SDL or Academic Med Course? (1 Viewer)

[RyBo]

SDL or Academic?
A question as old as PBL itself.

A wise man (Lexi) once said that most of the best doctors you have met were trained old skool.
So, all those who do med, what do we all think?

I've heard stories of 3rd/4th year meddies not knowing enough hard science (anatomy, phisiology, biochem, ect) for clinical studies. Is this true?

Is PBL flawed or do some courses just need tweaking because they are new?

Also, is there much wrong with the more academic courses?
do students not learn enough communication skills?
are the lectures not as intersting as PBL groups?

Thanx for putting up with me,
RyBo.

BTW, for all newbies
SDL = Self Directed Learning
PBL = Practice Based Learning

Basically less lectures, more group work, more research, more tutoring in small groups.

 

[inasero]

well i can say for sure that alot of people are dissatisfied there are not enough core sciences taught at monash and these have been downgraded in favour of communications, ethics and legal practice...

Now as much as communications are important, I think the faculty at Monash are overdoing it and alot of graduates come out the other end with hardly any anatomy knowledge. For example, must we have lecture upon lecture to drive home the point on the importance on complementary medicines such as Chinese acupuncture and herbal medicine?

But at least it's an improvement on the old courses where no communications were taught at all. In fact the success of the patient/doctor rapport lies in the interview and most of the time the diagnosis can be elicited from there (rather than physical examinations) so it's no doubt a very important skill to have.

In relation to PBL, its true that there is more group work and research but thats only marginal...we have two sessions a week of one and two hours (total three hours). Some people are making it out to be as if we spend all our time in tutorials which is hardly the case.

At the end of the day, I wouldn't say that PBL distinguishes the old course from the new so much as the greater emphasis on communications skills and scaling down of sciences. It doesn't matter anyhows- why do you need to know that vasopressin regulates the expression of the AQP2 gene?

I would say all in all the new courses are more efficient

Hope that helped.

 

[Lexicographer]

I haven't been in medicine long enough to give what I think is as qualified an opinion as those delivered by inasero and pointdexter will be. However, I must say that I'm finding my presence in a strongly (but not entirely) didactic course to be a double-edged sword.

I'll start with the (very familiar) good bits. Both courses expect students to gain an intimate understanding of the human anatomy, but my course actually devotes a significant portion of lecture time to teaching it (in addition to SDL for systems later on). My course holds students from doing much patient interaction stuff until we actually know things, which just about all doctors I have met believe to be wise. My course also gives us a lot of lab work, ensuring that when we send samples away, we'll actually be able to tell patients what will be done with them (as well as being able to question suspect results).

Keep in mind that some courses do some of these and others don't - I'm not bagging the "PBL schools" in general, just saying that didactic courses tend to put more emphasis on these things.

The bad bits are that for the next two years I don't really get much CLINICAL experience beyond interviewing and (non-invasively) physically examining my peers. I learn pretty much three-quarters biological sciences, and one quarter "clinical practice" until third year, when those biological sciences turn from normal systems to pathological systems and a few medical sciences (pharmacology, pathology etc). Still not heavy on the patients though.

Like I said, most of what I've told you is gathered more from the experiences of those around me than my own, since my experience thus far is limited to a single semester - and it's the least "medical" semester in the course. Ask me again in a year.

 

[Bob.J]

ok many ways to explain it...

pbl directed courses are good in that students become more clinically oriented (ie. newc) with the intergrated course... clinical exp. is important overall whereas anatomy/physiology is a life learning thing and all students/docs can continue to pick up more knowledge as they go along

 

[+Po1ntDeXt3r+]

we are now taught skills not science..

my exams are
clinical reasoning (no more pattern matching symptoms n signs with diseases)
anatomy pathology and histology (more efficient and relevant as inasero sed)
clinical research (yes they TEST ure research skills)
SAQ/MEQ (basic sciences)

+ 2 pracs (clinical exams on simulated patients.. lik respiratory etc)
+ comm skills ( i take a history interview)..
total: 15 hrs.. not as crazt but more relevant.. \

SBL puts considerable stress on my life.. and relationships.. cos i now actualli hav to learn concepts.. unlike.. memorising dot points..

also... medicine is about lifelong learning.. up to 10-40% of any section can be from previous yrs.. so.. stuff about angina (chest pain) can be assessed even tho i didnt do any of it in the last 8 months..

