The Use of Problem-Based Learning in Medical Education

Abstract

Since the introduction of a problem-based learning (PBL) curriculum at the McMaster University School of Medicine in 1969, many medical schools in different regions of the world have adopted this approach, usually with some variations to suit their local needs. The aims of this review are to report some of our experiences at McMaster, to discuss some of the concerns which are associated with the introduction of PBL in a traditional medical school, and to review our recent experience in the introduction of PBL in Physiology in a traditional medical school. Some of the advantages of PBL are: early exposure of students to clinical settings and patients; motivation to learn is self-imposed, because students can see the practical application of the knowledge they are acquiring during their studies; and the acquisition of various learning skills, which will assist them to become lifelong learners. There are also some perceived weaknesses to PBL, which include a lack of traditional structure and progression, and a lack of depth in the knowledge acquired. Teachers with these concerns do not recognize the integrative nature, and you- learn- what- you- need aspect of PBL. Specific evaluative tools have now been developed, which will provide better measures of the learning behaviour, knowledge and clinical skills. Our recent experience in the introduction of PBL in the teaching of Physiology at the University of Hong Kong shows that with appropriate training of the students and teachers, high school students entering first year university are capable of benefiting from the PBL approach. In conclusion, any modification or improvement in the curriculum needs to be based on sound reasoning and upon experimental evidence. We have gained a significant amount of knowledge about the use of PBL in medical education since 1969, but further improvements and refinements are still necessary in order to meet the needs of the students, and that of the society.