Making Sense of Trying Not to Teach

Abstract

To explore how a cohort of first-ever "foundation" tutors in a new problem-based curriculum characterized and made sense of problem-based learning (PBL). The sample consisted of all foundation tutors (n = 34) from The University of Liverpool's undergraduate medical curriculum, 1996-97, the first semester of the first year that PBL became a main vehicle for knowledge acquisition. The cross-sectional study design involved semistructured telephone interviews with the tutors about PBL and problem solving. The author taped and transcribed the interviews and conducted an inductive analysis of these qualitative data. All tutors responded, with interviews lasting about 20 minutes: 26/34 (76%) were men and 23 (68%) were medically qualified. Twenty-nine (85%) facilitated 19-21 of the 21 PBL sessions. Most tutors conceptualized PBL as being student-centered (68%), involving small-group work (53%), but ignored its reflective component. They conceptualized good PBL tutors diversely, but mostly as "knowing" when and how to intervene (41%) and empathizing with students (29%). Few tutors characterized PBL in terms of problem solving, yet over half agreed, cursorily, that they were intimately related. The tutors were generally unclear about this relationship. These tutors mostly characterized PBL positively as a philosophy, yet missed its reflective elements and were particularly challenged by their own fallibility in knowing when and how to intervene without teaching. Internal motivation and direct experience of PBL helped balance some of the tutors' confusion with the educational rationale, highlighting possibilities for future staff development.