Problem-based Learning Course Research Articles

A multimedia CD-ROM tool to improve student understanding of bile salts and bilirubin metabolism: evaluation of its use in a medical hybrid PBL course

Over the last 35 years our understanding of bile salts, bilirubin metabolism, and hepatobiliary transport has progressively increased. From 1965 to the end of 2002, 3,610 articles and review papers have been published on hepatobiliary and enterocyte transport of bile salts. However, there is a lack of information in the content of current textbooks about hepatobiliary physiology, bile salt transporters, bile formation, mechanisms underlying cholestasis, and drug-induced liver injury. The use of an integrated multimedia program on the liver covering these gaps in textbooks may be useful to student learning. This study aims to 1) assess student views on a multimedia CD-ROM ("The Liver") integrating basic and clinical sciences related to the liver, bile salts, and bilirubin metabolism, 2) assess the usefulness of problem-based learning (PBL) cases included in the multimedia CD-ROM, and 3) assess student learning before and after use of the multimedia CD-ROM. A total of 106 first-year medical students (27 with and 79 without a prior university degree) at the University of Melbourne participated in this study. Students were tested on the liver, bile salts, and bilirubin metabolism before and after using the multimedia CD-ROM. After completing the multimedia CD-ROM, each student filled out a 5-point Likert scale questionnaire evaluating the features of the program and its usefulness to their learning. Results show that the aims of the package were clear to participants, the contents were logically organized and clear, the key concepts were easy to identify, the contents were pitched to an appropriate level, and the package was interactive and encouraged participants to reflect on their learning. Students also agreed that the assessment tools used in the program and the feedback provided were meaningful and helpful to their learning. No differences were found when responses were compared on the basis of academic background, gender, citizenship, or first language of participants. Students agreed that the PBL cases in the CD-ROM kept them engaged, were useful to their learning, and matched with the overall philosophy of the program. Compared with graduate-entry students (those with a prior university degree), school leavers (those with no prior university degree) showed a more positive attitude toward the PBL cases included in the multimedia CD-ROM and agreed that cases kept them engaged (P = 0.033). Students who completed the test after using the multimedia CD-ROM scored higher compared with those who completed the test before using the multimedia CD-ROM (P < 0.001). In conclusion, using bile salts, bilirubin metabolism, and their hepatobiliary transport as an example, the incorporation of a multimedia CD-ROM into the first-year medical course has the potential to improve student understanding of the main concepts in a variety of body systems.

The qualities of a good teacher: how can they be acquired and sustained?

The introduction of problem-based learning (PBL) in undergraduate medical courses necessitates the special training of teachers and monitoring of their performance.1 In traditional courses the emphasis is on transmission of factual knowledge; teachers are the main source of information and students are offered few opportunities to identify their own learning needs or reflect collectively on their learning experience.2 Then, if the outcomes are unfavourable, the blame lies with the student, for lack of skills or motivation. By contrast, in PBL courses the responsibilities of teachers include: encouraging critical thinking; fostering self-directed learning and curiosity; monitoring group progress; and creating a learning environment that stimulates all members in the group, generates deep understanding, and promotes teamwork.1,3 These activities demand special attributes. Over the past five years I have run over forty workshops for would-be PBL tutors as well as refresher workshops for existing tutors who wish to enhance their skills as PBL facilitators. These workshops usually begin with a session titled What makes good teachers? and I ask participants to write down the name of the best teacher they have ever had and list his or her good qualities: ‘In what way did your best teacher help you to grow?’ Certain qualities are common to many of these teachers—for example, ‘He treated me with respect and was interested in helping and supporting me’; ‘She motivated me to love the subject she was teaching’; ‘She created a positive impact on my life that reshaped my vision and purpose’; ‘He was able to keep us engaged in his lessons, think, and ask good questions’; ‘I realized that learning can be fun and a life-long experience’. These responses stimulated me to examine the qualities of a good teacher in a more systematic way.

