Chinese whispers.

Learning in post-grad medicine is a lot like Chinese-whispers.

It's assumed that as post-grad entrants we're all adults and have also completed a previous degree and are therefore capable of studying the concepts of medicine on our own with as little direction AND correction as possible from the university staff. The direction that we do receive is through our PBL-sessions - twice-weekly meetings with five or six other students where we're presented with a medical case (ie. Patient X presented to hospital with symptoms-X and a past-history of...) and given a set of learning objectives.

'Learning objectives' is a broad term used to describe a list of anywhere from five to twenty concepts which we're expected to research and study, such as "Identify the pathology, clinical features and investigations of Endometrial Cancer". As I was saying - broad... very, very broad.

Although this is a fantastic way to learn - as it allows for adequate communication between students regarding the topics we're meant to be covering, it is also the FULL extent of involvement that the university has in directing our learning. This therefore means that our understanding of this topic solely relies upon the resources that we look up and the information that other students bring to the table during PBL. This means that should one student look up wikipedia for their information and the other looks up MD consult, regardless of the reliability of this information - it becomes fact.

This happened the other day in the hospital.

Registrar: Tell me about the eye-symptoms of GRAVES disease
Student A: Lid lag, lid retraction, proptosis and exophthalmus. Student recounts exactly what was learnt in PBL last year.
Registrar: Not quite. Graves Disease leads to exophthalmus (protrusion of the eye) and ophthalmoplegia (limited eye movement and double vision). Thyroid eye disease covers lid lag, lid retraction and proptosis.
Student B verifies this in the book...

Major PBL fail, because both students were from different PBLs but had both received the same information from their PBL group and because of the lack of regulation of the resources available to students by the university or the lack of regulation of what material is learnt...

I can imagine the following scenario taking place.
In PBL:
Student A: Ok - so Student B was going to tell us about pregnancies.
Student B: pregnancies... blah blah blah... can happen in men.
Student A: Hang on a second! Where did you find that?
Student B: In book C, page X, paragraph J.
Student C: Oh well, it must be right then...
In hospital.
Doctor: So tell me about pregnancies.
Student A (Thinking: they said male pregnancy is right): Pregnancy can happen in both MALES and FEMALES!