Introduction to Stages 1 & 2
Key learning activities
The key learning activity in Stages 1 and 2 is facilitated Problem-Based Learning (PBL) in small tutorial groups. These weekly PBL sessions explore the basic sciences in a clinical context with the help of a comprehensive set of online case resources and independent study guides.
Basic and clinical science learning is further supported each week by a series of integrated formal lectures and practical Theme sessions.
Clinical contact begins in the first week of Stage 1, with one day a week devoted to learning communication, clinical diagnostic (including history taking and physical examination) and procedural skills in a clinical setting.
By the end of Stage 2 students have a comprehensive background knowledge and basic competence in clinical skills before moving into the clinical school full time for Stage 3 (years 3 and 4).
Weekly learning
PBL process
A new problem is introduced each week (approximately 70 problems across the two years), and acts as a stimulus for the integrated learning of basic science. Each problem is spread over 3 x 1 1/2 hour tutorials.
At each tutorial, students work in groups of about 8, with a tutor, and take considerable responsibility themselves for tutorial process. The tutor's role throughout is that of a facilitator, acting as a "guide on the side" rather than a "sage on the stage".
Activity in each tutorial is guided by application of steps in a clinical reasoning process. To support this process, in each tutorial room students are provided with a whiteboard and pens, a computer with internet access and a collection of basic medical/reference textbooks.
Tutorial 1
Trigger/cues
The first step in the process is for students to access the website, view the problem trigger, and identify the important cues in the patient's presentation (see the demonstration PBL Case).
Problem formulation
Having viewed the trigger, and noted the important cues, students synthesise their thoughts about the problem into a statement and identify questions to investigate.
Hypothesis generation
Having made an initial identification of the problem, the students are encouraged to think broadly and systematically about the possible cause of the presentation, in terms of basic science mechanisms and epidemiological evidence. Once a sufficiently broad range of hypotheses have been generated, students identify learning issues which will need to be explored in order to test their range of hypotheses. Access to medical/reference texts in the tutorial room can help to sort out immediate "quick-reference" issues.
Tutorial 2
Review of learning
Students report back on learning issues and engage in discussion of how this information is used to test their previous hypotheses (see the demonstration PBL Case and learning topics associated with the problem).
Further enquiry plan
At this stage, students also identify what further information is needed from a patient history, physical examination and tests/investigations. Typically, the tutor (who has access to a "patient data sheet" role-plays the patient as the students seek their information. The tutor encourages students to justify their need for particular information in terms of hypothesis testing, and to speculate on what they would expect to find (see "Patient Data" in the demonstration PBL Case).
Diagnostic decision
With the combination of knowledge about learning issues, and patient information, students can arrive at a diagnostic decision, formalising this decision into a summary which explains cause in terms of basic science and epidemiological evidence.
Searching the evidence
Whenever possible, students are encouraged to consider the topics on which they would like more evidence in order to make decisions about their patient (cause of disease, diagnosis, intervention or prognosis) and to formulate at least one question that could guide a knowledge search.
Tutorial 3
Review of learning
Once again, students report on learning issues which have arisen during their exploration of the problem so far, and how this information assists in their understanding of the current problem.
Management
Students outline a plan of management, in broad terms only. This includes identifying appropriate goals, and their priority, alternative treatment options (again, in broad terms) what factors might need to be considered which could affect the achievement of the goals; and evidence that should be considered. Attention is also given to discussion of prevention; and to the identification of research questions which are relevant to cases of this nature.
Attention is also given to discussion of prevention; and to the identification of research questions which are relevant to cases of this nature.
Review of process
To "round-off" the problem for the week, students reflect on issues such as how well the group has worked; what might help next week's problem to work better; and ways in which individuals can contribute more effectively.
Other structured learning
Between tutorials, students explore identified learning issues and attend a number of scheduled sessions, including Lectures and Theme Sessions (see a sample Stage 1 timetable). Up to six lectures are offered each week and are representative of the four Curriculum Themes.
Theme Sessions are also offered by each Theme. Basic and Clinical Sciences sessions typically include laboratory work where students gain hands-on practical experience and learn from images, models, slides and museum or dissected specimens. In the Community and Doctor Theme, sessions are interactive and are presented in a variety of formats. Personal and Professional Development Theme Sessions are diverse, including aspects of personal development, evidence-based medicine, ethics and medical humanities. The Patient and Doctor Theme activities occur in the clinical schools (see clinical experience).
Learning Topics (up to 8 short summaries of key learning issues related to the problem of the week) are also provided in the first two years, together with reading lists, keywords and indications of other sources (including museums and computer-based resources) (see [[sample PBL). By the time of entry into third year, students are expected to be increasingly independent in their capacity to direct learning and to locate essential information.
Each week there is a scheduled one-day clinical placement. During this time, students attend skills laboratories, as well as being involved in ward visits for development of clinical skills (see Theme sessions in sample PBL).
Options
Students are required to complete at least one (and no more than two) Options in the first two years of the USydMP.
The purpose of the Options program is to provide short in-depth scholarly projects in order to nurture academic individuality.
Options can be used to overcome a weakness or a gap in knowledge or skill, broaden understanding in an unfamiliar area of medical science, expand horizons in humanities or social sciences, explore literature, and may even lead to subsequent study at postgraduate level.
Two types of options available:
- Faculty-initiated Options: where information regarding available options is provided to students, and
- Student-initiated Options: where students develop a plan for their own option and submit it to Faculty for approval.
Options are generally supervised by a member of the Faculty of Medicine and are to be completed by July of the second year of the USydMP degree.