A comparison of pyramids versus brainstorming in a problem based learning environment

Two years ago, the Department of Medicine at the University of Western Australia introduced problem based learning (PBL) into Foundations of Clinical Practice (FCP). The aim of this study is to compare pyramids and brainstorming in a PBL environment. First year medical students participate in one two-hour PBL tutorial every week as part of FCP. There are approximately twelve students in each tutorial group. Generally, two tutorials cover one problem. During the first tutorial a carefully constructed problem based on Public Health, Behavioural Science, General Practice, and/or Aboriginal Health, is brainstormed by the group as a whole.

Not all students are comfortable participating in such an environment and one of the tasks of the tutor is to facilitate the process by encouraging all students to contribute equally. In the first part of one of these PBLs the pyramid method was used to determine whether it might be more effective and acceptable to the students compared with brainstorming. The eleven students present sat in groups of three or four and were instructed about the pyramid method. After each trigger was introduced the students worked alone to tackle the problem before teaming up with their neighbour to share ideas. Each group then came to a consensus and pooled ideas in turn for the nominated scribe to write on the whiteboard. At the end of the PBL the students completed an anonymous, voluntary questionnaire comparing pyramids with brainstorming.

When considering increased personal involvement in the discussion, the students favoured the pyramid method over brainstorming. All students thought that pyramids allowed the group as a whole to define the objectives better, without taking longer, compared with brainstorming. An ideal PBL tutorial would encompass the creative thinking of brainstorming with the increased individual contributions of the pyramid method.

Background

PBL tutorials occur early in the week and are two-hour small (approximately 12 students) group sessions. In most cases a PBL spans two weeks. In the first session students identify learning issues that arise from a carefully constructed problem based on Public Health, Behavioural Science, General Practice, or Aboriginal Health and decide on research topics. The following week, the students present their findings and engage in evaluation of their own learning, that of others, and the overall problem.

During the first part of the PBL, the problem is brainstormed by the group as a whole. Not all students are comfortable participating in such an environment and one of the tasks of the tutor is to facilitate the process by encouraging all students to contribute equally.

Objective

Design and methods

The eleven students present sat around three tables in groups of three or four. They were instructed about the pyramid method and reassured that they would not be disadvantaged by participating in the trial. After each trigger was introduced the students worked alone to tackle the problem before teaming up with their neighbour to share ideas. Each table then came to a consensus and then pooled ideas in turn for the nominated scribe to write on the whiteboard. At the end of the PBL the students completed an anonymous, voluntary questionnaire comparing pyramids with brainstorming. The questionnaire (Figure 1) comprised four closed questions, three of which were based on a Likert scale from strongly agree (score 1) to strongly disagree (score 5), and an open question.

Figure 1: Comparison of pyramids versus brainstorming in PBL tutorials

Results

However, a student noted that the scribe "had to keep running back and forth" from table to whiteboard so that he could participate in the discussion, and another thought the process could have been "better managed".

Discussion

The pyramid method worked well in the PBL setting, but required more facilitation skills from the tutor and dedication from the students. It encouraged everyone to contribute equally, even the quieter students, and was more interactive. It allowed more discussion and definition of objectives at the individual level, within the same time frame, but this may have come at the expense of some creativity. An ideal PBL tutorial would encompass the creative thinking of brainstorming with the increased individual contributions of the pyramid method.

Acknowledgments

References

1. Foundations of Clinical Practice 111 and 112 Student Unit Book. Faculty of Medicine and Dentistry, The University of Western Australia, 2001.

2. Gibbs, G. Discussion with more students. The Polytechnics and Colleges Funding Council, Oxford, 1992: 8-17.