Problem-based learning (PBL) is an interactive, case-based educational forum that is well suited for continuing medical education (CME) and promotional pharmaceutical company sponsored programs. The primary purpose of continuing medical education is to improve patient outcomes by changing practitioners’ behavior toward following evidence-based guidelines with new information about treatment options. Studies have shown that didactic lectures, which are the most common type of continuing medical education, do not have an impact on health care providers’ professional practices and do not change their behavior or patient outcomes.
However, studies have shown that interactive programs (PBL) change physician behavior and do produce measurable positive changes in professional practices leading to improved patient outcomes.
A traditional lecture is a passive event in which clinicians are presented with slides and data to be memorized and later applied to clinical situations. However, this learning “in abstract” is not the best approach to long term retention. In contrast, PBL is an interactive case-based format that progressively discloses relevant clinical data while participants are encouraged to actively think through the case just as they would in their offices or clinics. A skilled PBL facilitator guides the discussion and interaction of the group as they work together to solve a clinical problem. This “role playing” approach enhances the mastery and application of clinical data by imprinting the case in the clinicians’ minds. This type of “true learning” is also called “learning in context.” In addition, studies have shown that participants overwhelmingly enjoy PBL more than traditional didactic lectures.
PBL has been used effectively for educational programs for physicians in psychiatry, asthma/allergy, diabetes, chronic headaches, heart failure, hypercholesterolemia, and osteoporosis. In addition, this model has been successfully applied to programs for dentists, veterinarians, nurses, optometrists, physical therapists, and respiratory therapists. PBL has been used in nonmedical education from kindergarten through graduate education, in business & law schools as well as medial schools. PBL cases can be developed and applied universally with respect to any problem when the case is presented by a properly trained “skilled facilitator.”
Dr. Davis is a board certified allergist/ immunologist. He received his medical degree from the University of Louisville School of Medicine in Kentucky. After serving his internship and residency at Washington University School of Medicine and St. Louis Children’s Hospital, he completed his fellowship in allergy and immunology at the National Jewish Hospital and Research Center, the National Asthma Center, and the University of Colorado Medical Center in Denver, Colorado.
Dr. Davis has also been in private practice with Allergy Consultants, P.C. in St .Louis for over 30 years. He has written several chapters in the Manual of Clinical Problems in Asthma, Allergy, and Related Disorders and has coauthored numerous articles and case studies in a variety of journals, including the Journal of Allergy and Clinical Immunology, New England Journal of Medicine, Annals of Allergy Asthma & Immunology, Allergy and Asthma Proceedings, and Pediatrics. A diplomate of both the American Board of Pediatrics and the American Board of Allergy and Immunology, Dr. Davis is a fellow of the American Academy of Allergy Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology (ACAAI). He is also a member of the Southern Medical Association and the Joint Council of Allergy, Asthma and Immunology.
During the past 20 years, Dr. Davis has facilitated more than 50 educational conferences per year on asthma and allergies across the country. These conferences have involved strictly interactive case discussions known as problem-based learning or PBL conferences featuring small groups of specialists, primary care physicians, nurse practitioners, physician assistants, nurses, and other health care personnel.. He has integrated PBL into the curricula of several major conferences, including the Eastern Allergy Conference in Florida (2005-14) and the Southwest Allergy Forum in Puerto Vallarta, Mexico (2006-08). He and Dr. Bukstein have also taught seminars on PBL facilitation skills at the annual AAAAI meetings in 2006, 2012-13 and both have lead Workshops at the annual meetings of the AAAAI and ACAAI done by PBL format. In addition, Drs Davis & Bukstein have taught over 600 other specialists how to become skilled PBL facilitators through a full day course they created called Teach the Teachers™.
Dr. Bukstein is a board-certified allergist/ immunologist and pediatric pulmonologist. He holds hospital staff appointments at St. Mary’s Hospital Medical Center, in Madison and Waukesha Memorial Hospital in Milwaukee, Wisconsin. He worked as a pediatric intensive care physician for 17 years at St. Mary’s Hospital Medical Center. He has been active in resident education and was an Assistant professor of Family Practice and pediatrics at the University of Wisconsin for over 30 years. He serves as a fellow of the American Academy of Allergy Asthma & Immunology; the American College of Allergy, Asthma & Immunology; and the American Thoracic Society.
Dr. Bukstein received his BA in English literature from Tulane University in New Orleans, Louisiana, and his medical degree cum laude from the University of Missouri–Columbia. He completed his internship and residency in pediatrics at Children’s Medical Center of Dallas, University of Texas Southwestern Medical School. He also completed two fellowships: one in allergy and immunology at the National Jewish Medical and Research Center and one in pediatric pulmonary medicine at the University of Colorado Health Sciences Center both in Denver.
Dr. Bukstein is considered a national expert in using clinical outcomes for managed care. He has had numerous articles published in peer-reviewed journals, including The American Journal of Managed Care, Allergy, Pediatrics, and Journal of Clinical Outcomes Management. He also gives approximately 50 presentations annually at national and international meetings. These presentations have focused on allergic disease, asthma, quality of life, health outcomes and telemedicine.
