Introduction

Educational theorists repeatedly remind us that learning information out of context is not only tedious, but retention of the information is poor. Clearly, dentists must develop a rational system of inquiry and knowledge retrieval to use when confronted with dental health problems. It is important to be able to effectively identify what must be learned in order to understand the mechanisms that underlie a patient's complaint. For these reasons, and others, IUSD has incorporated a significant amount of problem-based learning (PBL) into its curriculum.

The clinical reasoning process is the "scientific method" applied to patient problems and care, and this process is nurtured in PBL sessions (tutorials). The tutorial sessions utilize a series of real-life patient problems that provide an opportunity to develop clinical reasoning skills. For the student, the learning method is a very active one. In a tutorial, the student must analyze and synthesize available data, develop and test hypotheses and apply deductive reasoning to the identified problems.

Tutorial Sessions

In small groups (usually 6-7 people), students are presented with patient health care problems. With guidance from a faculty tutor, students actively discuss the problem and develop a way to approach it. They identify appropriate learning issues (what isn't known) and resources for information (books, journals, resource people, internet, etc.). After information or data is gathered, students summarize, discuss and integrate back into the problem the information they obtained individually. The tutor's role is to keep the discussions on track, but unlike the faculty member in a traditional lecture classroom, the tutor is not the provider of information.

Communication Skills

In order to have effective PBL sessions, students must develop and use effective communication skills. It is important that each member of the group become an active participant in the group in order to contribute his/her unique knowledge and ideas to the learning process. Information must be transmitted among group members clearly and concisely, and students must question each other and themselves for understanding and clarification of content. In addition, students must develop critical questioning skills for evaluating the validity and reliability of information. Critical questioning and communication skills learned in the group setting are invaluable in clinical practice with patients, staff, colleagues and dental sales personnel.

Assessment

Self- and peer-assessment are critical for a health care provider; professionals are self-regulating. Therefore, assessing one's own performance and the performance of peers is practiced in the tutorials. Students assess themselves and their group members in the areas of respect for individuals and the group as a whole; communication skills; responsibility; self-awareness; and knowledge acquisition. Tutors also provide students with verbal and written feedback of their performance in the sessions. Both student and tutor assessments are used in the formal grading process for PBL.

Group Support

One of the most powerful results of the PBL sessions is the support group members provide each other in areas other than academics. Emotional support, social interaction and personal growth are fostered by the close relationships developed within the groups. Since group members change periodically, these relationships allow students to become well-acquainted with virtually all their classmates as well as many faculty members. This helps to reduce the anxieties associated with a demanding curriculum and to promote the development of a collegial atmosphere within the school.