PBL
The socratic facilitated, tutor-directed approach was pioneered in the
Business Schools. However, the business schools tended, in general, to use
the approach to synthesize and illustrate the application of knowledge
already learned. One might refer to this as Problem-based Synthesis, PBS.
Thus, after students have had courses in human resources, accounting,
finance, economics and marketing, they will have a "policy" course that is
case taught. This approach illustrates how students can integrate and
apply the knowledge they have already learned. In the context of the book
HTGTM and this book, we consider using the problems to drive the
learning rather than synthesize it after we have learned it. Hence,
Problem-based Learning, PBL. Table A-14 illustrates the difference in
approach. This comparison is misleading in that some PBL programs in
business schools use cases to "learn new knowledge," and sometimes
medical schools use cases to "synthesize previously-learned knowledge."
However, the polarized distinction is useful to help use make the best uses
of books written on facilitating the business school "synthesis" approach. I
recommend Erskine et al. (1981) as a very helpful, how-to-do-it book on
socratic facilitation. Although it is written primarily for the typical
business school case approach, the book provides a rich set of suggestions
that can be used in the medical school PBL approach.

A.7-1 In-class facilitation
The socratic approach has been applied successfully to large classes for
Problem-based learning by Lea Ann Hansen, in Pharmacy at the Virginia
Commonwealth University, Richmond and by Ted Cleary, Pathology,
University of Adelaide, Adelaide, South Australia. Table A-15 summarizes
their approaches to model the eight-stage problem solving process used in
a typical PBL activity. Also given in Table A-15 is another option for
socratic facilitation of the problem solving process. Tables A-16 and A-17
show the context and timing of the process used by Hansen and Cleary,
respectively. Table A-18 illustrates the transparencies that might be used
in Guided Design facilitation of the process.

A.7-2 Personalized self-directed DA-E dialogue
The socratic facilitation approach was used in printed format for engineers
by Rudd and Watson (1968) through their Devil's Advocate- Engineer
dialogue. Herethe problem is posed and, through an imaginary
conversation between the Devil's Advocate DA (or tutor) and the Engineer,
E (or student), the student is asked to answer a series of questions posed by
the tutor. The questions and answers are printed such that the student can
wrestle with the question and arrive at his/her answer before uncovering
the recommended answer. Table A-19 shows a paper/computer
individualized layout of the process. The line in the left hand margin
visually reminds the student when to stop uncovering the information,
when to pause and formulate a student response. Computer technology
makes this style obsolete, but Table A-19 illustrates an approach.

A.7-3 References
Cleary, Ted (1994) Pathology, University of Adelaide, Adelaide, South
Australia, e-mail communication, Oct 4
<tcleary@medicine.adelaide.edu.au>

Erskine, J.A. M.R. Leenders and L.A. Mauffette-Leenders (1981)
"Teaching with Cases," School of Business Administration, University of
Western Ontario, London, ON.

Hansen, Lea Ann (1994) Pharmacy, Medical College of Virginia/Virginia
Commonwealth University, Richmond, VA, e-mail communication, Sept
29 <lhansen@gems.vcu.edu>

Rudd, D.F. and C.C. Watson (1968) "The Strategy of Process
Engineering," John Wiley and sons, New York, NY.

Woods, D.R. (1994) "Teacher's Guide to Process Design and Engineering
Practice," Prentice Hall, Englewood Cliffs, NJ, ISBN 0-13-373085-9

Woods, D.R. (1990) "Surface, Colloids and Unit Operations," McMaster
University, Hamilton ON

Table A-14 Two applications of socratic facilitation
"Typical" Medical school case, PBL learning of new knowledge and
previous knowledge.
Facilitation tends solve the case based on 3. What new information do you need to know? 4. Prioritize learning issues, identify learning resources, contract to teach 5. Self-study to learn new
information and resolve how best to
teach the others.
6. Teach each other; does everyone now know the key new knowledge? 7. When and how does implementation happen? 8. What is the overall evaluation? 8. Assessment, reflection, Table A-15: Three example options of using socratic facilitated, tutor-
directed PBL for large classes

Total time per case: 3 h/case
Problem: Problem statement
distributed to students in Problem distributed to class. Tutor introduces the students in class. Issues: Session 1: tutor
process, anticipate and pose the relevant and irrelevant Learning contracts/resources
and student task for next
meeting: students are asked to
case, work in groups of their own issues singly or in Observations, Assessment, Plan expert judgement Done within and outside of class; tutor facilitates two more meetings where information (here it is) now previous knowledge is reviewed, buzz groups formed to share findings, Students participate as group share via the tutor. small buzz groups, diads, Synthesis of Learning done
learning knowledge, then collects ideas, asks group to focus on the data to gather understand what has been via physical examination. explored, the tutor reveals Simulated patient is present for second cycle; discusses it and goes on to knowledge expert is The approach can also be presented as a self-paced Solving Case Students come to
plans. Tutor facilitates gathering diagnosis. Tutor Reflection Done throughout with Done throughout. Journal
Table A-16 Hansen's approach illustrating the context and timing of the
tutor facilitation meetings.

individually, or in groups, explore the issues ahead of time. tutor facilitates discussion: students list explore issues, issues, tutor writes issues on the board 2. Identify what students to defend/debate. 3. Identify what The tutor's role throughout is to don't know: list intervene and add critical thinking and learning issues. expert judgement throughout. This is to ensure that the students are "on-track." and their plan of action. students work singly or in cooperative groups. Each must write their own analysis following meeting with their individual assessments and plans. Tutor viewpoints, and the analysis, exploration and resolution. Table A-17 Cleary's approach illustrating the context and timing of the
tutor facilitation meetings.

answering specifics about the identified learning issues. throughout is to through physical tutor's role sharing and tutor facilitation, the group address the specific diagnosis, the differential diagnosis, the specific are likely to resolve these so that the group arrives at a working diagnosis or a differential diagnosis. Table A-18 Transparencies illustrating socratic facilitation in the context
of process design of a sulfuric acid plant (from Teacher's Guide to Process
Design and Engineering Practice, 1994).Table A-19 Paper copy dialogue
between the tutor (DA) and the student (E) in the context of colloids and
surface phenomena. (from Surfaces, Colloids, and Unit Operations, 1990)

Source: http://chemeng.mcmaster.ca/sites/default/files/media/PBL-book-Appendix-A.pdf

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