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Y1 Teaching and Learning at Manchester Medical School (PBL, Self-Directed Learning, Anatomy, CSLC)

Updated: Jul 25, 2021


Now that Year 1 of Medicine is over for us, we thought we’d tell you all about it! In this week’s blog, we’ll be covering the teaching and learning aspect of Year 1, including honest opinions of what we felt about it.


To be completely truthful, it was quite a roller coaster ride since we needed some adjusting to it. It wasn’t the difficulty that threw us off but the unfamiliar methods that the medical school used!


We’ll talk about the main teaching and learning methods we’ve experienced at Manchester Medical School, the pros/cons of each, how we adapted to them, and some tips along the way! Hopefully, after reading this blog you’ll have some idea of what to expect since you’ll be starting your first Essential Skills case soon! 


We’ll cover:

Due to the current situation, the exact way these methods will be implemented will be different from what we’ve experienced. However, the principles are the same so keep reading!


PBL (Problem Based Learning)


This was the main method of teaching for Year 1. At Manchester, we are assigned new PBL groups every semester and a tutor who facilitates our discussions.


PBL involved going through one case a week. We had opening sessions for a new case every Monday and closing sessions every Friday.


During the opening sessions, we got together with our PBL group to discuss the case and make a Learning Agenda (LA). One member of the group will be assigned the Chair and another Scribe. The Chair will facilitate the discussion and the Scribe writes down important points the group discusses/make a mindmap on a whiteboard. The discussions usually involved reading through the case, picking out any important cues (such as the patient’s history), and finally forming the LA. 


A LA is a list of questions related to the case involving Anatomy, Pathology, and psychosocial science. It is key to understanding the case because you’ll take the LA home to research the questions before the closing session. This is where Self-Directed Learning (see next section) comes in!


NOTE: Different PBL groups tend to have different LAs! Don’t panic when you realize that your LA isn’t the same as your friend’s in a different PBL group! The medical school provides a list of Intended Learning Outcomes (ILOs) for each case. These are what you need to know for each case so as long as your LA covers all the ILOs, you should be fine! You can also use case paragraphs provided for each Semester 1 case to see whether you’re missing anything.

For the closing session, we get together with our PBL group again to discuss what we researched and learned. This is a great time for you to see whether you’ve missed anything since you’ll compare to what others have found out! Keep in mind though that some groupmates will go into too much detail and in this case, the tutor will remind them that that is not needed. See what resources we used for PBL in the next section! 


Thinzar’s Perspective of PBL: 

Pros of PBL:

  1. PBL is discussion heavy. This can be both a pro and con but it’s a pro for me. I used to be shy to speak up in a group but since I had to do it in PBL twice a week, I got used to it and it helped me overcome my fears!

  2. You’ll be really engaged with the learning process since you’re involved in discussions and researching the LA! Since I’m actively involved, I find that I understand and remember information a lot better compared to just sitting through a traditional lecture!

  3. Improves team working skills! Teamwork in PBL is essential since you’ll need to form a well laid out LA for each case. You’ll learn to work and contribute your ideas as part of a team for this! You will also gain leadership skills by being a Chair.

  4. Helps you figure out what type of a learner you are! For example, I am more of a visual learner so I like to use Youtube videos to complete my LA. Some love textbooks on the other hand! Since in PBL you do self-directed learning, you can choose the resources that suit you!

Cons of PBL:

  1. Requires some adjusting to. PBL is a new method of learning which is rarely done during high school/college.

  2. Some might find it hard to contribute to discussions. This might be because group members like to speak too much or maybe discussions are not your thing! 

  3. Takes up a lot of time. Researching for PBL takes up a lot of my time during the week and sometimes I feel like I can’t fully enjoy doing other things unless my research is complete. 

  4. Some PBL groups aren’t the best! You’ll be put into groups that are really efficient working together but you’ll also encounter groups that don’t work well. PBL may require more effort if your group isn’t the best. 

  5. How much depth do I need? The question you’ll ask all the time in PBL. Sometimes the ILOs provided are really general and the LA doesn’t help. 

Advice for PBL:

  1. Don’t be too harsh on yourself if discussions aren’t your cup of tea! Try to contribute a little more each time you have a discussion and slowly you’ll get used to sharing your ideas in a group!

  2. Take PBL research seriously! A lot of the questions from our Semester Tests came from PBL cases and ILOs. Try to make your PBL notes as complete as you can.

  3. Read through the resources provided by the medical school for each case. These are important and may come up in your exams! 

  4. Learn to work with a group that isn’t efficient. If you feel your LA isn’t complete, add more questions by yourself. If you are confused about something after the closing discussions, look it up! Don’t just brush things off when you feel your group isn’t doing enough. 

  5. When wondering about how much depth you need to go into, ask yourself what you think a 1st-year Medical Student should know! You’re not doing a BSc and usually, very in-depth scientific knowledge and mechanisms aren’t needed. As you progress into the year, you’ll become more experienced at distinguishing what you need to and don’t need. 


