DESPITE the decision of Father Rector Tamerlane Lana, O.P. to revert to the synchronized medical curriculum and to phase out the problem-based learning method, it seems that the problem has just started.
Professors at the Faculty of Medicine and Surgery are now at loggerheads over how to interpret and implement the Rector’s directive to continue the PBL only with the sophomores and juniors until its phase out.
According to Dr. Alejandro Baroque, assistant Neurology module leader, the curriculum the Faculty will use for the second-and third-year contradicts Fr. Lana’s directive to “review, refine, and possibly consolidate” the recommendations of Regent Fr. Jerry Manlangit, O.P., the Department of Medical Education (MedEd), and the special committee to review the PBL headed by Dr. Dante Mercado.
According to baroque, majority of the department chairs last month voted not to touch the PBL, which he said was against the Rector’s order.
Baroque added that using the PBL curriculum also violates another instruction of Fr. Lana to use the recommendations and guidelines of proper authorities like the Professional Regulatory Commission (PRC) which gives the subject-based physician’s licensure examinations.
In an interview with the Varsitarian, Fr. Lana, however, said that consolidating all the recommendations doesn’t exactly mean removing the PBL.
“My decision still stands: PBL will be implemented in the second- and third-years provided that it would be upon review, refinement, and consolidation of the said people involved,” he said. “But to consolidate does not exactly mean to remove PBL as what two recommendations are implying. Those conflicts will just have to be worked out by the Faculty.”
On the other hand, Medical Faculty Association (MFA) vice-president Rebecca Castro said the Rector’s decision that PBL would still be used for the second- and third-years was not clearly expressed in his letter and the MFA learned of it only through the Medicine Administration and the Varsitarian. She said their group requested a meeting with the Rector for clarifications, but to no avail.
“It turned out he (Fr. Lana) already had a private audience with Assistant Dean Patria Punsalan, who in turn, promised us a written document of their meeting. Up to now, we still don’t have the document,” she said. “It’s not that we doubt them, but anything not written does not exist.”
Castro also expressed dismay over the department chairs.
“I don’t know what happened to these people. When we had a convocation last February, all of them voted against PBL. Now, they’re all for it,” she said.
MedEd chair Aurora Bauzon insisted they are following the Rector’s directive.
“What problem? Sila lang ‘yun,” she said, referring to the anti-PBL professors. “Kasi one can interpret anything the way he or she wants it to be kapag hindi malilinaw.”
Unwelcome visitor
The problem doesn’t stop there, however. Some faculty members questioned the presence of World Health Organization (WHO) consultant Dr. David Kwan of the McMaster University in Ontario, Canada, who held PBL workshops in UST last May 2 to 15.
In a letter to Bauzon last May 5, Orlina said that PBL workshops with a WHO consultant were too late. The Faculty should rather address the “academic problems brought about by PBL especially in the sophomore and junior years.”
“The meeting with Dr. Kwan is already improper. It is just to convince us about PBL when our inclination is already to follow the Rector’s directive,” Baroque added.
However, Bauzon explained that the event had already been planned even before Fr. Lana’s decision last month. She said outgoing Dean Dr. Angeles Tan-Alora had requested the WHO for a medical education expert as early as September 2002, but Kwan was not available on the original dates requested.
“It is not an answer to the recent events that happened,” she said. “Besides, it would still be beneficial since we are still implementing PBL in the second- and third-years.”
Bauzon added that the seminar-workshops with Kwan could be the chance for the anti-PBL faction to clarify their allegations against PBL.
During the faculty convocation last May 12, however, Medicine professor Dr. Artemio Ordinario said Kwan refused to answer some of the questions raised by the faculty.
“He was evading some of the questions—especially mine—and was very uncooperative towards the faculty,” Ordinario said.
Kwan denied the allegation and said the teachers were asking the same thing form different angles.
Ordinario said it was the first time he asked the questions.
“(Kwan) was already telling us what to do,” he added.
According to Castro, Kwan allegedly told them to implement PBL or they would become “irrelevant.”
Kwan, however, denied threatening the faculty.
“It wasn’t a threat; I was only telling them the truth,” he said. “They don’t realize that PBL is already a global event.”
Kwan also told the Varsitarian that he thought he would come to UST to enhance and train the Faculty for the PBL.
“When I arrived, I realized I would have to do more than what was originally planned. I will be writing a report to the WHO about what I have observed in UST, along with my recommendations,” he said. “When WHO sends those recommendations here, it’s up to the school whether they take it or not. After all, I am just a consultant.”
He also expressed dismay over some faculty members who were not willing to proceed with the PBL.
“Not one of them attended my workshops during the succeeding days. Those who don’t like PBL don’t understand. They don’t know, they don’t want to learn, but they’re still against it. It doesn’t make sense,” he said.
Ordinario reasoned that Kwan’s hostility during the convocation made them lose interest.
“Let’s put it this way: he was trying to sell himself, we didn’t buy,” he said.
“Besides, he’s not a medical doctor,” Castro said. “He only has a doctorate. He wouldn’t know the needs of a medical doctor. We completely disagreed with most of the things he said.”
Nevertheless, Kwan continued his seminars in the Faculty with other University representatives in attendance.
PBL history
The PBL method that has caused upheaval in the Faculty is one of the methods used in the innovative curriculum, which largely employs case studies in an inductive mode.
