Assessing Problem Based Learning in Child and Adolescent Psychiatry at the Trinity College Dublin, Ireland

Abstract

The School of Medicine, TCD (Trinity College Dublin) has developed the undergraduate degree in Medicine in accordance with the Medical Council and the World Federation of Medical Education guidelines. The course is 5 years. At TCD, clinical and theoretical aspects of psychiatry for 4th-year medical students are delivered during a two-month attachment. Four days of the two months are allocated exclusively to Child and Adolescent Psychiatry (CAP), and up to ¼ of all students do a two-week speciality clinical rotation in Child and Adolescent Mental Health Services. A team of academic child and adolescent psychiatrists at TCD developed the structure and content of the PBL-based component of the program for CAP. The introduced PBL into the curriculum was received positively by the students; PBL was well liked, stimulating and preferred, especially by those interested in psychiatry as a career.1 PBL was developed in late 1960’s at McMaster University, Canada. Now PBL is recognized by professional and funding bodies as an appropriate strategy for professional education and increasingly as the method of choice.2 Reviews of undergraduate medical education support the short term and long-term outcomes of PBL compared with traditional learning, however PBL also has some limitations: highly time intensive for faculty, lack of good prepared PBL cases and the need to develop them.3-5 Problem-based learning assumes that students already are good problem-solvers, whereas it may be a skill they need to develop or improve.3-5 It is well-known that didactic lectures covering the major conditions within Child and Adolescent Psychiatry are not always appreciated.6 It would seem that Child and Adolescent Psychiatry because of its inherently integrative, bio-psycho-social nature and emphasis on teamwork and collaboration, would be a specialty learned optimally through Problem Based Learning,7 using multi-page and multi-stage PBL cases which ultimately incorporate course content objectives.7,8 Another advantage of using PBL in medicine and especially in Child and Adolescent Psychiatry its potential ability to incorporate the evidence based approach in teaching. When confronted with a clinical problem, the EBM (Evidence Based Medicine) medical students (as well as qualified doctors) formulates a question, searches for the best available evidence to address that question, does a critical appraisal of that evidence and then applies the evidence to the patient that stimulated the question. The importance of assessment One of the most important drivers of student learning is how that learning is assessed.9 Students are strategic in their use of time and selectively negligent in avoiding content that they believe is not likely to be assessed. Thus well-timed and well-designed assessment can have a powerful impact on how students approach their learning.10,11