Self-Directed Learning


Both of us agree that the greatest change when going from A Levels/IB to Medicine was the marked increase in self-directed learning. Unlike when we were taking those exams, we had to figure out which resources/methods suited us the most, how to manage our time (to finish going through those pesky LAs!), and to what depth of knowledge we were supposed to get to. 


At Manchester, we’re expected to do a lot of independent study as goes with most other med schools. Lectures are a scaffold for us to base information on, along with PBL and other sessions. During PBL case close/Anatomy sessions, we come with what we’ve learned and build on the knowledge as we go. 


Jean’s Perspective of Self-Directed Learning: 

The Resources

To illustrate my point, I’ll tell you about my experience with this.


I initially found it very difficult to contribute to my PBL sessions because it appeared that I did not have the same depth of knowledge as the rest of my group mates. It turned out that I was using the textbook that wasn’t suited for my needs, which made me feel lost and unsure about what I knew.


I was hesitant to change the resources I used. However, it cost me the entire first semester just by using the wrong resources. Because of that my exam results weren’t as good as they could’ve been in Semester 1, but I improved immensely after adapting in Semester 2.


How much time do I need?


This was the bane of my existence in Semester 1. I had no clue how much time I needed for cases and usually ended up rushing most of it the day before the PBL close session. Not something I would recommend at all! It’s very stressful, and the stress actually made me less efficient with my time.


It’s very vague to say “I want to get through the entire PBL learning agenda for this week.” Instead, break it up into chunks! It’s a lot easier to visualise exactly what has to be done and assign tasks to each day of the week so you can still incorporate sport, social activities, etc into your schedule.


Before starting the week, I will go through the learning objectives for PBL and Anatomy then use those to come up with small tasks to accomplish across the week. These learning objectives will be available on OneMed Learn as the Anatomy Learning Agenda (found in the Anatomy subsection of the case) and the Intended Learning Outcomes (ILOs) at the bottom for each case.


For example, for respiration I will break down the topic into learning about the mechanics of it (diaphragm contracting, work of intercostal muscles, etc), quiet breathing VS forced breathing, the innervation of respiration and so on. 


My principle is to get some work done the day the PBL case opens instead of using the excuse that the scribe hasn’t sent the learning agenda to not start work. Once I’ve started, this keeps my momentum going so I learn throughout the week with a sustained effort instead of trying to cram right before sessions and getting too stressed about it. I usually do some Anatomy first because that helps me understand the related physiology better.


Pros of Self-Directed Learning:

  1. Encourages good habits with time management for example. All of these are good habits for the future when you start work as a junior doctor and still have to continue preparing for exams!

  2. Helps you understand yourself as a learner what works for you (in terms of resources, methods etc)

  3. You build on what you know as you go along the week and the semester. For me I find this to be a great way to incorporate active recall, especially since we do a new case every week at Manchester and don’t get a lot of time for each!

Cons of Self-Directed Learning:

  1. Steep learning curve when you start. You feel quite lost even though there are so many resources/sources of support available. It can be very stressful since the only way for this to get better is by gaining experience and understanding over time.

  2. You reap what you sow. Not exactly a con, but if you don’t put in the work then you lose out on your learning opportunities! If that’s the case you don’t get the maximum benefit out of the sessions you attend.

Advice for Self-Directed Learning:

  1. Just go with something at the start. Something is better than nothing in this case and you’ll improve as you go. Which leads us onto the next bit of advice…

  2. You don’t have to get it right from the start! Self-directed learning is a continuous learning process and you find out more about your own preferences over time!

  3. Don’t be afraid to change your methods if you have to, even if they were effective for you in the past! Old habits are tough to kick but they can have a significant impact on your performance in medical school, as I’ve illustrated using my own experience.

  4. Try out different resources and revision methods early on. Everyone will use what they prefer but even that changes over time. Try things out earlier so that you don’t affect your studies as much! It’s better to make your mistakes earlier than later.

  5. Some sources you can use to figure out the depth of knowledge required include: formative exam questions, Sem 1 case paragraphs, PBL group discussions (take this with a pinch of salt because some groups can go into a lot of depth whereas some don’t go in as much!), and friends from other PBL groups.

Anatomy

Jean’s favourite bit of the week!


At Manchester, cadaveric dissection is used in Anatomy teaching, alongside anatomical models and prosections. In Year 1, sessions in the dissection room were either on Monday or Friday. Depending on what day your anatomy session is, you can go to the anatomy resource room before/after your session to aid consolidation. Other resources provided by the medical school for Anatomy include Acland Anatomy videos and the Anatomy Learning Agenda for each week.


Jean’s Perspective of Anatomy: 

The one thing that helped me a lot with Anatomy was visual learning. It’s one thing to read up about something in the Anatomy textbook, and another to be able to identify/visualise it on the human body. The Acland anatomy videos and models/prosections in the resource room were my main resources for this.


After I cover sections from the Anatomy Learning Agenda for each week, I would watch the Acland anatomy videos and see whether there was anything I missed out. Because my Anatomy sessions were on Friday for both semesters, I would go to the resource room before my sessions and test myself using the questions and models there.


