Problem-based learning (PBL) is one major component of the Keele MBChB curriculum. Students work in small groups to study written descriptions of clinical situations.
Information contained in this section relates to current delivery, based on the School's Curriculum 2018 Programme.
In 1993, the General Medical Council published a radical document, 'Tomorrow's Doctors', calling for major change in UK undergraduate medical education. Since that time, the GMC have continued to update its standards and outcomes for medical education and training in the UK. They continue to set the standards and outcomes that all medical students must meet if they are to graduate and work as a doctor in the UK, with all the details described in the GMC's standards and guidance for undergraduates. Important themes in the MBChB at Keele University, aligned with the GMC policy, are:
- Stimulation of curiosity; learning through problem-solving and experience: Rather than learning by rote, which emphasises recall of knowledge, students are expected to demonstrate ‘understanding’ of topics, relevant to medicine as a whole, which emphasises application of knowledge. Learning opportunities are provided in the appropriate context so students can relate the knowledge they acquire to the practice of medicine. Students should develop into doctors who are scholars and scientists.
- Students take responsibility for their own learning: The Keele curriculum utilises adult learning principles, making it ‘student-led’ rather than ‘teacher-led’ as far as possible. However, the support of tutors is still a vital and significant ingredient.
- Core Curriculum: The course has a defined ‘core’ comprising the attitudes, skills and knowledge required of a graduate competently to manage, on their own or as part of a team, the clinical situations they are likely to meet in their Foundation Years training.
- Integration: Students are encouraged to develop an understanding that spans disciplinary borders. Specific understanding of individual disciplines like anatomy, physiology, medicine, pathology and so on, is acquired in the context of medicine as a whole, and throughout the course. In the early years of the course, there is more emphasis on acquiring bioscience and clinical principles. In the later years the emphasis is on the application of knowledge and patient management in the clinical environment.
- Community-orientation: Throughout their training, students are encouraged to understand and apply knowledge of personal, community and population ‘dimensions’ of illness. They will acquire experience of the behavioural and social aspects of medicine in community placements in both health and social care environments.
- Explicit development of clinical skills and competence: The 2018 edition of ‘Outcomes for Graduates’ specifies the core skills and competences expected of our graduates to function as newly qualified doctors. These skills are systematically taught and systematically tested. Incompetent students will not qualify, no matter how strong they are in theory. There is a strong emphasis on communication skills and encouragement to develop appropriate professional attitudes. We expect Keele graduates to be competent and professional practitioners.
- Choice: There are ‘core’ parts of the curriculum which all students study in common but there are also substantial blocks of time when students are given choice about their learning—Student Selected/Elected Components occur in every year of the programme.
- Scholarship: Students have opportunities to undertake research and scholarship activities throughout the curriculum. These include core activities, e.g. understanding and interpreting evidence-based medicine and research literature, and attachment to research groups in the student selected blocks in Year 3. Students can also engage in research outside of the core curriculum, with support from the Medical School for summer vacation research studentships; and the opportunity to intercalate to obtain a bachelor's level degree after Year 2 or a master's level degree after Year 4.
Problem-based learning is one major component of the Keele curriculum. Students work in small groups to study written descriptions of clinical situations. Using a specific set of study skills, students use those scenarios to guide them towards relevant theoretical and practical learning. Normally, each scenario is the focus for learning for a week, with two tutorials (tutor in attendance) devoted to it. This process starts at entry to the medical school. From Year 3 onwards PBL develops into case-based learning where the written scenarios are augmented using discussions of patients encountered by students in their clinical placements.
The PBL programme is supported by a variety of methods which include: plenary lectures, seminars, laboratory practical classes, and a wide variety of placement experiences in primary and secondary care. Placements begin in Year 1 and students learn the skills needed to get the best out of placements prior to their occurrence. The emphasis throughout the course is firmly on student-led and self-directed learning. Students are expected to demonstrate knowledge and understanding in interactive group sessions.
Each teaching hospital has a clinical skills laboratory, allowing students to develop many clinical skills in the relative safety of simulation—for example, by examining each other, or performing practical procedures on manikins. Those skills are then systematically tested in OSCEs (objective structured clinical examinations).
Communication skills are taught and tested with the help of ‘standardised patients’ (volunteers who can mimic various clinical situations and give feedback to students).
Students are encouraged to think of the whole teaching hospital and its surrounding community as a huge and readily available resource for their learning; an integrated curriculum has no boundaries and barriers. The hospitals operate ‘sign-up schemes’ to match up manageable numbers of interested students with appropriate learning opportunities. Students receive conventional clinical teaching (with a strong emphasis on clinical skills/competence) from the start of the course.