Community-Based PBL: Challenges and Prioritized Health Problems

This project delves into the utilization of Problem-Based Learning (PBL) within the realm of healthcare education, focusing on its application in addressing various health conditions such as cancer, dementia, coronary heart disease, diabetes mellitus, HIV/AIDS, and others. The project examines the objectives and methods of PBL, highlighting its constructivist and rationalist educational viewpoints. It explores the challenges and issues encountered during the implementation of PBL curricula, providing real-world examples and justifications from existing literature. Furthermore, the project adopts a scientific methodology, akin to that of Towards Unity for Health (TUFH), to prioritize ten health problems suitable for a PBL curriculum within a community setting. The analysis considers various factors and indicators, culminating in a prioritized list of health issues relevant to the specific community. The project emphasizes the significance of community-based education (CBE) in preparing healthcare professionals to meet the health needs of the population, focusing on equity, relevance, and cost-effectiveness.

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PBL
Illnesses are presently the major reason of death and incapacity among grown-up,
older people and children in almost all nations yet the means
of stopping and governing most chronic illnesses are well recognized (Neufeld, Pickering, &
Simpson, 1997). A combined approach to long-lasting sicknesses also comprises
administration when it previously happens. PBL can be extensively used in dissimilar health
condition. The use of PBL to patient training usually involves a minor assembly of six to
eight diseased people (kids, adolescents or youngsters) and a knowledgeable expert
(dietician, nurse, and physiotherapist) deliberating real patient circumstances. The PBL
method offers a chance for patients to recognize approaches to better maintain specific long-
lasting illnesses (MacDonald, Chong, Chongtrakul, Neufeld, Tugwelld, Chambers, Pickering,
& Oates, 1989). PBL provides both the constructivist and rationalist view of education. From
the rationalist viewpoint, PBL uses instructional approaches to help
patients to progression and store information in such a method that it may be effortlessly
retrieved when obligatory in the future. The procedure of PBL assists patients to trigger
prior information and link new information to previous knowledge
Cancer: There is a range of methods obtainable for addressing attitude, information, and
abilities about cancer ache and its managing. Different instructive formats comprise
customary lectures, query and answer courses, small-group case-based deliberations,
problem-based learning (PBL), role-playing movements, and role modeling. PBL is being
applied as one of these approaches (MacDonald et al., 1989).
Objectives PBL approach

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 To designate and deliberate the prevalence of cancer (compassion, uniqueness and
prognostic value). To discuss the consequence of age, race, and daily life (food,
smoking, and pressure) on the occurrence and prevalence of cancers in the populace.
 Define and deliberate vague indication complexes related to a broad range of
neoplasms (ache, exhaustion, loss of hunger).
 Define and deliberate the role and purpose of the interdisciplinary wellbeing care
group in caring for somebody with cancer.
 Define and deliberate tumour pain recommendations.
 List the varied aetiologies of exhaustion and weight loss counting those which
appeared from mental as well as biologic issues.
 List the essentials in the deceased person's and family's communal history (age,
civilization, sex, work position and job, family subtleties) which are significant
deliberations in history taking.
 Discuss and define the suitable laboratory and screening test, considering their sign,
boundaries, and cost (Schmidt, Magzoub, Feletti, Nooman, & Vluggen, 2000).
Dementia
How it can be used in PBL curriculum
 To comprehend the core indications of Alzheimer’s illness and other types of
dementia.
 To appreciate the differences between numerous subdivisions of dementia, and
progress a differential analysis for senior patients having cognitive impairment.
 To explain the part of historical, scientific, neuro-radiological, and
neuropsychological examinations in creating the identification of dementia.
 To recognize possible signs of senior abuse.

