Learning Need Determination
The third step in the process of investigating a PBL problem is the determination of “Learning Needs.” These are the topics that will provide the information to evaluate the Ideas that were generated. Learning Need determination addresses the question “What do we need to know?” The determination of Learning Needs does not begin until the group members have completed the generation, grouping, and prioritization of their Ideas. The group should identify Learning Needs sufficient to allow an evaluation of every Idea that was given a high priority by the group. The information acquired by researching the Learning Needs will represent new Facts for the group and thus allow the students to evaluate the validity of their Ideas. The Learning Needs are linked to the problem under investigation through the Ideas and thus the patient’s “problem” remains the focus of learning. The group should continue to refine the Learning Needs until a consensus is reached.
How it is done:
Once the group members have completed their Idea generation they are ready to move to the determination of Learning Needs. Ordinarily the students will quite readily identify the gaps in their knowledge that are related to their Ideas. When a Learning Need topic is written it is useful for the group to link the topic to a specific Idea or group of Ideas so that it will be apparent how the new information generated by the Learning Need topic will be applied to the case. In our previous example Idea about bleeding ‘gums’ and low platelets, the group might chose to select the topic of “blood clotting problems” or “coagulation problems” with the mindset of having to answer how platelets fit into the process. As in other steps in the PBL process the scribe will record the Learning Needs suggested by individual members and agreed upon by the group. The group will often refine a suggested Learning Need topic to provide greater focus and more direct application to the case. When the list of Learning Needs is completed, the group members should agree that these will help them evaluate all of the Ideas they have decided to address. At this time the group may identify specific Learning Need topics that have highest priority and identify other topics that might be deferred pending additional information about the patient’s presentation.
Once the high priority Learning Need topics are identified the group should decide on the approach to researching and presenting the learning materials needed to satisfy the expectations of the group. Important for the group to consider is what materials should be covered, what type of summary should be included, what presentation style should be used, how and where references should be included and whether other types of learning tools such as diagrams, images, 3-D aids should be incorporated. A Learning Need topic may be assigned such that ALL members of the group research the topic individually. Alternatively individual Learning Need topics may be assigned to individual students or subsets of students in the group.
The process assigning topics should be the work of the group and based on consensus reached by the group, with only limited participation by the facilitator. Groups use a myriad of means to assign Learning Needs to their members and the critical element is that the group agrees to the approach and that the method is fair and equitable. Once the Learning Needs have been assigned the group is ready to move to the next step in the process.
Why it is done:
The identification of gaps in knowledge and the empowerment to fill those gaps is an important element of effective and self-directed adult learning. This process also builds life-long learning skills that will be valuable to clinicians as the body of evidence grows in their discipline. The process of determining Learning Needs is also analogous to the request for additional tests that would be made in a clinical setting so that the Differential Diagnosis can be refined. In a clinical situation these tests are ordered on a prioritized basis and some appreciation for how the outcomes will influence the process of differential diagnosis is required prior to requesting the tests. The data from both clinical tests and Learning Needs becomes a set of new Facts to apply to the patient’s case. This requires a critical skill to interpret outcomes and apply them to the previous thinking. In general, students will not have been required to practice this type of process in their previous coursework, where the learning environment was more passive and the learning objectives were defined by the instructor. There is evidence in the literature that adult learners are more motivated to learn when they have identified the learning objectives themselves. Thus PBL is an important transition between traditional passive learning styles and the more active adult learning styles that will be necessary throughout the remainder of the clinician’s career.
