Problem-based Learning Graduates Research Articles

Follow-up assessment of problem-based learning in dental alveolar surgery education: a pilot trial

Limited information exists on the effects of an oral and maxillofacial surgery integrated problem-based learning (PBL) course for dental undergraduates and the performance of these students after graduation. Therefore, we designed a PBL-implemented course with integrated dental alveolar surgery to evaluate its effects on the preparedness of graduates for clinical practice, their lifelong learning habits and their ability to collaborate, compared with the results of traditional courses. A randomised controlled trial was performed with 90 undergraduate students. The undergraduates were asked to perform a theoretical examination and to complete a clinical case analysis at the end of the course. Three years later, a follow-up survey was administered via a telephone interview and a questionnaire that measured self-perceived and supervisor-rated preparedness for clinical practice related to professional knowledge of dental alveolar surgery, lifelong learning habits, attitude and collaboration ability. All results were analysed using one-way analysis of variance (ANOVA) and a t-test. At the 3-year post-graduation time point, both PBL graduates and their supervisors rated their preparation for clinical practice as higher than those who received traditional lecture-based courses. In addition, the respondents in the PBL group believed that they were more likely than their counterparts in the traditional group to consult with professionals and other health-care staff members. No significant between-group differences were observed in the graduates' habits or lifelong learning attitudes. The PBL mode of teaching integrated dental alveolar surgery may improve preparedness for clinical practice and help undergraduates to develop the desire to collaborate.

Graduates’ Perceived Preparedness for Dental Practice from PBL and Traditional Curricula

The objective of this study was to compare dental graduates' perceived preparedness for practice after being educated in a problem-based learning (PBL) curriculum with those who graduated from a traditional undergraduate curriculum, both at the University of Hong Kong. A cohort of graduates from the traditional dental curriculum (1997-2001) and a cohort of graduates from the PBL curriculum (2004-08) rated their self-perceived preparedness for dental practice in fifty-nine aspects of dentistry across nine domains. Perceived preparedness for dental practice was compared at domain and item levels (accounting for multiple comparisons) using chi-square statistics. Both cohorts felt well prepared for the "bread and butter" aspects of dentistry, but less so for specific specialty disciplines. There was no significant difference between PBL and traditional graduates' self-perceived preparedness in eight of the nine domains of dental practice (P>0.05). However, in the area of orthodontics, both cohorts felt ill-prepared for practice and more so among the PBL cohort (P<0.01). For the most part, regardless of curriculum design, these dental graduates perceived themselves to be well prepared for dental practice.

The influence of an undergraduate problem/context based learning program on evolving professional nursing graduate practice

Graduates' perception of the value of their undergraduate program is a critical component of professional program evaluation and contributes a viewpoint rarely reported in the literature. It has been proposed that Problem Based Learning (PBL) enhances knowledge acquisition, clinical competency and professionalism as a consequence of students assuming the role of registered nurse as they work through real practice situations on a daily basis in the classroom. The purpose of this study was to determine how PBL graduates describe the contribution of the educational experience to their professional practice as nurses. Using focused ethnography, PBL graduates (N=45) participated in the study as individuals or through focus group discussions. Graduates described themselves as: self aware and self directed critical thinkers, patient advocates able to engage in evidence based holistic practice and interdisciplinary team members able to take on leadership roles and handle conflict.

Supervisor and Self-Ratings of Graduates From a Medical School With a Problem-Based Learning and Standard Curriculum Track

Background: Medical schools recognize the importance of following up on graduates to evaluate performance during residency. Such performance is of particular interest for schools with problem-based learning (PBL) and conventional curriculum tracks. Purposes: Our purposes were to determine any differences in ratings of resident performance in 3 competency areas compared across two different curriculum tracks, 1st and 3rd postgraduate years, and self versus supervisor. Methods: Performance ratings by residents and their supervisors for the 9 years during which 2 curriculum tracks were operative were analyzed using t tests. Effect sizes for statistically significant results were calculated. Results: Several comparisons found differences, although effect sizes were almost uniformly small. The exception was the rating of self-directed learning habits, in which graduates from the problem-based track rated themselves higher than graduates from the standard curriculum (both Years 1 and 3) and higher than their supervisors in Year 3. Conclusions: Ratings by supervisors for both groups and both rating times are above average in the rating scale. Supervisors differentiated between the curricula tracks in postgraduate year 3 (PGY-3), rating Standard Curriculum graduates higher than PBL graduates in 5 of 6 noncognitive items and in two of three general ratings. Supervisor ratings increased between PGY-1 and PGY-3 for Standard Curriculum graduates in 9 of the competencies, whereas there were no changes for PBL graduates. In conclusion, performance differences and effect sizes are minimal, and it is possible to conclude that graduates from the 2 curricular tracks achieve at similar levels during their residency programs.

