An Online PBL Case: Start to Finish

Welcome back to Zoom university, today w- hello? Can everyone hear me? Where’s that background noise coming from? Whose camera is pointing at the ceiling?

Sound familiar?

If you’re a student at pretty much any level of your education, this has probably been what you’ve been hearing at the start of every Zoom/Microsoft Teams/Google Classroom/Skype session for the past month or so.

The reality of the Covid-19 pandemic is impossible to deny by this point. I remember the first few days after this all started, I imagined myself waking up in a cold sweat, exclaiming “what a bad dream!” before getting on with my regular, everyday life. Oh, how distant and sweet normal life seems now.

No matter, we improvise, adapt and overcome regardless, because unfortunately for a lot of students, studying-from-home has become our new lifestyle.

So today I wanted to share a PBL case week-in-my-life kind of blog post for case eight for this semester, which we did while in lockdown. I hope this gives you some interesting insight into PBL online & how we dealt with it, because if this is the new normal, then PBL being online may be a more frequent occurrence in the future.

Saturday 18/4

There is often a lot of overlap between cases for me. While I’ll still be working through the PBL from the previous week (case seven in this case), I’ll also be making my anatomy notes for the next week. I find this is a good day to get a head start on anatomy because it gives me a distant sort of familiarity with the systems and organs we’ll be working through for the next case, since anatomy and PBL topics normally coincide quite nicely with each other (though this isn’t always the case).

If you’re interested in how I’ve done anatomy in my pre-clinical years of med school, check out this post which is the first in a three-part series on my anatomy process.

Sunday 19/4

I don’t do anything for the upcoming case on Sundays because I’m normally tying up the previous case on this day.

Monday 20/4

The PBL week runs from Tuesday to Monday in second year, so this is the day we have our closing session for the previous case.

This is also the day where any sort of PBL-specific preparation occurs. So in second year, there has been a huge emphasis on clinical reasoning, which involves working through the initial information, history/examination, tests/investigations, diagnosis and management step by step, having discussions with the rest of the group at each stage to suggest and rule out possible diagnoses as we find out more information. Normally, it’s pretty obvious what’s going on, either through the early information, or other logistical causes like seeing the titles of the lectures beforehand. Essentially, they suggest that going in blind is more effective than reading all the case details before opening session, but this works sometimes, but not always.

Personally, it depends on how well put-together I am and how I’m feeling on any given Monday as to whether I read the case beforehand or not. I always read the initial information given in the case booklet, and sometimes if it really piques my interest, I cannot stop myself from reading everything (yes, I’m also that person that skips to the end of the book/movie when things are getting rough because I get nervous for the end, don’t hate me).

Tuesday 21/4

PBL opening session day! Let me run through how it normally works:

  • We read through the initial information in turns, taking two sentences each
  • We discuss what thoughts we’re having & the scribe collates all the information and our ideas into a big mind-map on the whiteboard
  • Rinse and repeat for every remaining section

As I mentioned earlier, we’re eliminating more and more differentials at each stage and before we get on to the tests/investigations section, we try to imagine what kind of tests we’d like to see done in relation to the symptoms and history. At the end, the scribe types up a learning agenda with questions that we all chip in to write based on what we think is important to learn for the case. Our tutor always inputs all the information that we end up missing out so we can never really miss any crucial information out and our session ends.

While PBL was happening in real life we’d have the scribe to make the mind-map, but since we did PBL over Zoom for this particular case, our tutor suggested that we all make our own mind-maps to summarise the information. To be super honest, I have no idea why I wasn’t already making my own mind-maps since I did it for the last three cases and I found it extremely helpful to summarise the case. One thing I noticed in semester four was that the cases were more complex and had more facets to them, so a good summary mind-map was key.

The mind-map I made for this case

Wednesday 22/4 & Thursday 23/4

The midweek grind revolves around watching lectures and doing other PBL questions. I normally start the PBL topics that don’t have specific lectures dedicated to them because I like to use the lectures as my main foundation of knowledge, and then add supplementary information wherever I deem necessary.

A lecture on kidneys I was working my way through understanding

Friday 24/4

In semester four, I normally aimed to complete all the PBL questions by Friday night because I set aside Saturdays for working on my PEP literature review (Personal Excellence Pathway, which is a research-based project of sorts we do in every year of the degree). That’s why Friday nights normally ended up being quite late nights for me because I tried to finish all the PBL before the weekend.

The result of a long Friday night!

Saturday 25/4

As my routine was still set to how it was before the semester ended so abruptly, I ended up finishing all my PBL before Saturday, leaving this day completely free for me. This was a nice time to relax and actually enjoy my weekend as much as I could during quarantine, though I did make a start on the next week’s anatomy notes.

Sunday 26/4

Sundays I always set aside for preparing for the closing session (on Monday), so I make my condensed notes and diagrams that I’d use for the session. This is ideal to do on Sunday because it’s the day before PBL close and the information stays fresh in my mind. Also, there have been a lot of occasions where I’ve read over my detailed notes and had to redo some research on them because I don’t even understand it, so this is an important, unmissable step for me.

Monday 27/4

PBL closing session day! To keep with the theme, I’ll run through how it works:

  • The chair directs the discussion and we go through the learning agenda question-by-question, with everyone contributing their insight into topics.
  • Often there will be diagrams drawn & questions asked around to clarify the information from lectures and other resources

I find the atmosphere so lovely during these sessions, and even over Zoom, it was clear that everyone was trying their best, so these sessions didn’t suffer significantly as a result of being made virtual. Although there could have been the ability to share screens and have people drawing diagrams, it was a little bit advanced for our group and, besides sharing the odd picture via screen-share, we mostly stayed away from it.

Had we not been in the midst of a global pandemic, we would have also had our anatomy session for this case on the Monday, but obviously, this was not the case on this particular week.

So, there you have it, a week of virtual PBL. I tried to include information about how PBL would have been during a normal week as well, just to cover all the bases. I hope this has been informative and interesting to hear about. I’m quite interested myself, to see if/how virtual teaching will advance as a result of current affairs.

Thank you so much for reading, sending lots of love and positivity always.

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