Paired basic science and clinical problem-based learning faculty teaching side by side: do students evaluate them differently?

Many studies have evaluated the desirability of expert versus non-expert facilitators in problem-based learning (PBL), but performance differences between basic science and clinical facilitators has been less studied. In a PBL course at our university, pairs of faculty facilitators (1 clinician, 1 basic scientist) were assigned to student groups to maximise integration of basic science with clinical science. This study set out to establish whether students evaluate basic science and clinical faculty members differently when they teach side by side. Online questionnaires were used to survey 188 students about their faculty facilitators immediately after they completed each of 3 serial PBL cases. Overall satisfaction was measured using a scale of 1-7 and yes/no responses were gathered from closed questions describing faculty performance. results: Year 1 students rated basic science and clinical facilitators the same, but Year 2 students rated the clinicians higher overall. Year 1 students rated basic scientists higher in their ability to understand the limits of their own knowledge. Year 2 students rated the clinicians higher in several content expertise-linked areas: preparedness, promotion of in-depth understanding, and ability to focus the group, and down-rated the basic scientists for demonstrating overspecialised knowledge. Students' overall ratings of individual faculty best correlated with the qualities of stimulation, focus and preparedness, but not with overspecialisation, excessive interjection of the faculty member's own opinions, and encouragement of psychosocial issue discussion. When taught by paired basic science and clinical PBL facilitators, students in Year 1 rated basic science and clinical PBL faculty equally, while Year 2 students rated clinicians more highly overall. The Year 2 difference may be explained by perceived differences in content expertise.

A guide for entry level PBL courses in engineering

The University of Southern Queensland has recently introduced problem-based learning (PBL) as core courses in all its Engineering programs. Core courses typically have enrolments of several hundred students, most of whom study off-campus. This paper reports the development, implementation and critical evaluation of a guide for these PBL courses. The guide is a full course management guide that has been used to assist in addressing the training needs of a wide range of staff members involved in the PBL courses. It is a unique source of consolidated information that is particularly relevant where large numbers of off-campus students are involved.

Influence of Redesigning a Learning Environment on Student Perceptions and Learning Strategies

In society, there is a growing need for graduates who possess competencies consistent with deep learning. This means that, amongst other competencies, graduates should be capable of dealing with the complexity of the tasks in which they will engage in professional situations. We tried to increase the depth of students’ learning by changing the format of a so-called assignment-based learning to a problem-based learning course. The goals of this research were to determine if students, firstly, perceived the redesigned course as being more challenging and, secondly, adjusted their learning strategies towards deeper learning. Participants were two groups of second-year International Business Studies students attending the International Business Strategy course in consecutive years. Students’ perceptions of the learning environment and their learning strategies were measured in both the original (n = 406 students) and the redesigned course (n = 312 students) using the Ramsden Course Experiences Questionnaire and the Biggs Study Processes Questionnaire. In contrast to our expectations, the results indicated that the students from the redesigned course showed a higher degree of surface learning and a lower level of deep learning than the students from the assignment-based learning course. Additionally, the students perceived the new learning environment to be less positive in terms of the clarity of its goals, the usefulness of the textbook and the workload. Improvement in terms of students’ perceptions of the learning environment and their learning strategies could be expected to be fostered by the implementation of a more advanced staff development program, focusing the curricular assessment system on problem-solving skills, supporting the students in the development of the skills necessary to cope with the demands of the redesigned course, and giving them more opportunities to experience this instructional approach.