Predicting doctor performance outcomes of curriculum interventions: problem-based learning and continuing competence

Problem-based learning (PBL) is an educational strategy designed to enhance self-assessment, self-directed learning and lifelong learning. The present study examines a peer review programme to determine whether the impact of PBL on continuing competence can be detected in practice. This study aimed to establish whether McMaster graduates who graduated between 1972 and 1991 were any less likely to be identified as having issues of competence by a systematic peer review programme than graduates of other Ontario medical schools. We identified a total of 1166 doctors who had graduated after 1972 and had completed a mandated peer review programme. Of these, 108 had graduated from McMaster and 857 from other Canadian schools. School of graduation was cross-tabulated against peer rating. A secondary analysis examined predictors of ratings using multiple regression. We found that 4% of McMaster graduates and 5% of other graduates were deemed to demonstrate cause for concern or serious concern, and that 24% of McMaster doctors and 28% of other doctors were rated as excellent. These differences were not significant. Multiple regression indicated that certification by family medicine or a specialty, female gender and younger age were all predictors of practice outcomes, but school of graduation was not. There is no evidence from this study that PBL graduates are better able to maintain competence than graduates of conventional schools. The study highlights potential problems in attempting to link undergraduate educational interventions to doctor performance outcomes.

Prescription writing skills of residents in a family practice residency programme in Bahrain

Purpose of the study:To evaluate the prescription writing skill of final year residents in a family practice residency programme (FPRP) in Bahrain, and to compare skill of residents who have...

Problem‐Based Learning at the Harvard School of Dental Medicine: Self‐Assessment of Performance in Postdoctoral Training

Problem-based learning (PBL) was implemented into the dental curriculum at the Harvard School of Dental Medicine (HSDM) in 1994 with an expectation that this pedagogy would enhance students' critical thinking and communication skills as well as general professional competencies. Previous studies have described several aspects of the outcome of PBL curricula at the predoctoral level. However, there is no information available on the perceptions and performance of PBL graduates during their postdoctoral training in dentistry. The purpose of this study was to evaluate the effect of PBL methodology on the performance of HSDM graduates during their postdoctoral training in comparison with their non-HSDM (traditional) co-residents. Surveys containing traditional knowledge-based criteria, preclinical and clinical criteria, and PBL criteria were sent to HSDM graduates from the classes of 2002 through 2004 who were in postgraduate training programs. The HSDM and traditional graduates were asked to evaluate and compare their performance in selected areas with those of their co-residents from either a PBL curriculum or a traditional curriculum. The directors of each program were also asked to assess HSDM graduates relative to other graduates in the program based on the same aspects. Overall, HSDM graduates rated themselves more highly than non-HSDM graduates on all competencies. No significant difference between HSDM and non-HSDM responses was found in general dental knowledge, specialty specific knowledge, preclinical skills, clinical skills, communication with staff, and patient education, whereas significant differences (p<0.05) were found for communication with patients, critical thinking, independent learning, performance in small group settings, self-assessment, and teamwork. The data obtained from the program directors revealed corresponding results. The HSDM graduates' capacity for independent learning was rated as "excellent" by 65.31 percent of the directors and 80.95 percent of the HSDM graduates themselves. These findings suggest that the performance of HSDM graduates during their postdoctoral training met expectations and were similar to non-HSDM graduates for traditional residency program competencies. However, the PBL training appears to provide HSDM graduates with enhanced abilities in independent learning, communication, and cooperation skills.

Educational supervisors evaluate the preparedness of graduates from a reformed UK curriculum to work as pre-registration house officers (PRHOs): a qualitative study

In 1996 the University of Liverpool introduced an integrated problem-based learning (PBL) medical curriculum incorporating the recommendations of Tomorrow's Doctors. This paper investigates whether the PRHO (pre-registration house officer) educational supervisors who supervise Liverpool graduates believe that the reformed curriculum is producing house officers who have the competencies outlined by the General Medical Council. Forty-one interviews were arranged with a sample of educational supervisors in the Mersey Deanery area to ascertain their views on the competencies of Liverpool PRHOs. The interviews were tape-recorded, transcribed and analysed. The supervisors felt that the PRHOs had been well prepared to work as PRHOs, and compared with traditional graduates they were actually better prepared for the job of PRHO. They saw the PRHOs as competent communicators with improved clinical skills, who had good attitudes, were aware of limitations, were team workers, good at history-taking and examination and had different approaches to finding information. There was a very confusing picture regarding basic knowledge, with some consultants expressing concerns, despite saying they had adequate knowledge to work as PRHOs. It emerged that there was little consensus about the knowledge base of the traditional or PBL graduates or what knowledge level was needed at this stage. Educational supervisors believe that the reformed curriculum in Liverpool is producing competent PRHOs who have been better prepared for the role of PRHO than previous graduates. It could be that uncertainty over knowledge base may be the price paid for reducing the factual burden and improving preparedness for professional practice.

