title: PBL Trigger Design by Medical Students: An Effective Active Learning Strategy Outside the Classroom.
abstract: BACKGROUND
  Problem Based Learning (PBL) is known world over as an effective, active learning strategy with many benefits for the student. Usually, in medical schools, PBL triggers are designed by a well-trained group of faculty from basic and clinical sciences. The challenge was whether this task could be given to students in the first year of their curriculum and be executed by them effectively.
  
  
  OBJECTIVE
  To enhance active learning, comprehension and critical thinking with a view to promote horizontal and vertical integration between subjects.
  
  
  METHODS
  Student volunteers of the first year MBBS course (n=10), who had been exposed to the curriculum for approximately 38 weeks and were familiar with the PBL process were recruited for the study. In addition to a handout on the topic 'gout', they were given the freedom to access any resource in the university library to construct the PBL triggers. The PBL triggers were vetted by two faculties. In addition to a focus group discussion with students, students' and faculty's responses were collected on a Likert scale.
  
  
  RESULTS
  Students opined that the exercise helped improve their comprehension (100%), critical thinking abilities (90%) and clinical orientation to the topic (100%). They felt that designing a PBL trigger was a relevant active learning strategy (100%) and would help them answer questions on this topic better in the future (90%). The clinicians who examined the PBL triggers, felt that they were of good quality and that the process was a good tool for vertical integration between basic and clinical sciences.
  
  
  CONCLUSIONS
  The results prove that students when given a challenge will rise to the occasion. Unfamiliarity with the nuances of a disease did not prevent them from going the extra mile to achieve their target. By taking part in this exercise, students benefitted in many ways and got a holistic understanding of the topic.
  
  
  CONCLUSIONS
  PBL trigger design can be introduced as an active learning strategy for students in medical schools where PBL is part of the curriculum. It promotes integration across subjects and is very effective in augmenting student motivation.
authors.affiliation: Professor, Department of Biochemistry, Melaka Manipal Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Maya
authors.initials: M
authors.lastname: Roche
authors.affiliation: Professor, Department of Biochemistry, Melaka Manipal Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Indira Kakkunje
authors.initials: IK
authors.lastname: Adiga
authors.affiliation: Lecturer, Department of Biochemistry, Melaka Manipal Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Akshatha G
authors.initials: AG
authors.lastname: Nayak
keywords: Active learning; Critical thinking; Problem based learning; Trigger design