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 To raise the value of the specific mental vulnerabilities characteristic in geriatric
inhabitants.
 Distinguish that elder mistreatment can arise in several forms
 Distinguish when the conservatorship might be suitable for a senior patient with
intellectual impairments.
 Demonstrate the suitable threshold of mistrust for recording elder mistreatment.
 Be aware of what a doctor has a responsibility, under regulation, to report supposed
elder mishandling in a patient.
 Show empathy and sympathy for the exclusive situation of somebody in the initial or
mid-phases of dementia. Increase in value the problems and defies for the specific
person, family, and community, of supporting those with the Alzheimer’s disease
(Torp, 2002).
Coronary heart disease
Several readings demonstrated that how diseased person has problems in changing
daily life routine or lifestyle even though such alterations are important as they are suffering
from a life-frightening illness. Patients with Coronary artery disease (CAD) used problem-
based learning (PBL) to progress their enablement and self-ability in building lifestyle
alterations. Self-care, like a regular workout and/or discontinuing smoking, alters the results
after an occasion of coronary heart disease (CHD), threat factors remain (Wood, 2003).
Results can progress if core constituents of secondary deterrence programmes are
operationally and educationally applied using mature learning values e.g. problem-based
learning (PBL). The supposition is that PBL can reduce cardiovascular occasions in the long-
standing and may also be economical compared to manage. Additionally, the knowledge

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gained from the PBL implementation may add to enlightening patients’ capability to manage
self-care, and also, may decrease the numeral of patients having consequent CHD events
(Albanese, 2000).
Diabetes mellitus
In the Problem-Based Education, method education is linked to the student’s
background and beliefs, and social communication has a key role. Hypothetically, the PBL
technique offers many benefits in diabetes patient training: the everyday difficulties of
diabetes upkeep serve as education material, assembly sessions afford diseased person a
chance to act together with other people; there is a highlighting on individual responsibility in
education and choice making; exercise in problem-solving improves the abilities and
information needed in everyday diabetes self-upkeep, which in turn assist adoptive
individuality and self-confidence in young patients of diabetes. The PBL technique in patient
teaching makes conceivable a new way, distinct as empowerment (Dochy, Segers, Van den
Bossche, & Gijbels, 2003).
HIV/AIDS
PBL is the small group situation study method that presents a condition (difficulty) to
students for which, by project, they are usually unprepared. Together, the contributors are
therefore obligatory to recognize and then pursue out the information they can consequently
use to deal with the case they have. They also absorb from each other and are both educators
and students in this equally helpful and accommodating process (McParland, Noble, &
Livingston, 2004).
Liver diseases
The objectives of PBL in liver disease are

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 Distinguish between viral hepatitis and other reasons for liver diseases.
 Select and read the toxicological and serological screening essential to conclude the
reason for liver disease.
 List the symptoms for stomach ultrasound, ascetic fluid examination, and liver biopsy.
 Conduct an operational plan of administration.
 List signs for lively and inert prophylaxis in contradiction of infective hepatitis
 Those patients in the requirement of particular care.
 Counsel and teach patients about deterrence approaches for viral hepatitis
 List and categorize the causes of stomach distension rendering to the patient's stage
and sex.
 Differentiate on scientific grounds the reasons of abdominal swelling counting ascites,
gas, distended organ, mass, pregnancy, and fitness.
 List the indications on physical inspection of liver disease.
 List the signs on past and physical inspection to backing the analysis of alcoholism.
 State the significance of gaining a collateral past in patients with doubted material
abuse or in patients who are, for any cause, incapable to offer a complete history.
 Outline an analytic method to the issue of ascites.
 Plan a diagnostic method for the issues of chronic liver illness.
 List and categorize the problems of chronic liver sickness.
 Outline the organization of the alcoholic and his/her family.
 List and categorize space-occupying cuts of the liver (Colliver, 2000).
Malnutrition