Comparison of the Academic Achievement by Self-Directed Learning Readiness Levels in a Hybrid Problem Based Learning Course

Comparison of the Academic Achievement by Self-Directed Learning Readiness Levels in a Hybrid Problem Based Learning Course

Theory and Practice Behind the Course Designing Enterprisewide IT Systems

As a consequence of the co-evolution of business and information technology (IT), the responsibilities of software engineers are expanding. They are becoming much more involved in business-related issues. When defining computing curriculums, this trend needs to be taken into consideration, for example, by proposing courses on business and IT integration. This paper presents a transdisciplinary, problem-based learning course that addresses business and IT. The target audience is computer science and software engineering students. The course has three modules: a competitive game to illustrate business thinking, role-playing to practice IT requirement analysis, and an IT integration project to present how modern off-the-shelf technologies contribute to IT system realization. Each module has several sections comprising experiential learning and traditional ex cathedra lectures. The originality of the course lies in the combination of breadth of the subject and depth on what is taught. The goals of the course and its detailed contents are presented: the emphasis is on the process-related/technical and emotional learning experience by the students and on the author's experiences gained from teaching that course.

New path for teaching anatomy: Living anatomy and medical imaging vs. dissection

New path for teaching anatomy: Living anatomy and medical imaging vs. dissection

Effects of problem-based learning on clinical reasoning in occupational therapy.

Problem-based learning (PBL) has been described as an educational method that enhances clinical reasoning skills. The purpose of this study was to determine the effects of an intensive, problem-based course on the development of clinical reasoning skills of undergraduate occupational therapy students. A quasi-experimental pretest-posttest design was used with a convenience sample of 48 undergraduate seniors. All students participated in an intensive 5-week, 30-hour, PBL course scheduled just prior to Level II fieldwork. The Self-Assessment of Clinical Reflection and Reasoning (SACRR) developed by Royeen, Mu, Barrett, and Luebben (2001) was administered on the first and last days of the course. The Wilcoxon Signed Ranks Test revealed statistically significant differences in pre- and posttest scores for 11 of 26 items on the SACRR. In addition, the overall total score increased from 96.88 to 102.55 (p < .01). The results suggest that a short, but intensive PBL course in the senior year of an occupational therapy curriculum can significantly facilitate the development of students' clinical reasoning skills.

Exploring the context of drug use: a problem-based learning course in pharmacoepidemiology for undergraduate science students.

The teaching of pharmacoepidemiology has been largely confined to health care professionals and graduate students. This paper reports an attempt to use problem-based learning (PBL) to teach the elements of that discipline to undergraduate science students. Carefully sequenced problems led students to consider the following issues: the terms used in epidemiology, merits and demerits of different epidemiological study designs, pharmacovigilance, the nature of evidence in law and science, economic evaluation of drugs and the use of drugs in different cultures. The 12-week course was taken by students in their final term prior to graduation. Multiple evaluation procedures were used: specific forms for assessing tutorial participation, individual explorations assessed usually by written essays and problem-solving exercises. The course has received high ratings from the students. The observations over a 10-year period suggest that PBL is a feasible approach to teach the social dimensions of drug use.

An interprofessional problem-based learning course on rehabilitation issues in HIV

This study examined students' perceptions of their learning through participation in an interprofessional problem-based course on rehabilitation and HIV. Students representing five health professions participated in an eight-week tutorial course. Qualitative analysis of journals that the students completed throughout the course, and of interviews of the students at completion of the course, revealed that they valued their learning experience. Students gained an appreciation of the roles of others and developed a sense of confidence through justifying their professional role. Through the interprofessional discussions, students were able to increase the breadth and depth of their learning and also gained a rehabilitation perspective. Learning related to HIV and rehabilitation is ideally suited to an interprofessional, problem-based environment.

Promoting the integration of theory and practice by the use of a learning contract

This qualitative study presents occupational therapy BSc students' perceptions of the value of learning contracts to promote the integration of theory and practice within a problem-based learning course. Focus groups, consisting of first- and third-year students, were used to generate data. Content analysis was carried out to establish common themes. The main findings indicated that students use learning contracts within the academic field to structure their learning, identify knowledge and remain client-centred. Within the fieldwork setting, learning contracts were influenced by supervisory styles and the ability of the students to negotiate their learning needs. The key factor that promoted integration was negotiation, enhanced greatly when students were given the lead role as negotiator. Learning contracts were perceived as being of value in integrating theory and practice. Placements using group or long-arm (off-site) supervision were seen as making the best use of learning contracts. Recommendations centre on the need for the continuing education of students, staff and clinicians on the process and benefits of using learning contracts to enhance development.