According to Bauzon, the need to revise the traditional curriculum started in 1997 because of feedbacks from the faculty and the department chairs that the students had very superficial knowledge of medicine and experienced difficulty synthesizing medical data.
“There were too many overlapping subjects taught through lectures,” she added.
Bauzon also said the PBL approach for the Faculty was based on other Universities in the country implementing PBL like the Manila Central University, Zamboanga Medical Foundation, and the Mindanao State University. The PBL method at some schools overseas like the University of Maastricht and University of Newcastle was also studied.
“In review of these medical schools which had adopted PBL earlier, there was no significant difference in the licensure examination performance between the students under the traditional and PBL approach,” she said.
Under the PBL approach, Bauzon said the students became more analytical and critical thinkers and they became more knowledgeable with patient’s problems. They also tended to retain information longer because what they learned was linked and integrated.
A transition curriculum was implemented in 1998, known as the synchronized curriculum where the “good elements” of the traditional curriculum was still maintained.
Bauzon said seminars on curriculum innovation, workshops and feedback gathering were conducted to prepare the Faculty for the change. Correlates, or mini-lectures, were also introduced.
The structure of the medical school was also formatted to be PBL-compliant, including the removal of laboratories and cadaver tables.
During this time, there were already misgivings from the faculty, but Mercado said the PBL was given the benefit of the doubt.
The innovative curriculum using the PBL strategy was introduced in 2001, much to the disapproval of some faculty.
Conflicts continued even after last Jan. 22 when the special committee, headed by Mercado, wrote to then Vice Rector for Academic Affairs Fr. Jose Antonio Aureada, O.P. complaining that the Faculty has prematurely implemented the PBL method.
Mercado said there was not enough study to support the method’s implementation. There was also “undue haste” in starting the PBL even when there were insufficient resources.
In addition, Mercado claimed that the faculty members were not involved in the planning and organizing phase.
Students demoralized
Mercado said students have been negatively affected.
“The students’ workload is now less demanding giving them a false sense of security and confidence because PBL makes medical school too easy,” he said.
“The absence of lectures in PBL does not help.”
A medical student, who refused to be identified, said he has transferred to another school because he was frustrated with PBL. He said he had asked to be allowed to repeatthe first year, but was denied by the administration. He believes the PBL method makes things easy but only on the short run.
“I am going to be dealing with people’s lives here. Paano kapag mali pala naiintindihan ko sa proper kasi walang professor na nag-correct sa akin?” he said.
The student said he wanted to repeat the first year because he missed out on lot of things while he was in the Faculty. He observed that in every small group discussion, he and his groupmates hardly agreed on anything and the facilitator was not willing to help.
“Kung ganito lang naman pala, I should have bought a couple of Medicine books and read on my own, as what they (the facilitators) always tell me,” he said.
“Hindi ko na rin sana pinagastos ang parents ko ng pagkataas-taas na tuition kasi the teachers here don’t have any use anymore.”
The student also said he was compelled to transfer because the licensure examinations conducted by PRC are still subject-based.
“The PBL may be ideal, but if I fail the board, hindi rin ako magiging doktor at ako pa rin ang talo,” he said.
However, Kwan explained that even the PRC and other authorities on medicine are starting to conduct PBL workshops.
“They too, realize that PBL is a global event. There is already a subcommittee formed for these agencies to study the method and make recommendations,” he said. “They told me that they are supporting PBL, but they haven’t made it official yet.”
The student said he tried repeating in the University but was not allowed by Bauzon.
“She told my friend that if we repeat, mawawalan daw ng slots yung ibang freshmen,” he said.
However, the transferee admitted that he doesn’t entirely blame PBL.
“Siguro katamaran din on my part, kasi minsan sa sobrang boring, na magbabasa-basa ka lang, tutulugan ko na lang yung period,” he said. “But still wala kasing motivation, like professors.”
The student added he knows at least 30 batchmates of his who already quit and at least 10 who transferred to other schools.
However, according to Kwan, the students were demoralized not because of PBL but due to the “war” between the pro- and anti-PBL factions.
Kwan also added that the students told him that some of the facilitators sleep during class hours.
Bauzon added that the PBL is not for everyone.
“Kung pang-spoonfeeding ka lang, then it’s ok. Go for a traditional school. Same with the faculty. If they want to lecture, let them take small group tutorials.” Kwan agreed.
“If they really don’t want to be facilitators, then they can be the resource persons or teach clinical students,” he said. “The school still needs their expertise.”
Curriculum Update
According to Physiology Department chair Tim Trinidad, the first-year department chairs have decided to use the 2000 pre-PBL curriculum, but with some modifications.
“Compared to the other pre-PBL curricula, the 2000 pre-PBL curriculum maximizes the Faculty’s resources and implements the full degree of synchronization of the systems,” he said. “But we changed the sequencing of some topics that we feel are needed earlier as prerequisites of some of the other systems.”
He added that there will be some “integrated activities” at the end of each system, but gave assurances that it is still not PBL in its strictest sense.
“We are very careful about these changes that we will not go against the directive of the Rector,” he said.
Likewise, Bauzon said the changes in the second- and third-year’s curriculum are proceeding well.
“It’s just as the Rector said, PBL with some improvements in the second- and third-year because they started with that when they entered,” she said.
In addition, Bauzon said the six hours that were supposed to be for independent learning will only mostly for basic sciences lectures. Elka Krystle R. Requinta
