My PBLI Journal in General Surgery

I recommend that all surgical residents and general surgeons keep tab of the problem-based learning issues that they will most likely encounter in all patients they will manage and in questions of consultants and colleagues during surgical conferences and rounds.

Problem-based learning issues are those gaps in knowledge that one needs to fill in, preferably in the soonest time possible, so that they can be used in future patient management and answering the questions of or improving previous answers to consultants and colleagues during surgical conferences and rounds.

Problem-based learning issues are offshoots of problem-based learning. Problem-based learning in medicine and surgery is essentially learning the science and art of medicine and surgery in the clinical or functional context.

In the practice of medicine and surgery, the following events actually or should take place:

1. A physician meets a patient without prior knowledge of what the patient’s problem is.

2. During the encounter, the physician establishes rapport, diagnoses, treats, and gives advices with the goal of resolution of the health problem of the patient.

3. In the process of understanding and resolving the patient’s problem, the physician invariably encounters some insecurities, questions, and gaps in competencies.

4. The physician fills in the gaps in competencies through various means, such as self-study and learning from other people like consultations, referrals, and enrolling in a formal course.

5. The new competencies acquired are used by the physician on the patient on hand and on future patients.

If PBL in medicine and surgery is learning the science and art of medicine in the functional context, then the educational activities should consist of the following:

1. The student is presented with a health problem which can be simulated or actual, without the student having prior study on the problem. This means there is no prior teacher’s lecture nor prior assignment to study on the problem.

2. The student tries to understand and to solve the problem.

3. In the process of trying to understand and to solve the problem, the student will invariably encounter questions, uncertainties, and gaps in competencies, which constitute the so-called “learning issues”.

4. The student then decides how to go about settling the “learning issues”.

5. The student implements his plan of study.

6. The student applies what he learned to the problem on hand as well as to future problems or patients.

I have been advocating problem-based learning in surgery as early as 1982 when I started my academic career in the Philippine General Hospital; in 1991 when I established a structured distance education in general surgery in Zamboanga Regional Hospital (now Zamboanga City Medical Center); in 1994, when I helped established the problem-based learning curriculum for Zamboanga Medical School Foundation (now Ateneo de Zamboanga School of Medicine); and in 2001, when I became the chairman of the Department of Surgery of Ospital ng Maynila Medical Center.

Personally, I have been formally jotting down my problem-based learning issues on notebooks with a label of PBLI (Problem-based Learning Issues). [See samples of evidences below.] If I don't have my notebooks with me, I write down my PBLI on sheets of papers. These notebooks and sheets of papers contain the registry of my PBLI.

With the registry of PBLI, as soon as able, I try to look up answers for the questions raised. The registry serves as a reminder for me akin to a task list or things to do list.

In May 18, 2011, I created a website entitled Problem-based Learning in Surgery. I started posting my PBLI in general surgery with answers. The website is still in existence. I will continue to blog my PBLI in general surgery.

I will strongly recommend all surgical residents and general surgeons keep tab of the problem-based learning issues that they will most likely encounter in all patients they will manage and in questions of consultants and colleagues during surgical conferences and rounds.

For this purpose, I will recommend all surgical residents and general surgeons put up a "My PBLI Journal in General Surgery."

Aside from the journal serving as a task list or registry of PBLI, it can be used for other purposes and benefits:

1. To answer gaps in knowledge (primarily).

2. To reflect and analyze issues.

3. To write about the issues to share with colleagues and public (preferably with publication in the Net).

4. To document self-directed learning.

5. To propel continual professional education towards improving quality and safe patient care.

One can use a notebook or any digital device to jot down the PBLI.

Suggested format:

Date:

Categories / Tags:

PBLI:

ROJ@18dec16