Use of a modified problem-based learning approach in aphasia therapy teaching

Dr Arpita Bose, School of Psychology and Clinical Language Sciences
a.bose@reading.ac.uk
Year of activity: 2011/12

Overview

9254A modified problem-based learning approach was developed and implemented in Communication Impairment 3 (PL2CI3/PLMCI3) within the School of Psychology and Clinical Language Sciences.  While the adoption of this approach was unpopular with students on the module, there was a notable improvement in the marks achieved in exams, and this suggests that subtle modification may provide a problem-based learning approach to which students respond well, and that provides for the achievement of improved grades.

Objectives

  • Implement a problem-based learning approach in aphasia therapy teaching.
  • Enable students to apply knowledge obtained through study to be applied to real world clinical cases.
  • Through use of problem-based learning, prepare students for the workplace by allowing them to experience and practise decision making skills and processes.

Context

Speech and Language Therapies programmes taught at the University of Reading aim to prepare evidence-based practitioners, able to apply their knowledge to clinical problems, and make effective decisions in their practice. The problem-based learning approach has been widely adopted within a wide range of academic contexts and professional disciplines, including for Speech and Language Therapy. Under the problem-based learning approach in Speech and Language Therapy, students are encouraged to solve problems that are set in the real world, enabling them to use specific knowledge obtained through self-directed learning with the support of their lecturer to make clinical decisions.

Implementation

The initial task was to create a raft of fictional case studies. The creation of good ‘problems’ is the essence of successful problem-based learning approaches, and so several weeks were spent modifying each case so that students would be able to understand the content area that needed to be taught. Additionally, it was necessary to find appropriate resources that could go with the case studies.

Several resources were generated in order to support the students in solving the case studies, and specific pointers were provided towards the thinking about the case studies (in class), literature (detailed reference list), web-based resources, and resources from the department and library. The module convenor was available for discussion to the assigned group during module-specific office hours.

At the beginning of the problem-based aspect of the module, classes were divided into groups of between five and six students. Each week, the groups chose one of the two cases within the week’s topic, and determined the therapy for a fictional client based on the questions for each case.

Each group was required to give a presentation on their assigned case study, answering questions in five sections. Following this there were two to three minutes available for the audience to critique the answers, and for other possible solutions to be discussed, with students basing their critiques upon their own reading. This allowed various methods to be discussed using different cases. Following this, each group updated their slides and submitted a report, with both of these being uploaded to Blackboard Learn, allowing all students on the module access to the slides and information relating to a particular case, which they could use for their own learning and have available for future clinical practice. In addition, students working on a case study received formative feedback from the seminar leader and their peers.

Having built up their ability to respond to theoretical clinical cases during the teaching of the module, in the module’s examination one of the two questions on the therapy section was modeled on solving a case based on available information, with students being required to attempt one of the two questions.

Impact

In the pilot year, in the examination the problem-based question was attempted by more of both the undergraduate and postgraduate cohorts, and the mean marks were higher for students attempting the problem-based question than those that did not. Additionally, individual students expressed interest in doing aphasia topic for their theses, and module evaluation revealed that students felt better prepared for aphasia therapy in their placements.

Reflections

While the results obtained by students in examinations and engagement suggested value in the implementation of the problem-based learning approach, this was not without its difficulties. The principal difficulty experienced was a poor reaction to the introduction of problem-based learning approach on the part of the students on the module. The introduction of problem-based learning approaches increased the workload upon students, who also had to fit the workload around their placements, and students were unappreciative of the benefits that this increased workload might bring. This may also have resulted from the fact that the undergraduate students on the module were in their third year of study, and so had difficulty adjusting to the expectations of the problem-based approach.

The second issue was that developing a problem-based learning approach necessarily increases the workload of the module convenor. It takes a considerable amount of time to write the cases and generate the resources for the students. As Dr Bose felt that developing teaching in this manner would help students learn the material better, she was willing to put the time and effort in, but this should be a consideration for others looking to adopt a problem-based learning approach.

As a result of these issues, changes were planned to and enacted upon the module in order to get students on board with the problem-based learning approach, and prepare them early on for the demands of the approach, with the workload expectations being somewhat adjusted in order to better respond to the existing workload of students. Additionally, as the delivery of a problem-based learning approach was workload-intensive, arrangements were made to provide co-teaching staff, allowing the workload to be made more manageable.

Follow up

Following the pilot year of using a modified problem-based learning approach in aphasia therapy teaching, problem-based learning has continued to form part of the delivery of this module. Following student feedback in the pilot year, the problem-based elements of the course had been stripped back somewhat in order to respond to this, and student feedback has improved: recent examination results and student feedback, however, suggest that minimal use of a problem-based learning approach is not sufficient if one wishes to see the benefits of such an approach, and that therefore the amount of problem-based learning that is required should now be increased.

Thanks to the effort put in during the first years of running the module using the modified problem-based learning approach, there now exist a number of suitable case studies for use in this approach, and thus the workload is not as intensive as it once was, and only minimal amounts of work are required to ensure that the case studies are current and relevant.

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