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Problem Based Learning (PBL) delivers a unique chance for medical learners to study
nutrition values in the setting of evidence-based medical cases (Ehrenberg, & Häggblom,
2007).
Multiple sclerosis
Problem-based education is the active education method grounded on the usage of ill-
structured issues as an inducement for education. Ill-structured complications are
multifaceted glitches that cannot be resolved by a simple procedure. Such glitches do not
essentially have an alone correct response but need learners to reflect substitutes and to
deliver a coherent argument to back the elucidation that they make. In PBL, learners have the
chance to grow skills in cognitive and self-directed education. Empirical readings of PBL
have established that learners who have educated from PBL prospectuses are well able to
relate their understanding to novel glitches as well as make use of more operational self-
directed knowledge approaches than learners who have educated from old-fashioned
curricula (Hmelo-Silver, 2013).
Stroke; objectives of PBL in Stroke
 Discover the structure of the cerebral and carotid blood vessels.
 Evaluation of muscles of the chest – flexors, and extensors.
 Recognize regions of the brain exaggerated by the mind in expressions of the
hemorrhagic infarct.
 Discover the stroke classifying scheme for muscle feebleness.
 Distinguish the part of the physiotherapist on the major few days after admittance.
 Clarify the reintegration procedure of a patient with stroke (short and long term) and
the part of physiotherapists (kinds of workout/gym work)
 Compare the dissimilarities between an early analysis and a complete assessment.

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 Elaborate on handovers, bed, and chair arranging for patients with stroke.
 Discuss the problem of manual handling included in moving a stroke patient
(MacDonald et al., 1989).
 Compare and differentiate the usual sitting, position, and steadiness with that of a
stroke patient.
 To explain how understanding, feeling, proprioception and body consciousness are
evaluated.
 Recognize effects on the daily life of the stroke patient (Evensen, Hmelo, & Hmelo-
Silver, 2000).
Suicide
PBL can be used in a patient with suicidal thoughts to analyze the issue by
brainstorming. Learners can develop their knowledge to analyze the difficulty based on
previously learned information and relating the knowledge to present situation (Wong, Lee,
& Mok, 2001). A learner can generate and highlight learning purposes (e.g., how to measure
suicide risk; what queries to ask the person to find out if he or she is suicidal) (Neufeld,
Pickering, & Simpson, 1997).

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References
Albanese, M. (2000). Problem‐based learning: why curricula are likely to show little effect on
knowledge and clinical skills. Medical education, 34(9), 729-738.
MacDonald, P.J., Chong, J.P., Chongtrakul, P., Neufeld, V.R., Tugwelld, P., Chambers,
L.W., Pickering, R.J. & Oates, M.J., (1989). Appendix B: Setting Educational Priorities for
Learning the Concepts of Population health.
Colliver, J. A. (2000). The effectiveness of problem-based learning curricula: research and
theory. Academic medicine, 75(3), 259-266.
Dochy, F., Segers, M., Van den Bossche, P., & Gijbels, D. (2003). Effects of problem-based
learning: A meta-analysis. Learning and instruction, 13(5), 533-568.
Ehrenberg, A. C., & Häggblom, M. (2007). Problem-based learning in clinical nursing
education: integrating theory and practice. Nurse education in practice, 7(2), 67-74.
Evensen, D. H., Hmelo, C. E., & Hmelo-Silver, C. E. (2000). Problem-based learning: A
research perspective on learning interactions. Routledge.
Hmelo-Silver, C. E. (2013). Creating a learning space in problem-based
learning. Interdisciplinary Journal of Problem-Based Learning, 7(1), 5.
McParland, M., Noble, L. M., & Livingston, G. (2004). The effectiveness of problem‐based
learning compared to traditional teaching in undergraduate psychiatry. Medical
education, 38(8), 859-867.
Neufeld, V., Pickering, R., & Simpson, J. (eds.) (1997). Priority Health Problems in the
Education of Health Professionals. Network Publications, Maastricht

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Schmidt, H., Magzoub, M., Feletti, G., Nooman, Z., & Vluggen, P. (eds.) (2000).Handbook
of Community-Based Education: Theory and Practices. Network Publications, Maastricht,
Netherlands. Chapter 7: Identifying Educational Priorities in Health Sciences Programs.
Torp, L. (2002). Problems as possibilities: Problem-based learning for K-16 education.
ASCD.
Wong, F. K. Y., Lee, W. M., & Mok, E. (2001). Educating nurses to care for the dying in
Hong Kong: a problem-based learning approach. Cancer Nursing, 24(2), 112-121.
Wood, D. F. (2003). ABC of learning and teaching in medicine: Problem based
learning. BMJ: British Medical Journal, 326(7384), 328.