Problem based learning better prepares students for practice

Medical graduates who have followed a problem based learning (PBL) course report that they have a different set of skills when they start working than students who have followed a traditional course (Medical Education 2005;39: 394-401). Katinka Prince and colleagues analysed responses from 1159 graduates from one PBL (239) and four non-PBL (917) medical schools in the Netherlands. (At the time of the study there was only one PBL medical school in the Netherlands.) Graduates answered a questionnaire 18 months after graduating. “We explored graduates' perceptions of how well their training had prepared them for medical practice, particularly in general competencies. We compared the opinions of graduates from PBL and non-PBL schools, because PBL is supposed to enhance general competencies,” Dr Prince explained. The PBL graduates rated their quality of training, and in turn, their preparation for practice, significantly more highly than their non-PBL counterparts. Non-PBL graduates (83%) ranked their own expert medical knowledge significantly more highly than the PBL graduates (72%). Most PBL graduates (83%) considered that they had competent communication skills in contrast to a minority of non-PBL graduates (41%). Dr Prince said, “This study showed that PBL graduates gave higher ratings for the connection between school and work and their preparation for practice. We expected this as PBL is supposed to enhance preparation for practice. We found it interesting that the PBL school appeared to provide better preparation with respect to several of the competencies needed in practice—profession specific skills, communication skills, and teamwork.” The study showed, however, that most graduates (46% PBL and 34% non-PBL) report a lack of training in computer work, planning and organisation skills, and leadership skills at medical school. Most graduates (53% PBL and 58% non-PBL) agreed that although they had attained most of their knowledge during medical school, they had learnt …

General competencies of problem-based learning (PBL) and non-PBL graduates

Junior doctors have reported shortcomings in their general competencies, such as organisational skills and teamwork. We explored graduates' perceptions of how well their training had prepared them for medical practice and in general competencies in particular. We compared the opinions of graduates from problem-based learning (PBL) and non-PBL schools, because PBL is supposed to enhance general competencies. We analysed the responses of 1159 graduates from 1 PBL and 4 non-PBL schools to a questionnaire survey administered 18 months after graduation. Compared with their non-PBL colleagues, the PBL graduates gave higher ratings for the connection between school and work, their medical training and preparation for practice. According to the graduates, the most frequently used competencies with sufficient coverage during medical training were expert knowledge, profession-specific skills and communication skills. The majority of the PBL graduates, but less than half of the non-PBL graduates, indicated that communication skills had been covered sufficiently. All the graduates called for more curriculum attention on working with computers, planning and organisation, and leadership skills. More PBL graduates than non-PBL graduates indicated that they had learned profession-specific methods, communication skills and teamwork in medical school. Overall, the graduates appeared to be satisfied with their knowledge and skills. The results suggest that the PBL school provided better preparation with respect to several of the competencies. However, both PBL and non-PBL graduates identified deficits in their general competencies, such as working with computers and planning and organising work. These competencies should feature more prominently in undergraduate medical education.

Problem‐solving competency of nursing graduates

This paper reports a study describing and evaluating the outcomes of problem-based learning (PBL) programmes in nursing schools in South Africa in terms of the competence of graduates to solve problem in actual clinical settings, and comparing this competence with that of graduates from non-PBL programmes. The nursing literature tends to equate problem-solving with patient-centred problems or the nursing process. However, it is also a skill used in managing the work role, working in a team and managing a health care unit. Problem-solving refers to the process of selectively attending to information in a patient care setting. The investigation of problem-solving in nursing is complicated by the complex relationships between different cognitive processes. A qualitative evaluation study, descriptive and comparative in nature, was carried out. In-depth interviews were held with graduates and their supervisors, asking them to identify problem-solving incidents in which they had been involved. Template analysis style and Benner's interpretive approach were used to analyse the data. The majority of the incidents described by the graduates (84%) were graded at the advanced beginner level or above. The majority of incidents at the novice level came from the non-PBL group. 'Using people skills' and 'being assertive' were the two problem-solving strategies most often used. The PBL group fared better than the non-problem-based group in the level of their problem-solving ability. The findings of this study suggest that further research is warranted into the problem-solving abilities of PBL graduates, their personal development over time and at different stages of practice. In addition, it would be interesting to follow the development of their problem-solving abilities over time.

Problem-based learning

The effects of problem-based learning (PBL) were examined by conducting a meta-analysis-type review of the English-language international literature from 1972 to 1992. Compared with conventional instruction, PBL, as suggested by the findings, is more nurturing and enjoyable; PBL graduates perform as well, and sometimes better, on clinical examinations and faculty evaluations; and they are more likely to enter family medicine. Further, faculty tend to enjoy teaching using PBL. However, PBL students in a few instances scored lower on basic sciences examinations and viewed themselves as less well prepared in the basic sciences than were their conventionally trained counterparts. PBL graduates tended to engage in backward reasoning rather than the forward reasoning experts engage in, and there appeared to be gaps in their cognitive knowledge base that could affect practice outcomes. The costs of PBL may slow its implementation in schools with class sizes larger than 100. While weaknesses in the criteria used to assess the outcomes of PBL and general weaknesses in study design limit the confidence one can give conclusions drawn from the literature, the authors recommend that caution be exercised in making comprehensive, curriculum-wide conversions to PBL until more is learned about (1) the extent to which faculty should direct students throughout medical training, (2) PBL methods that are less costly, (3) cognitive-processing weaknesses shown by PBL students, and (4) the apparent high resource utilization by PBL graduates.