PROBLEM BASED LEARNING IN THE
ERA OF WIKIPEDIA & GOOGLE
Amin Azzam, MD, MA
University of California, Berkeley &
San Francisco
Dennis Valenzeno, PhD
University of Kansas School of
Medicine, Wichita
A. Azzam. D. Valenzeno.
IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
WHO WE ARE
Amin Azzam, MD, MA
Dennis Valenzeno, PhD
 University of California,
 University of Kansas School of
Berkeley & San Francisco
 Here are my current role-
responsibilities
Medicine, Wichita
 Here are my current role-
responsibilities
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
WHO YOU ARE
Name
Institution
Role
Name at least one thing you hope to
get out of today’s workshop
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
REFLECTIONS ON INFO EXPLOSION
Originally from
Rosenfeld &
Moreville:
“Information
Architecture.”
Volume
1992
Internet
explosion
Milestones in
Content Growth
1900
London library
(500,000 volumes)
1884
as reproduced at:
1450
http://blog.famakin
wa.net/content/info
rmation-explosion
First
mechanical
Vatican library typesetter
(1500 volumes)
1480
Information
Architects
arrive
Guttenberg’s
500 hand press
Monks copy
books by
hand
1994
SGML
developed
3000 BC
Earliest
written
record
Dewey Decimal
System
1970
1876
Assyrian king organizes
tablets by subject
660 BC
Time
Alexandria Library includes
120 scroll bibliography
330 BC
Milestones in
Content Organization
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
REFLECTIONS ON INFO EXPLOSION
Originally from
Peter Diamandis:
“Abundance: The
Future is Better Than
You Think.”
as reproduced at:
http://awealthofcom
monsense.com/futu
re-better-think/
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
REFLECTIONS ON INFO EXPLOSION
Exabytes: Documenting the ‘digital age’
and huge growth in computing capacity
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
REFLECTIONS ON INFO EXPLOSION
Volume
1992
Internet
explosion
Content
Growth
1900
1884
First
1480 mechanical
Vatican typesetter
library (1500
1450
Guttenberg’ volumes)
s hand
Monks copy press
books by
3000 BChand
Earliest
written
record
London library
(500,000
volumes)
500
Assyrian king
organizes tablets by
660 BC
subject
Dewey Decimal
System
1876
Alexandria Library
includes 120 scroll
330 BC
bibliography
Informati
on
Architects
1994
arrive
This is you
dear
1970
medical
scienceTime
educator!
SGML
develope
d
Content Organization
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
BREAK OUT GROUPS: WHAT TO DO?
“I’m
overwhelmed.”
“I suppose we can’t
just keep doing the
same old thing and
expect it to keep
working.”
“Do you think we
should tell the
audience what we
think they should do?”
“Me too– what’s an
educator to do?”
“You’re right– times
change, so should we.”
“No, of course not! In
true PBL fashion we
should have them
tackle the problem!”
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
BREAK OUT GROUPS: TASK
Discuss educator and educational strategies that
might be useful in the modern information era
Identify a scribe at each group to capture your
wonderful ideas
Identify a person willing to “report-back” when we
re-convene as a large group
Let’s see how much you can accomplish in 15
minutes!
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
BREAK OUT GROUPS: REPORT BACK
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
PBL DEFINED: ELEMENTS 1 & 2
Definitional Element
Our Clarification
1. Students should be
In contrast to large
lecture-based groups.
2. Learning must be
In contrast to instructorcentered teaching.
organized into small
groups with a “tutor.”
student-centered.
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
PBL DEFINED: ELEMENTS 3 & 4
Definitional Element
Our Clarification
3. The “tutor” must act as
As opposed to a knowledge
or content expert.
4. Problems based in the
In contrast to front-loading
a curriculum with the
“basic foundations” before
encountering “real”
problems.
a facilitator or guide.
practical world must be
presented at the beginning
of the learning process.
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
PBL DEFINED: ELEMENTS 5 & 6
Definitional Element
5. Problems should serve as
tools for acquisition of
knowledge and problemsolving skills.
Our Clarification
As opposed to merely
learning the “correct
answer” to this specific
problem only.
6. Content knowledge should
As contrasted with
be acquired via self-directed “educator directed”
(e.g. a syllabus is educator
learning.
directed).
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
VARIATION IN USE OF PBL IN PRECLERKSHIP MEDICAL SCHOOL YEARS
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
VARIATION IN USE OF PBL IN PRECLERKSHIP MEDICAL SCHOOL YEARS
No. (%) of US
Medical Schools
Percentage of
curriculum
39 (45)
28 (33)
14 (16)
< 10 %
10 – 25%
26 – 50%
5 (6)
51 – 75%
Though the
majority of US
medical schools
used PBL, they
did so as a
relatively small
percentage of
their students’
curricular
experiences.
