The Use of Student-Centered, Problem-Based, Clinical Case Discussions to Enhance Learning in Pharmacology and Medicinal Chemistry

INTRODUCTION Traditionally, pharmacy education has consisted primarily of didactic, subject oriented and knowledge-based teaching. While these are essential methods, they do not provide optimal opportunities to learn processes needed to identify and treat drug related problems confronting today’s practicing pharmacist(1). In 1975, the Millis Study Commission on Pharmacy listed problem identification, problem solving, and continuing education as essential skills needed to practice in any health service profession(2). Unfortunately, concerns have been voiced in the pharmacy literature that students are entering clerkships without appropriate problem solving or clinical decision making skills(3,4). Similarly, a significant need to improve problem solving skills has also been documented among community pharmacists(5). To improve problem solving skills and link basic sciences to clinical practice, medical educators have turned to problem based learning (PBL) as a partial replacement for traditional didactic approaches to teach basic and clinical sciences. Instead of traditional lecture based format, students learn by solving problems. Instead of sitting in class taking lecture notes, students take active responsibility for their learning in the student centered, problem based format(6-9). Student centered, problem based learning methodology utilizes collaborative study of clinical cases in small discussion groups, facilitated by faculty direction that concentrates on group process(10). Problem based, student centered learning develops clinical reasoning strategies through scientific understanding of basic sciences. In addition, problem based learning facilitates the assimilation of new information by allowing knowledge to be learned in the context in which it is to be applied(1,5-10). Problem based case discussions force students to use hypothesis driven reasoning, which is more effective than lectures in developing problem solving ability because students must apply scientific knowledge to problems in clinical cases(3,6-8). This method of instruction has been shown to create a knowledge base that is recalled as well as, or better than, This article is based on a portfolio submitted to the AACP Council of Faculties and presented during the Innovations in Teaching Awards Special Session, at the 98th Annual Meeting, Indianapolis IN. July 15, 1997.