Anatomy should be taught better and it progressively gettin better.. Physiology.. think about this... ALL PHYSIOLOGY BOOKS HAV DISCLAIMERS in the 1st 10 pages.. read them and they encapsulate the nature of medicine..

PBL teaches combining ure skills.. btw i think i do the most PBL out of the boys here.. IM ON 6 F*CKIN hrs a week.. and with MPPD (comm skills) its 2hrs more and up to 30 hr weeks.. im not whinging.. but i dunno how u can cover medicine in less time.. also i spend 8 hrs at hospital and up to 1-2hrs with patients talking about their conditions a week..

"most of the best doctors you have met were trained old skool."
cos if they werent old.. they realli dun hav the experience..

"I've heard stories of 3rd/4th year meddies not knowing enough hard science (anatomy, phisiology, biochem, ect) for clinical studies. Is this true?"
Not realli its just the initial batchs.. they are different and had to struggle with a new system... Adel is graduating its first FULL PBL yr this yr

"Is PBL flawed or do some courses just need tweaking because they are new?"
-Didactic learning has gained acceptance since its anticipation at the dawn of man..
PBL is less than 20- 30 yrs old and mabbe less in schools lik UNSW.. i say give it ..500 yrs. .then rip it apart..

" is there much wrong with the more academic courses?"
- no none at all .. just u need to balance medicine.. its both practical and researchin..

"do students not learn enough communication skills?"
-u ever deal with an angry addict? most ppl wont.. so we just cant ad lib it.. its called practice.. its just we need more.. it helps all aspects of life..

" are the lectures not as intersting as PBL groups?"
-Lecture = "1 person telling us stuff"; interestingly the lecturer today made a mistake and screwed me up.. but it was sorted out in PBL..
PBL="8 ppl in a room with a moderator (person w/ PhD or MBBS) and u discuss.." u got to be awake.. and u got to contribute.. its not easier learning IMO

I think if ppl were more passionate bout PBL they would do better in PBL courses.. which need better balance of SDL/Didactic learning esp with newer courses (<3 yrs old)

 

[Lexicographer]

I guess I should tell you more about my course eh.

UWA runs an integrated course, "updated" for their reaccreditation by AMC a few years back. First semester is foundation sciences (Animal and Human Biology, Cell Biology, Medical Chemistry) plus Clinical Practice. Second semester and all of second year consist of more Clinical Practice and the monolithic Normal Systems unit, which is a totally integrated three-semester "block" which covers all (normal) body systems in intimate detail. Third year is pathological systems and medical sciences (eg pathology, epidemiology). Fourth through sixth year are clinical, including the obligatory (often international) elective rotation and the (highly popular) rural clinical school.

Clinical Practice is the subject with PBLs in - the others are old school lectures and labs (which I believe works perfectly for medical SCIENCES). Clinical Practice is taught in three two-hour sessions each week. The first is the two hour PBL (yes I only do two hours of PBL a week) which initially (ie now for me) is all artsy "what is health" crap, then moves onto health "issues" (eg factors affecting old aboriginal people in the country) and in third year dies. The second two-hour block is the Fixed Resource Session (read: lecture). It's dead boring and she just reads slides, I don't normally go. Third session is the GOOD one - clinical skills. This is where I've (re)learned interviewing, and will next semester begin clinical examinations like auscultation (stethoscopering). It is also where I will learn diagnosis and stuff, as well as WHAT to look for when I stick my finger up your butt.