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
PUTTING THIS IN A UNITED STATES
WESTERN REGIONAL CONTEXT
School
Description
UCSF
7 cases over 2 years
U Colorado Denver
2 hours / week
UCLA
Percent of overall
curriculum in 2009
<5%
8%
Workshop at4AAMC
WGEA
Regional Meeting 2009.
hours
/ week
UC Berkeley JMP
7.5 hours / week
17 %
~ 80%
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
THE SIX CORE ELEMENTS OF PBL
1.
2.
3.
4.
5.
6.
Students should be organized into small groups
with a tutor.
Learning must be student-centered.
The tutor must act as a facilitator or guide.
Problems based in the practical world must be
presented at the beginning of the learning
process.
The problems should serve as a tool for the acquisition of both
knowledge and general problem-solving skills.
Content knowledge should be acquired via self-directed learning.
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
BARRIERS & OPPORTUNITIES
Barriers
Opportunities
 insert
 insert
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUR LOCAL CONTEXTS
“Let’s start with
you, Dennis.”
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
UNIVERSITY OF KANSAS
Clinical campus
since 1975
Expanded to 4-years
in 2011 (28/~70)
+
Since 1905
Kansas City (175)
Salina (8)
=
Jayhawk Doc
A “Jaydoc”
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
KU SCHOOL OF MEDICINE CURRICULUM
ALL 3 CAMPUSES
1st Year
Foundations
Break
Break
Years 1 and
2 Infl/Imm Cardio Gen/Neo
pulmonary GI/Nutr Ren/Endo Repro/Sex
4 weeks
4 weeks
8 weeks
8
weeks
4 weeks
4 weeks
4 weeks
• Organ-System Based Curriculum
Tests
Tests
Tests
Tests
Tests
Tests
Tests
Where
isTests
PBL
in thisTests
curriculum?
• Interactive
TV
lectures;
local
faculty
for small
groups
2 Year
Break
Break
•3 &and
Small
YearsBrain
4groups
Blood
Mus/Skel
Behavior
Infect
Dis Integrate/Consolidate Board Prep
4 weeks
4 weeks
8 weeks
8
weeks
8 weeks
 basic
science oriented
caseand
studies
• Disciplinary
sequence
of clerkships
electives
Current PBL
Tests
Tests
Tests
Step 1
Tests
Tests
Tests
Tests
Tests
histopath
labseach
• Taught separately
on
campus
• development of clinical reasoning
3 Year
 anatomysame
labs goals and assessment
 coordinated,
Psych
Pediatrics Geriatrics Neuro
Medicine
Surgery per year
Ob/Gyn
Family Medicine Internal
• 6-7
PBL cases
4
weeks
4 weeks
6 weeks
4 weeks
8 weeks
6 weeks
8 weeks
 8 weeks
clinical skills
/ standardized
patients
• 2 meetings per case
 PBL
• variable, but significant, faculty direction
4 Year
nd
rd
th
Subintern
Rural
4 weeks
4 weeks
Crit Care Pub Hlth
4 weeks
4 weeks
Electives
16 weeks
KU SCHOOL OF MEDICINE CURRICULUM
ALL 3 CAMPUSES
1st Year
Foundations
8 weeks
Tests
• 3
2nd Year
Mus/Skel
Gen/Neo
Infl/Imm
Cardio -
pulmonary GI/Nutr Ren/Endo Repro/Sex
weeks
4 weeks 104 years
weeks
4 weeks
4 weeks
After
of 8an organ-system
based
curriculum
where are we headed?
Tests
Tests
Tests
Tests
Tests
4 weeks
Tests
Tests
Tests
year study of modern medical education
Break
Break
Blood
Board Prep
& Behavior
Infect
Dis Irby
Integrate/Consolidate
•Brain
Carnegie
reports:
Flexner,
1910, Cooke,
and O’Brien, 2010
4 weeks
8 weeks
4 weeks
• Multiple campus visits
Tests
Tests
• Tests
Full accreditation
renewalTests
• Principles for new curriculum
3rd Year
Internal case
Medicine
Family Medicine
• Clinical
focus Surgery
8 weeks
4th Year
Break
Break
8 weeks
• Adult learning
8 weeks
8
weeks
Tests
Tests
Ob/Gyn
6 weeks
• Active learning
• Expert
guidance
Crit Care Pub Hlth
Subintern
Rural
Electives
4 weeks
4 weeks
16 weeks
4 weeks
4 weeks
• Technology
• Pilot course running this summer with 7 students
8 weeks
Tests
Pediatrics
6 weeks
Step 1
Tests
Geriatrics Neuro
4 weeks
4 weeks
Psych
4 weeks
OUR LOCAL CONTEXTS
“Over to you,
Amin.”
