Abstract
The influence of problem-based learning (PBL) and open-book tests on long-term knowledge retention is unclear and subject of discussion. Hypotheses were that PBL as well as open-book tests positively affect long-term knowledge retention. Four progress test results of fifth and sixth-year medical students (n = 1,648) of three medical schools were analyzed. Two schools had PBL driven curricula, and the third one had a traditional curriculum (TC). One of the PBL schools (PBLob) used a combination of open-book (assessing backup knowledge) and closed-book tests (assessing core knowledge); the other two schools (TC and PBLcb) only used closed-book tests. The items of the progress tests were divided into core and backup knowledge. T tests (with Bonferroni correction) were used to analyze differences between curricula. PBL students performed significantly better than TC students on core knowledge (average effect size (av ES) = 0.37–0.74) and PBL students tested with open-book tests scored somewhat higher than PBL students tested without such tests (av ES = 0.23–0.30). Concerning backup knowledge, no differences were found between the scores of the three curricula. Students of the two PBL curricula showed a substantially better long-term knowledge retention than TC students. PBLob students performed somewhat better on core knowledge than PBLcb students. These outcomes suggest that a problem-based instructional approach in particular can stimulate long-term knowledge retention. Distinguishing knowledge into core and backup knowledge and using open-book tests alongside closed-book tests could enhance long-term core knowledge retention.
Highlights
In preparing students to function as medical professionals, they have to be trained to become active, independent learners and problem solvers who are able to use and manage the growing and rapidly changing body of knowledge (Dolmans and Schmidt 1996; HeijnePenninga et al 2008a)
problem-based learning (PBL) students performed significantly better than traditional curriculum (TC) students on core knowledge (average effect size = 0.37–0.74) and PBL students tested with open-book tests scored somewhat higher than PBL students tested without such tests
The results showed that PBL students outperformed TC students on core knowledge of most progress tests
Summary
In preparing students to function as medical professionals, they have to be trained to become active, independent learners and problem solvers who are able to use and manage the growing and rapidly changing body of knowledge (Dolmans and Schmidt 1996; HeijnePenninga et al 2008a). Students in PBL curricula solve and discuss problems in small groups under supervision of a tutor They are assumed to be better able to learn and recall information than students in more traditional curricula (Schmidt 1993; Dolmans and Schmidt 1996). A way to assess how students process the expanding body of knowledge is the use of open-book tests (Heijne-Penninga et al 2008a). During these tests the students are allowed to consult their references, if they feel a need to do so. The influence of open-book tests on long-term knowledge retention is not yet known
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