Along with Dr. Davis, the last few years, he has team-taught a course on becoming a PBL facilitator called Teach the Teachers™ to over 30 groups of physician speakers for both CME and promotional medical education.
In September 2004, Drs. Davis and Bukstein published a study on PBL in the Annals of Allergy Asthma and Immunology. The study demonstrated the efficacy of PBL for changing physicians’ prescribing behavior toward a more proactive use of preventative medication for asthmatic patients. In addition, this article reviewed the literature demonstrating how much more effective PBL is for educating health care providers compared to traditional didactic lectures.
PROMOTIONAL PBL PROGRAMS
THE Problem Based Learning Institute can teach a select group of speakers from your speakers’ bureau or your University department faculty the techniques necessary to become skilled facilitators of Problem-based learning (PBL) sessions for “promotional” or CME talks. The full day seminar is a unique meeting we call Teach the Teachers™ and can be focused upon the topic, problem or disease state of your choice. It is an intense day of learning and practicing the appropriate techniques and critiquing to mold new facilitators into their newly learned skills. Due to the nature of the course, the ideal number is between 12-14 attendees per day. We can accommodate more if it is necessary, however, with advanced planning.
The Institute has experts who develop clinically relevant cases based on real patients in the proper PBL format to maximize the effectiveness of the interactive discussions. We are happy to work with any key faculty members in your division or content experts in your speakers’ bureau in developing the case(s).
We would love the opportunity to teach your faculty or speakers the techniques that we have mastered from over 25 years of experience. We have taught this one day seminar over 60 previous times for most of the major Pharmaceutical companies as well as for several CME groups. Please contact us for more information and a sample Agenda with a detailed explanation. We tailor the day of Teach the Teachers™ for you!
Another option is Web based PBL training or telephone conference PBL training. This can be done as two separate two hour sessions. The obvious advantage is that this is less expensive by saving on speakers’ travel expenses (hotel, airline tickets and food). However, clearly, those speakers trained in PBL strictly over the Web or via teleconference will NOT have the skills required for face to face PBL teaching sessions. But, this additional option may offer an alternative format of continuing medical education at a more convenient time and place for some health care professionals.
CME PBL PROGRAMS
In the last few years we have a trained a select group of Pediatricians from the University of California at San Diego, Rady Children’s Hospital and Cardiologists from the Division of Cardiology at Vanderbilt University School of Medicine for the purpose of integrating PBL sessions into their CME meetings as well as their weekly conferences.
Furthermore, we have developed national CME dinner program initiatives that were more “disease state” PBL dinner programs for Pharma companies who have CME divisions wishing to do so. We are experts at developing content, obtaining CME approval, credits and certificates as well as coordinating restaurant choices, picking national faculty who are PBL trained, and inviting ideal health care providers from extensive databases. An example of a full one hour PBL done for CME is available below.
“THE place to become a skilled PBL facilitator...just learn from the masters like you. Agree interactive learning is the way to go and hopefully will become the standard and not the exception.”
— Dennis Ledford, M.D., Past President of the AAAAI and Professor of Internal Medicine, Division of Allergy and Immunology, University of South Florida School of Medicine, Tampa, FL
“It was an excellent program and thoroughly enjoyable and instructive at the same time.”
— Mark Boguniewicz, MD, Professor, National Jewish Hospital and Research Center
“There is no question in my mind that interactive educational activities such as problem based learning programs are far superior to didactic “promotional talks”. I believe that both of you have done a wonderful job in training physicians in PBL techniques and have vastly improved industry sponsored educational activities as well as CME presentations that employ your teachings”
— Myron Zitt, M.D. Past President of the American College of Allergy Asthma and Immunology
“After training with the techniques that you taught me, I felt that I could facilitate a group of mechanical engineers, even though I knew absolutely nothing about building a car.”
— Steven Weinstein, M.D., Director, Allergy & Asthma Specialists, Huntington Beach, CA
“I have attended a million pharm meetings, and have learned absolutely nothing at 90%of them over 20 years of trying. Imagine my surprise when I attended today and have a complete re-thinking of the teaching process! THANK YOU! I have been skilled, but not inspired, for years. You have restored the inspiration...”
— Mark Mehle, MD, FACS, Assistant Clinical Professor Northeast Ohio Medical University, ENT and Allergy Health Services, Cleveland, Ohio
The following video clips are excerpts from a one-hour PBL case on COPD vs. Asthma. The video clips, although brief, demonstrate the stark contrast between a PBL session and what you might imagine the talk would have looked like if a traditional didactic lecture had been given on the same topic. If there is time, please view each sequence; if you are pressed for time, make sure to view the last few clips showing a dynamic interaction which would never be seen in a lecture. Remember, with PBL, one of the key goals is to engage everyone while the facilitator does a needs assessment of the group on their knowledge of clinical medicine. At the end of the case discussion, the facilitator tailors a “mini-lecture” to correct misinformation and reinforce key concepts in the objectives of the case.