Small Group Discussion/ Tutorial

dr. Desi Isnayanti, M.Pd.Ked

Medical Education Unit
Senin, 5 September 2016

Faculty of Medicine, UMSU

 Learning Outcomes
In the end of this lecture, students are able to:
1.Explain the tutorial process in Problem Based
Learning
2.Explain the component of tutorial and their
roles.
3.Explain the rules of tutorial process.
4.Explain assessment in tutorial process.

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 Introduction
• In problem based learning (PBL) students use
“triggers” from the problem case or scenario
to define their own learning objectives.
• PBL is not about problem solving, but rather it
uses appropriate problems to increase
knowledge and understanding.

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• Tutorial is the heart of PBL.
• Group learning facilitates not only the
acquisition of knowledge but also several
other desirable attributes, such as
communication skills, teamwork, problem
solving, independent responsibility for
learning, sharing information, and respect for
others.

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 Generic skills and attitudes
• Teamwork
• Chairing a group
• Listening
• Recording
• Cooperation
• Respect for colleagues’ views
• Critical evaluation of literature
• Self directed learning and use of resources
• Presentation skills

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 Tutorial process
• PBL tutorials are conducted in several ways.
• The examples are modelled on the Maastricht
“seven jump” process.
• A typical PBL tutorial consists of a group of
students (usually eight to 10) and a tutor.
• Tutorial groups meet for 2-hour sessions twice
a week.

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• Between tutorial sessions, students research
their assigned topic(s) and prepare materials
to facilitate group learning.
•  During tutorial, students present their
material in a manner most conducive to
integration of content relative to the patient
case, to problem-solving and to critical
thinking.

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Roles of participants in PBL tutorial

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 The Maastricht Seven Jumps Process
• Step 1—Identify and clarify unfamiliar terms presented in the scenario; scribe lists
those that remain unexplained after discussion
• Step 2—Define the problem or problems to be discussed; students may have
different views on the issues, but all should be considered; scribe records a list of
agreed problems
• Step 3— Brainstorming” session to discuss the problem(s), suggesting possible
explanations on basis of prior knowledge; students draw on each other’s
knowledge and identify areas of incomplete knowledge; scribe records all
discussion
• Step 4—Review steps 2 and 3 and arrange explanations into tentative solutions;
scribe organises the explanations and restructures if necessary
• Step 5—Formulate learning objectives ,group reaches consensus on the learning
objectives; tutor ensures learning objectives are focused, achievable,
comprehensive, and appropriate
• Step 6—Private study (all students gather information related to each learning
objective)
• Step 7—Group shares results of private study (students identify their learning
resources and share their results); tutor checks learning and may assess the group

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 The steps of tutorial in FM UMSU
• Open discussion with do’a
• Tilawatil Qur’an
• Elect a chair and a scribe.
• Create group rules
• Step 1: Identify and clarify unfamiliar terms
• Step 2: Define the problem
• Step 3: Hipotesis
• Step 4: Analysis problem
• Step 5: Formulate learning objectives
• Step 6: Private study
• Step 7: Group shares results of private study ( second meeting)
• Feed back for discussion
• Close discussion with do’a

Faculty of Medicine, UMSU

Trigger material for PBL Scenarios
• Paper based clinical scenarios
• Experimental or clinical laboratory data
• Photographs
• Video clips
• Newspaper articles
• All or part of an article from a scientific journal
• A real or simulated patient
• A family tree showing an inherited disorder

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 Example
• A Woman, 25 years old, comes to her GP
because of fever for 3 days. It is a continuous
fever and not with chills.

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1. Identify and clarify unfamiliar terms
2. Define the problem fever for 3 days,
continuous fever and not with chills.
3. Hipotesis: Infection, dengue fever, thyphoid
fever, malaria
4. Analysis problem  discuss the problem and
generate an equiry strategy. What additional
information are required?

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 New information

Revising hypotheses

Discard / Re-rank / Other hypotheses

5. Formulate learning objectives
6. Private study
7. Group shares results of private study ( second
meeting)
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 Assessment of Tutorial Process
• Assessment of students’ activities in their PBL
groups is formative.
• Tutors should give feedback for students.
• PBL performance including communication
skills, respect for others, and individual
contributions.

Faculty of Medicine, UMSU

 Reference
• Wood DF. Problem based learning in ABC of learning
and teaching in medicine. BMJ vol 326. 2003.
• Davis MH, Harden RM. AMEE medical education guide
number 15: problem-based learning: a practical guide.
Med Teacher 1999;21:130-40.
• Norman GR, Schmidt HG. Effectiveness of problem-
based learning curricula: theory, practice and paper
darts. Med Educ 2000;34:721-8.
• Albanese M. Problem based learning: why curricula are
likely to show little effect on knowledge and clinical
skills. Med Educ 2000;34:729-38.

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