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
UNIVERSITY OF CALIFORNIA
Masters’ degree
+
“Pre-clerkship” years
of medical school
+
“Clerkship” years of
medical school
=
Happy Graduate
MD, MS
2 years
3 years
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
UC BERKELEY – UCSF JOINT MEDICAL PROGRAM (JMP)
PRE-CLERKSHIP MEDICAL SCHOOL ROADMAP
Break
1st Year
Anatomy
&
JUMPstart
PBL Core Experiences
Break
PBL Core Experiences
Clinical Skills Experiences
Clinical Skills Experiences
HMS Masters Thesis
HMS Masters Thesis
Contextually-Integrated Case-Based Curriculum
Assessment
Assessment
Assessment
Assessment
(CICBC)
Clinical Skills Patient Care Curriculum (CSPCC)
Break
Break
Year
• 2Covers
the
equivalent
of
the
“foundational
sciences”
• Covers
theThesis
equivalent of “intro to doctoring”
courses
Master’s
PBL Core Experiences
PBL Core Experiences
Individually
• Entirely
Problem-Based
Learning (PBL)
scheduled
• Culminates
with
an
Observed
Clinical
Clinical
Skills
Experiences
Skills Experiences
• Spans the entire 3 years (notStructured
just 2) Clinical
time
• No Exam
required
lectures!
Masters
Thesis
(OSCE)
to ensure
readiness
for clerkships
HMS Masters Thesis
• IncludesHMS
general
training
in research
skills
&
Assessment
Assessment
Assessment
longitudinal
mentoring Assessment
Break
3 Year
• RequiredPBLand
elective UC Berkeley
coursework
Core Experiences
PBL
Clerkship
Individually
USMLE
• Culminates
with
a research thesis
scheduled
Rotations begin
self
Clinical Skills
Experiences
Clinical Skills
time
study
at UCSF
Thesis
• The M.S.HMS
is Masters
an academic
degree inMasters
Health and Medical
Sciences awarded
Berkeley Assessment
Assessment by UC
Assessment
nd
rd
UC BERKELEY – UCSF JOINT MEDICAL PROGRAM (JMP)
PRE-CLERKSHIP MEDICAL SCHOOL ROADMAP
Break
1st Year
Anatomy
&
JUMPstart
Break
PBL Core
PBL Core Experiences
After
10Experiences
years of an entirely PBL-based
Clinical Skills Experiences
Clinical Skills Experiences
pre-clerkship
medical school curriculum:
HMS Masters Thesis
HMS Masters Thesis
• This really does work– students are incredibly creative and talented teachers!
Assessment
Assessment
• It is wise to prepare
students for thisAssessment
radically-different notion
of an entirelyAssessment
collaboratively and student-led curricular structure
Break
Break
2nd Year
• There can be amazing synergy between students’ individual strengths and areas
PBL Core Experiences
PBL Core Experiences
for growth
Individually
Clinical outgoing
Skills Experiences
Clinical
Experiences
•scheduled
Handoffs between
and incoming faculty tutors
are Skills
highly
valuable
time
• The most “poisonous”
element
out”
HMS Masters
Thesis is when individual students
HMS“check
Masters Thesis
• Group tension is inevitable over the long journey(s)
Assessment
Assessment
Assessment
Assessment
• One must carefully
respect student
autonomy and ownership
of the process
Break
3rd Year• One must also maintain a safe space for
students to learn
• Other curricularPBL
models
may feel “threatened” byPBL
the information era, but we
Core Experiences
Clerkship
Individually
USMLE
feel
it
only
enriches
our
students’
capacities
to
fully
engage
the
power
of PBL!
scheduled
Rotations
begin
self
Clinical Skills Experiences
Clinical Skills
time
HMS Masters Thesis
Assessment
Masters
Assessment
study
at UCSF
Assessment
“Problem-Based
Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
QUESTIONS & ANSWERS
What questions
can we try to
answer?
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
REFLECTIONS
Let’s review your
original goals for
this workshop and
see if we
addressed them
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
WHERE DO YOU GO FROM HERE?
Self-directed Learning:
 Did you get what you wanted out of today’s
workshop?
 Is there anything else you want to look up
soon?
Index card next step activity!
 Side 1: What do you hope to accomplish 3
months from today?
 Side 2: What mailing address would you like
us to send this index card to 3 months from
now?
Image from http://lenpenzo.com
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
OUTLINE
Duration
Topic
5 min Who we are
10 min Who you are and what you want
5 min Reflections on the “information explosion” era we’re in
Brainstorm educational strategies to address the
“information explosion” era
Mini-didactic
5 min
 Core tenets of PBL
 Variation in the use of PBL
15 min
15 min Discuss barriers and opportunities in your local context
Our local contexts:
15 min
 Building from scratch
 10 years of experience
10 min Q&A
10 min Conclusions, Reflections & Next Steps
“Problem-Based Learning in the era of Google & Wikipedia”
A. Azzam. D. Valenzeno. IAMSE Conference 2014
PROBLEM BASED LEARNING IN THE
ERA OF WIKIPEDIA & GOOGLE
Amin Azzam, MD, MA
University of California, Berkeley &
San Francisco
amin_azzam@berkeley.edu
Dennis Valenzeno, PhD
University of Kansas School of
Medicine, Wichita
dvalenzeno@kumc.edu
A. Azzam. D. Valenzeno.
IAMSE Conference 2014