Does Project L.I.V.E. Case Modality Impact Critical Thinking in PBL Groups

Problem-based learning (PBL) with simulated cases is one method of delivering standardized pediatric curricular objectives, but the fact that students are dispersed and participating in community-based practices makes group meetings difficult. To address these issues, researchers developed and tested a new modality for presenting PBL cases, a CD-ROM/Web hybrid computer program to standardize the national pediatric curriculum: Project Learning through Interactive Video Education (L.I.V.E.). Project L.I.V.E. used digital video case simulations to present PBL with the stimulus case followed by asynchronous case discussions among students at multiple clinical sites. The study sought to determine if critical thinking as shown by discourse among students during group discussion differed by presentation format. Approximately 128 medical students participated in 3 conditions: (1) a face-to-face group with text/paper case modality; (2) a face-to-face group with a video case modality; and (3) a virtual group with digital video case modality. Study findings suggest that the virtual group engaged in more critical thinking, as represented by their dialogue within the group, than did the other two modalities, perhaps because of the increased individual accountability required by the online discussion. However, the virtual group did have a reduced sense of group process. The findings also provide insight into the advantages of using video. (Contains 21 tables and 32 references.) (SLD) Reproductions supplied by EDRS are the best that can be made from the ori inal document. Does Project LINDE. Case Modality Impact Critical Thinking in PBL Groups? Carol Kamin Patricia 0' Sullivan Robin Deterding Paper presented at the 2002 AERA Annual Conference BEST COPY AVAILABLE qr. PERMISSION TO REPRODUCE AND CO DISSEMINATE THIS MATERIAL HAS BEEN GRANTED BY CY) CD TO THE EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) 2 U.S. DEPARTMENT OF EDUCATION Office of Educational Research and Improvement EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) O This document has been reproduced as received from the person or organization originating it. O Minor changes have been made to improve reproduction quality. o Points of view or opinions stated in this document do not necessarily represent official OERI position or policy. Does Project L.I.V.E. Case Modality Impact Critical Thinking in PBL Groups? Carol Kamin, Ed.D., Patricia O'Sullivan, Ed.D., Robin Deterding, M.D. Educators frequently run into a mismatch between what students need to learn and their opportunities to learn in clinical education. Consider the following examples. First, students learning about pediatric care directly with patients may see limited kinds of cases depending on the season. In winter and spring, respiratory diseases predominate, but fall more commonly brings croup and diarrhea with dehydration. However, students must gain competency in understanding and treating all of these clinical pediatric conditions. Second, the Council on Medical Student Education in Pediatrics (COMSEP) reports that students do not have enough time to gain competencies in areas such as child abuse, genetic disease, and adolescent issues during a pediatric clerkship.1 Third, the clinical portion of medical education is increasingly centered in community-based practices. This decentralization enhances exposure to primary care, but creates difficulty in administering a standard curriculum. Problem based learning (PBL) with simulated cases is one method of delivering standardized pediatric curricular objectives; however, dispersed students make group meetings difficult. To address these issues, we have developed a new modality for presenting PBL cases, a CDROM/web hybrid computer program to standardize the national pediatric curriculum: Project L.I.V.E. (Learning through Interactive Video Education).2 While Project L.I.V.E. may resolve some curricular issues, it must also maintain or enhance the goals of PBL. PBL is designed to promote skills in critical analysis, self-directed learning, and problem-solving.' Groups scrutinize ideas, which encourages inquiry-based attitudes that depend upon recognizing problems and logically assessing evidence. These skills reflect the construct of critical thinking. Medical educators often discuss teaching methods that encourage in-depth processing, a characteristic of critical thinking. This in-depth processing, or deep learning, is necessary to derive clinical inferences from available data (deductive reasoning), recognize unstated assumptions by weighing evidence, and distinguish between weak and strong arguments.' In PBL, students demonstrate this critical thinking in their group discussions. We must ensure that this continues in Project L.I.V.E. PBL typically uses paper (text) cases that allow the patient's story and physical examination findings to unfold. However, unlike adult patients who can provide a history, pediatric patients very often cannot. Therefore, the text case modality may limit PBL. Physicians must recognize visual and auditory cues to accurately diagnose a child. Using a video case modality rather than text modality may better approximate reality and allow the student to work on observational skills. Project L.I.V.E. uses digital video case simulations to present PBL. These cases serve as a stimulus for learning followed by asynchronous case discussions among students at multiple clinical sites. This discussion is key to learning in PBL. Thus, the CD-ROM/web hybrid program provides a new "virtual" modality for presenting a PBL case. While the case is the stimulus in the PBL experience, actual learning occurs during the group's collaborative discussion of the case. Providing structure for students to discuss the case asynchronously with a facilitator was a key component of the program's design. This meant