As described earlier, PBL is more than a paradigm shift, it
requires its own space to comfortably accommodate multiple
small groups operating independently but simultaneously. At
the University of Rochester School of Medicine and Dentistry,
with 100 students per class, 12 PBL rooms were constructed
and are used in shifts by each class throughout the
day. In addition, more faculty and faculty-contact time has
been required to tutor the PBL program. Faculty either give
lectures, tutor PBL cases, or do both. We assigned to the
course a staff member who spent virtually 100% of his or
her time facilitating the faculty’s efforts, photocopying, and
processing assessments while the course was running. In the
two months preceding the course and following it, this person
spent approximately 30% of his or her time preparing
course materials, coordinating faculty training, and finalizing
course summaries and assessments of the students and faculty.
PBL is a faculty and student partnership. It requires students
to want ownership of their learning and receive instruction
for how to do so. This relationship with the students
involves student and faculty assessments of students’
learning process and the faculty’s willingness to make appropriate
changes (based on students’ feedback) to facilitate
that process. This means that significant adjustments are
necessary in faculty’s and students’ attitudes and, therefore,
training opportunities need to be developed.3,4,10–12
When faced with curricular reform, faculty may accept
‘‘fixing’’ something that is ‘‘broken,’’ but they are not as easily
convinced that a paradigm shift will necessarily make
something better. I would argue that if students only feel
relief when our courses are done, and we feel that we are no
longer providing them with the intellectual tools they will
need in the post-genomic era, then our courses are in fact
already ‘‘broken.’’
Incorporating PBL into the Biochemistry Course
Approaches for implementing PBL into biochemistry courses
generally fall into two camps: either PBL experiences are
added to an existing curriculum as part of planned redundancy
or as a means of extending or diversifying learning,
or they are written to provide the primary strategy for accomplishing
learning in the entire course. In my experience,
either approach can foster problem-solving skills and accomplish
the intended learning objectives if the PBL cases are
prepared and implemented correctly.
There are likely to be several satisfactory strategies for
introducing PBL in biochemistry. A useful starting point is
to appreciate that biochemistry is taught within a curricular
context. Courses taught prior to biochemistry provide important
background information just as the biochemistry
course itself provides an essential foundation for all courses
that follow it. The course director, participating faculty, and
the curriculum steering committee should develop a list of
the skills, knowledge, and applications in biochemistry, cell
biology, genetics, and molecular biology that medical students
will need as health care professionals. The biochemistry
course cannot be treated as a one-time learning experience
(the sole responsibility of the biochemistry course
director). Essential knowledge and applications should be
evaluated in the context of the strategic plan for the entire
curriculum for the depth of learning expected, when this
learning should be initiated and how it will be reinforced.
Once the course director and faculty have identified the
subjects and skills they consider the domain of the biochemistry
course, it is important to think about them as groupings
of learning objectives that could be written as PBL cases.
This step is critical and is what I refer to as ‘‘letting PBL
take the lead in achieving the learning objectives.’’ The
learning objectives in the PBL cases, lectures, and labs cannot
be entirely overlapping; not enough time exists for this
in the crowded curriculum. Rather, PBL should involve
novel learning issues (or first-contact knowledge experiences).
The PBL case must require the acquisition and application
of new understandings to be solved.
The PBL process should include several in-class, smallgroup
discussions that convene over consecutive parts of the
case. Not handing out the entire case at once encourages
students to propose and research their own hypotheses and
to explore more issues collateral to the case because they are
not biased by knowing what comes next and how the case
ends. Importantly, there must be adequate time for independent
research of learning objectives as they arise. Independent
research is essential for information gathering and hy