A practical guide to implementing problem-based learning in anesthesia

Problem-Based Learning Discussion to Introduce Quality Improvement to Residents in the Perioperative Setting

INTRODUCTION

Quality improvement (QI) is a growing and critical part of perioperative medical practice. However, there are few examples of educational tools to introduce new learners from anesthesiology to QI. This may contribute to a lack of enthusiasm to learn about and apply these concepts.

METHODS

This problem-based learning discussion (PBLD) was designed to teach anesthesiology residents about QI in a way allowing for the application of core concepts in a group setting. We created this PBLD using available literature on QI in the perioperative setting. Basic concepts and terminology necessary for new learners to communicate about QI were specifically addressed. Feedback from staff anesthesiologists and resident participants in the PBLD was used to tailor it to the needs of the target learners and to reach the educational objectives.

RESULTS

We delivered this PBLD in two separate learning sessions both to board-certified anesthesiologists (N = 10) and to resident anesthesiologists (N = 19) at our institution. The exercise was reviewed anonymously, and qualitative feedback was used to improve updated versions. Respondents felt that the PBLD would be improved by avoiding jargon-based humor, considering the systemic implications of QI, and limiting the overall length of the learning tool. The PBLD has been adopted as a starting point for discussions about QI in our training program.

DISCUSSION

We feel this PBLD can introduce new learners to the learning objectives. This tool has provided an alternative to lectures or computer-based modules for teaching QI.

Problem-based learning research in anesthesia teaching: current status and future perspective

The teaching curriculum in anesthesia involves traditional teaching methods like topic-based didactic lectures, seminars, and journal clubs; intraoperative apprenticeship; and problem-based learning (PBL) and simulation. The advantages of incorporating PBL in anesthesia teaching include development of skills like clinical reasoning, critical thinking, and self-directed learning; in addition it also helps in developing a broader perspective of case scenarios. The present paper discusses the characteristics, key elements, and goals of PBL; various PBL methods available; lacunae in the existing knowledge of PBL research; its current status and future perspectives in anesthesia teaching.

The educational effectiveness of problem-based learning discussions as evaluated by learner-assessed satisfaction and practice change

STUDY OBJECTIVE

To elicit attendees' opinions and perceptions of problems-based learning and to asses the ability of this format to influence practitioner behavior.

DESIGN

Analysis of quality assurance material as part of the evaluation process of the Problem-Based Learning Discussion (PBLD) Committee of the American Society of Anesthesiologists (ASA).

PARTICIPANTS

Attendees of the 2002 PBLD Program and the annual meeting of the ASA, Orlando, FL.

MEASUREMENTS AND MAIN RESULTS

Exit and 6-months post-PBLD evaluations of individual PBLD sessions were offered to attendees of the program. A total of 742 evaluations were completed and collected at the conclusion of the individual sessions. Of the participants, 98.2% rated their sessions either good or excellent, 98.5% of whom enjoyed the interactive nature and 98% expressing a willingness to participate in future PBLD sessions. There were 221 questionnaires (17% response rate) completed after 6 months. Actual changes in practice were few, but attendees reported an increased ability to anticipate problems and/or complications and an increased knowledge and awareness about issues regarding patient care. 95.4% considered PBLD a worthwhile learning experience.

CONCLUSIONS

PBLD remains a popular educational offering. Although 6 months may be too short an interval to gauge the ability of PBLD to change physician practices, attendees feel that it does confer increased knowledge and awareness about patient care issues.