Problem Based Learning

Problem based learning (PBL) is a popular method of learning, currently used by most health professional courses in the UK.

The aim of PBL is for you to read through a complex and broad series of information, to identify areas of interest and areas you would like to explore further, in order to further your knowledge of specific topics, through self-directed learning.

 The questions our mentors have provided offer ideas of topics to explore and are written in three streams for aspiring medics, dentists and veterinarians; focus on all three or simply what interests you!

  • Remeber you can leave a comment if you have any questions and we will be sure to answer them.
  • We will  be discussing and answering the PBL cases in the VMS meeting at 7pm – 8pm on 9th March 2020.


THE Dental PBL Case

Joe is a 9 year old boy, who is brought by his Grandma to his annual check up with you. He presents with no pain and no complaints. His Grandma says his parents are concerned about the appearance of his ‘wonky front’ teeth. 

Upon examination, he has two carious (decay) lesions, one on the occlusal of the lower right first primary molar and occlusal of the lower left first primary molar. These carious teeth require restorations (fillings). His upper central incisors are protruded and create an overjet of 7mmm. During the examination, Joe appears quite anxious.  

  1. What is consent?
  2. Who can give consent?
  3. What questions would you like to ask grandma in regards to consent?
  4. What does occlusal mean?
  5. Can you carry out these restorations? 
  6. What is an overjet?
  7. What is orthodontic treatment?
  8. What age do children get referred for orthodontic treatment?
  9. What is index of treatment needs (IOTN)?
  10. What are the risks and benefits of orthodontic treatment?
  11. What anxiety management strategies can be used to help Joe accept dental treatment?


THE Medic PBL Case

You are a work experience student sitting in on a GP surgery when a mother brings in her very unhappy eighteen-month-old daughter, Talia. Upon further questioning, the doctor learns that she has not been sleeping very well at night, and she has been quite distressed with a fever for two days. Talia has just gotten over a cough that started a week ago. During the consultation, Talia starts crying and pulling at her left ear. 

 The doctor examines Talia’s ear and looks inside with an otoscope. There is nothing of note seen on the outside or surrounding the ear. They are able to visualise the tympanic membrane, which is seen to be bulging and reddened. The doctor prescribes some antibiotics for Talia to try and recommends some ibuprofen. The infection resolves without any issues. 

Two months later, Talia’s mother brings her back to the surgery, as she is concerned that Talia is acting up and often not responding to her name. The doctor looks inside Talia’s ear again and sees the same bulging of the ear drum, but there is no redness. They diagnose ‘glue ear’. After deciding to watch and wait for twelve weeks and there not being any improvement, the doctor refers Talia to the ear, nose and throat clinic at the hospital, where they decide to insert a Grommet. 

  1. What is the structure of the ear? 
  2. What is inside the nasal cavity?
  3. What are the different types of ear infection (otitis) you can get? 
  4. What are the risks of a severe middle ear infection? 
  5. What is the Eustacian tube, and what does it do? 
  6. Why are children more likely than adults to get ear infections?
  7. What is the relevance of the cough that Talia had before presenting to the GP? 
  8. What is glue ear and how does it happen? 
  9. What is a Grommet? 
  10. Challenge – Why is glue ear in adults more concerning?


THE Vet PBL Case


A client brings their 12 week old female Cavachon puppy to you for its 2nd vaccination. The breeder organised the first vaccination with their own vet practice so this is your first time seeing the animal. On clinical examination, you notice a small, soft bulging lump at the puppy’s umbilicus (belly button). The puppy is non painful when palpating this lump. 

Case 2 – FARM

You are called to a farm to see a 1 week old scouring calf. It has been showing progressive diarrhoea for the past 48 hours with associated dehydration (sunken eyes, skin tent). The farmer thinks it is ‘coccidiosis’ and wants you to check for this before treating. 

Case 3 – EQUINE

You are a new graduate ambulatory equine vet. On your visits today you need to go to a stud farm to visit a newly born foal. The colt foal was born 24 hours ago and had a normal birthing by an experienced mare. However, there is something not right about the foal as he is very small, has a bulging head and mild diarrhoea. The owner is very concerned as so much work has been put into breeding this foal. 

Case 1

  • What could this lump be? 
  • The lump is ‘reducible’ what does this mean and why is it important? 
  • What advice would you give to the owner regarding this lump?

Case 2

  • What is ‘coccidiosis? And how would you diagnose this? 
  • Why is it very unlikely this calf is suffering from coccidiosis? 
  • Name 3 other causes for scour in a 1 week old calf. What treatments would you like to give this animal?

Case 3

  • What other questions may you want to ask the owner to help with your history taking?
  • Name 3 possible conditions that could be affecting this foal. 
  • What is the normal gestation period of a mare? 
  • What is the difference between dysmaturity and prematurity?