Problem-Based Learning: UBC Collaboration with Nepal

Problem-Based Learning:
UBC Collaboration with Nepal

Carol-Ann Courneya
1998 3M Teaching Fellow

n my first trip to Nepal in 1999 I met Dr. Arjun Karki, a Nepali medical doctor, who shared with me his vision for a new privately funded, notfor- profit, medical school. He wanted a school whose pedagogical structure would instill in the Nepali students a stronger social consciousness. His dream was that Nepali medical students would remain in N epal (population 24 million) and practise in non-urban areas. Of the 500 to 600 new Nepali physicians trained each year, the majority remain in urban Nepal, with few providing health care in rural areas where 86% of the population lives. That’s a ratio of one doctor for every 30,000 patients outside the urban centers.

In early 2000, I flew to Kathmandu to begin discussions with Dr. Karki and colleagues about creating a medical school whose pedagogical structure would be similar to the University of British Columbia Medical School. They decided on a curriculum which would involve early clinical exposure, small group, problem-based learning (PBL) to study the basic sciences, and a strong psycho-social influence throughout the program.

Since 2001, I have made two trips to Nepal with various colleagues (Dr. Bill Webber, Dean Emeritus and Dr. Rose Hatala from the UBC Medical School as well as Dr. Martha McGrew from the University of New Mexico). The focus of these visits has been to enable the potential faculty to develop and to teach a problem-based learning medical curriculum.

Along with support from other North American universities, in 2004 a partnership was developed through Patan Hospital (Patan is a suburb of Kathmandu) to develop a Health Sciences University which will house the proposed Patan Hospital Medical School.

In April 2004, Rose Hatala and I gave a seven-day workshop for Dr. Karki and seventeen Patan Hospital doctors. The participants were introduced to PBL using actual PBL cases in which they were the students and Rose and myself were the tutors. This was enlightening for some of the Nepali doctors who had never experienced small group, active learning strategies in their own medical training. Afterwards one exclaimed, “I was born too soon, I would have loved to learn medicine this way.” A day was dedicated entirely to PBL case writing. The participants were divided into four small groups which shared common clinical and professional interests. By the end of the day they had the scaffolding for four wonderful PBL cases that could be used in their curriculum. Each of these cases encompassed basic science learning objectives germane to the Nepali people and their culture. One of the key factors that brings the learning to life in medical PBL tutorials is the students’ motivation to understand the root of the medical problem they face. Without that it simply becomes an exercise in doing what the tutor wants them to do.

We asked the Nepali participants, whose previous learning settings had been entirely didactic, for feedback on how it had been to learn in this new “active” way. A very shy young woman put her hand up and said, “It’s the first time I was able to learn with my own mind, and not the mind of my professors!”