Thursday, April 19, 2018

Implementation of a problem-based learning style curriculum within a physical medicine and rehabilitation residency: A mixed method study of residents experiences with a pilot curriculum

Ashlee Bolger
Cincinnati Children's Hospital
Objective: Problem based learning (PBL) was originally developed as a type of medical school curriculum focused on teaching self-directed learning skills. It is a case-based curriculum that involves repeated cycles of group learning. It has been widely implemented and studied in medical schools, but research on PBL in residency is minimal. The purpose of this study was to evaluate resident satisfaction with and feasibility of using PBL in residency, and examine its effects on self-directed learning.

Methods: This was a mixed method pilot study implemented in a small, Midwest physical medicine and rehabilitation (PM&R) residency. Two pediatric rehabilitation problem-based learning cases were developed and implemented. Outcome measures evaluated resident satisfaction, feasibility of implementation, and effects on self-directed learning. These included pre- and post-surveys, the Self-Rating Scale for Self-Directedness in Learning, and semi-structured interviews. Quantitative data were analyzed with descriptive statistics and Wilcoxon signed rank tests. Qualitative data were analyzed via thematic analysis using components of grounded theory.

Results: Seven residents participated in the pilot curriculum. Five themes emerged as describing residents’ experience with implementation of PBL: 1) positive aspects of learning related to PBL occur with resident learners 2) group dynamics influence residents’ experiences, 3) individual learner characteristics influence residents’ experiences, 4) resident learners have a “fear of missing out”, 5) cognitive load is a factor when completing PBL.

Conclusion: A PBL style curriculum can be beneficial and feasible to implement in residency as reported by resident physicians. The effects of PBL on self-directed learning skills in residents are less clear.