The volume of information covered in Anatomy is HUGE. Textbooks can go into great detail about one single anatomical structure and once again, deciding what depth you need to go to is a challenge. I always found it helpful to base it on what is covered during Anatomy sessions and in the resource room.


Pros of Anatomy: (the pros of how it is taught at Manchester)

  1. A great way to incorporate active recall with the resource room, sessions and more!

  2. Your demonstrators are very knowledgeable. They usually have a medical background and may be able to help you answer some of the more clinical questions on your PBL learning agenda related to clinical reasoning.

  3. Great way to understand conditions! We develop a medical condition because some part of the body isn’t functioning the way it should be. Understanding how the body is normally structured can help you understand the pathology of a condition.

Cons of Anatomy:

  1. The terminology used in Anatomy is a whole different language. It takes some time for you to pick up and get used to it.

  2. Volume. Lots to cover in a short period of time.

  3. Names of structures can be very similar, making them quite difficult to remember.

  4. Anatomy may require regular reviews for it to click. This takes time and can be frustrating.

Advice for Anatomy:

  1. Read up about anatomical terms and planes of the body! They take some time to understand but once you do, it makes Anatomy learning far easier. Some people choose to do this before they start medical school whereas some do it after they start. Make sure you have a solid understanding of what terms such as “medial”, “proximal”, “sagittal” mean!

  2. Cover those basic topics that you find at the start of textbooks about muscles, bones, joints and more! They will help you understand the fundamentals of what you’re covering in Anatomy. For example, knowing what origins and insertions mean will help you remember the muscles you’ll be covering a lot more than just memorising the two anatomical locations.

  3. Find a textbook you like and stick with it! At Manchester, our anatomy learning agendas are based on the online anatomy textbook by Moore and Dalley so that may be a potential textbook you would want to use. Other Anatomy textbooks commonly used by medics include Grey’s and Snell’s. However, some textbooks might not cover every point on the Anatomy Learning Agenda. You may have to use a different one at some point.

  4. Make good use of resources available. Some of those available from the medical school can be costly if you had to get them yourself. There are lots of free online resources available as well, including sites such as TeachMeAnatomy, Youtube channels such as AnatomyZone, Armando Hasudungan, and many more! The resources that I’ve mentioned here have been linked so you can check them out for yourselves.

  5. Make links to clinical problems/your PBL case if possible! These links will aid your understanding immensely.

CSLC


CSLC (Communication Skills Learning Center) is where we go to learn communication skills but most of us just call this method of teaching and learning CSLC.


We had CSLC once every week and during that session we learned how to communicate with patients and practice clinical skills such as measuring blood pressure.


In Manchester, we are taught by doctors and simulated patients (SPs). CSLC sessions usually start with some teaching and explanation about what we’re doing, followed by the doctor’s demonstration of communicating with/examining an SP. Then, we usually split off into groups to interact with SPs ourselves. 


During Year 1, we were put into pairs for CSLC and placements so while talking to the SPs or real patients you’ll never be alone. Although some people feel more at ease this way, we wanted to be alone at times, especially when our partners talk all the time and don’t give us a chance to talk to patients! 


While we talk to the SPs in pairs, the rest of the group observes. This was quite daunting for us at the beginning. But, this way, we could learn from others’ mistakes and what they did well.


Thinzar’s Perspective of CSLC: 

Pros of CSLC:

  1. Prepares us for placements! CSLC teaches you how to talk to patients and you can get a lot of practice for both placements and for OSCEs.

  2. You are allowed to make mistakes! Since SPs are not real patients, you can make mistakes while practicing communication skills with them. You can also pause at times when you don’t know what to say next and they’ll guide you on the right track!

  3. Great way to learn from others! Since in Manchester we need to observe and give feedback to others during CSLC, we can learn from them. By emulating what others do well, we hope to improve our rapport with future patients.

Cons of CSLC:

  1. Limited time during sessions! For example, we usually don’t get to properly close the consultation with the SPs and because of this, some of us found it hard to do it during placement.

  2. It isn’t the same as talking to real patients! I find that SPs usually get to the point when they answer our questions (this might be because we’re in our 1st Year and they don’t want to throw us off) but for real patients, they usually get side tracked so you’ll have to work harder to get answers.

  3. Quite intimidating with others observing you.

  4. Might be difficult if you don’t work well with your clinical partner.

Advice for CSLC:

  1. Try to volunteer to talk to SPs as much as you can! Sometimes when we have extra time, SPs will ask whether someone wants to do an extra consultation.

  2. Don’t be scared to make mistakes! Mistakes can help you learn and you won’t be judged for them at CSLC.

  3. Talk to your partner when you feel you aren’t working well together! For example, sometimes your partner may talk too much without realizing it and not give you time to talk. You should talk to your partner about this so that you guys can work together better.

Conclusion

Thanks for sticking through till the end of this post! That was the summary of the main teaching and learning methods we experienced in Year 1 at Manchester. Would you like to see a post about resources next? Let us know by DM-ing us on our Instagram! Hope everyone is adjusting well to the start of the year and good luck to the first year medics at UoM! We’ll be posting regularly on our IG to keep you guys updated about how our year is going as well! 


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