Student Use and Perceptions of Different Learning Aids in a Problem‐Based Learning (PBL) Dentistry Course

First-year dental students in a new problem-based learning (PBL) course, the Bachelor of Dentistry (BDent) Program at the University of Sydney, Australia, completed the Study Process Questionnaire and two other questionnaires in this study. The study aimed to identify student perceptions of a written formative assessment and the helpfulness of various learning aids used to prepare for this assessment and preparing to be a dental clinician. Correlations between approach to learning and perceptions of assessment and learning aids showed theoretically expected associations. Surface learning was associated with students' concerns regarding whether assessment items reflected curriculum content, a valuing of lectures as a learning aid, and low scores for theme sessions. Deep learning was associated with a perception that the assessment tested application of basic and clinical sciences and a valuing of both independent study groups and learning topics as learning aids. An achievement orientation to learning was associated with a valuing of formative assessment as a learning aid and an intention to modify study habits as a result of participating in formative assessment. The findings provide insight into student learning in a PBL context that will help teachers and curriculum developers better understand the value of teaching aids provided in the program and the impact assessment has on study styles.

Vygotsky's Zone of Proximal Development and Problem-based Learning: Linking a theoretical concept with practice through action research

This paper describes how an influential theory of cognitive development informed teaching on a problem-based learning (PBL) course in Zoology. Vygotsky's zone of proximal development (ZPD) was introduced to the course tutors as a set of 'common sense' ideas with the potential to enhance professional practice and improve teaching in PBL. Through collaborative action-research, a reflexive critique of experiences was systematically documented over 3 years and the present account focuses on three areas of practice influenced by the ZPD. These were a new emphasis on diagnostic teaching and learning, creating and maintaining instructional environments centred on authentic activities and supporting students as peer-teachers to help develop student autonomy in the context of collaborative learning.

An interprofessional problem-based learning course on rehabilitation issues in HIV

This study examined students' perceptions of their learning through participation in an interprofessional problem-based course on rehabilitation and HIV. Students representing five health professions participated in an eight-week tutorial course. Qualitative analysis of journals that the students completed throughout the course, and of interviews of the students at completion of the course, revealed that they valued their learning experience. Students gained an appreciation of the roles of others and developed a sense of confidence through justifying their professional role. Through the interprofessional discussions, students were able to increase the breadth and depth of their learning and also gained a rehabilitation perspective. Learning related to HIV and rehabilitation is ideally suited to an interprofessional, problem-based environment.

Effects of problem-based learning curricula on faculty learning: new lenses, new questions.

Literature on the impact of problem-based learning (PBL) in medical education has short-changed important questions about the effect of PBL curricula on faculty learning and on faculty knowledge of their subject matter. This paper opens up new questions about the impact of PBL in medical colleges and other health sciences by focusing attention on its effects on faculty learning, on collegial networks in medical colleges, and, consequently, on other scholarly work by faculty. A brief review of research on the effects of PBL on faculty and faculty development is followed by a synthesis of relevant research findings from research on teaching and faculty learning in other disciplines. A new conceptual framework, drawn from the educational paradigms, methods and empirical findings from those other areas of higher education research and research on secondary school teaching, is applied to designing, examining, and evaluating problem-based learning. Viewing faculty as learners prompts a new research agenda including questions such as: What do faculty members learn by participating in integrative, interdisciplinary problem-based learning courses? How? How is that learning related to or integrated with other aspects of their scholarly work?

