Pedagogy in Education
“Next time you experience awkward silence with a resident, remember to pull up one of the many PBLDs available and get to teaching.”
Problem-Based Learning
Matthew. Gao, MD
Three hours into an eight hour DIEP flap, you and your resident are both silently staring at the blue drapes wondering what to talk about next. Wouldn’t it be nice if there was some resource available to break up the awkward silence? Luckily there is. Problem Based Learning Discussion, or PBLD, is a teaching method in which complex real-world problems are used as a vehicle to promote student learning of concepts and principles as opposed to direct presentations of facts. PBLDs have been shown to promote development of critical thinking skills, problem solving abilities, and communication skills (Dutch et al, 2001).
A PBLD library is available on Docebo as well as on the ASA website (see QR codes below). Both sites are available as a mobile version and contain PBLDs for residents and trainees of all levels and subspecialties. Instructors have access to the “instructor version” with samples answers and further topics for discussion, while learners have the question stem only. These are great resources for intra-operative teaching and further discussion, especially for our incoming CA-1s. We recommend notifying the resident the night before of which PBLD topic they should be ready to discuss. Since each PBLD is broken up into several discussion points, instructors have the flexibility of pausing in between to attend to other matters.
Next time you experience awkward silence with a resident, remember to pull up one of the many PBLDs available and get to teaching!
2) You suspect an allergic reaction given her history of a penicillin allergy. What symptoms would you look for in a patient under general anesthesia?
Anaphylaxis is a type I hypersensitivity reaction mediated by IgE immunoglobulins. Within minutes of exposure, a sensitized individual may experience severe hypotension, rash, circula- tory shock, wheezing, acute respiratory distress and airway edema. Under general anesthesia, the only symptoms may be hypotension, subtle rash and perhaps wheezing. The incidence of anaphylaxis during anesthesia ranges between 1:4000- 1:20,000 anesthetics. Death and serious organ damage occur in 2-5% of cases.
Sample discussion point from the Anaphylaxis PBLD