Faculty Development Program in Dokuz Eylül School of Medicine: In the process of curriculum change from traditional to PBL

Introduction: In Dokuz Eylül School of Medicine (DESM) a faculty development program is being carried out by the “Trainers’ Training Committee?. DESM made a fundamental change in its curriculum from traditional to Problem-based Learning (PBL) in 1997. This was the first implementation of a PBL curriculum in Turkey. Faculty development activities were initiated in the same year. This paper describes the faculty development activities with a special emphasis on PBL courses.Program description: Between 1997-2000 27 four-day long PBL courses were held for 343 participants. The curriculum consisted of PBL philosophy, PBL steps, role of the tutor and students in PBL process, effective case design, assessment principles and group dynamics. PBL simulations enabled the participants to play the roles of both tutors and students.Process evaluation: At the end of the program most of the participants stated that length of the program, content, training methods and the course organization was appropriate. The majority of the participants (89.5%) found the program very useful. PBL steps, PBL practices and PBL philosophy were found as the most useful sessions.Discussion: These courses gave medical staff the opportunity to develop their understanding of PBL methodology and theory. PBL courses and continuous educational activities such as weekly tutor meetings are being held and new courses on advanced tutoring skills are being planned for the near future in DESM.

A Problem-Based Learning Approach to Facilitate Evidence-Based Practice in Entry-Level Health Professional Education

This article will provide an overview of the problem-based learning process, and an illustration of how problem-based learning can facilitate development of critical appraisal necessary for evidence-based practice. It will trace the development of problem-based learning as an educational methodology for entry-level health professional education. The information seeking and appraisal themes common to both problem-based learning and evidence-based practice will be examined, along with the roles and responsibilities of faculty and tutors who are part of problem-based learning courses or curricula. Examples of strategies for student assessment will be discussed, for both mastery of didactic content and for contribution to the interactive processes that are part of problem-based learning courses and curricula. A “case” will be presented to illustrate application of problem-based learning principles as a means of facilitating skills necessary for effective evidence-based practice.

What is a good tutorial from the student's point of view? Evaluation of tutorials in a newly established PBL block course "Basics of Drug Therapy".

Problem-based learning (PBL) within a tutorial is the core element in a 6-week block course "Basics in Drug Therapy" recently introduced into the medical curriculum of an eastern German university. Under the supervision of one tutor a group of 6-9 students solved a total of six clinical cases related to drugs used in general anaesthetics; to analgetic/antiphlogistic, antihypertensive, cardiovascular and lipid-lowering drugs; to drugs acting on the central nervous system; and to intoxicating agents. By answering questionnaires students and tutors extensively evaluated each individual case as well as the whole block course. Factors evaluated also included students' and tutors' behaviour during sessions. The purpose of the analysis was to identify factors associated with the students' perception of tutorials with the aim of improving future courses. The ratings which tutorials, cases and tutor performance received by the students differed significantly between 14 groups that could be analysed. A ranking order of groups was established according to the scores they gave for the cases and the three groups with top ratings were further compared with the three groups with lowest ratings. We found significant differences between the two groups in their assessment of tutor performance and perception of team-work during tutorials. The tutors of the groups giving top ratings were considered to have more effectively supported the students' work during tutorials. Furthermore, self-assessment of the tutors judging their own ability to facilitate PBL correlated with their familiarity with case content. The marks achieved in the first national exam (i.e. "Physikum", equivalent to medical school entrance exams), performance in triple jump examination and multiple choice test at the end of the course, or marks obtained in the first state board exam after the course, did not differ between the two groups. From students' point of view, the main characteristics for a good tutorial as far as tutors are concerned consist of allowing enough time for discussion, accepting students as partners, refraining from interference and having expertise. As a consequence we will increase our efforts to optimise case quality as well as support and training of tutors in order to improve our new PBL course.

The TRIPSE: A process‐oriented evaluation for problem‐based learning courses in basic sciences

AbstractA process‐oriented problem solving exercise is discussed that attempts to mimic the scientific process. This would be particularly useful for problem‐based courses in the basic biomedical sciences.