Problem-based Learning Group Research Articles

Application of problem based learning in clinical internship in department of gastroenterology

Objective To evaluate the efficacy of applying problem based learning (PBL) combined with traditional teaching in clinical internship in department of gastroenterology.Methods Totally 60 full-time medical undergraduates of clinical medicine in clinical internship in department of gastroenterology of the Second Hospital of Baoding were randomly divided into PBL group (n=30) and traditional group (n=30).Practical effect of the different modes was evaluated by questionnaire and examination resuits.Data were analyzed by SPSS 15.0.Enumeration data were compared between groups using x2 test and measurement data were manifested (x-) ± s with P ＜ 0.05 signifying significant difference.Results PBL group was superior to traditional group in comprehensive analysis capabilities,motivation to learn and learning outcomes with statistically significant differences between the two groups (P values were 0.001,0.007 and 0.005).Concerning stimulating students' interest and satisfaction of the teaching mode,the difference between the two groups was not statistically significant (P ＞ 0.05).PBL group was superior to traditional group in the pre-class preparation,full and accurate expression of views in classroom and clinical logic,with statistically significant differences between the two groups (P values were 0.002,0.000 and 0.002).There was no difference in communicative abilities with patients between the two groups (P=0.118).PBL group had higher scores than traditional group in the quiz,case analysis and overall performance,with statistically significant differences between the two groups (P values were 0.005,0.045 and 0.013).Concerning score of glossary and multiple-choice questions,differences between two group were not statistically significant (P＞0.05).Conclusions PBL combined with traditional teaching method is suitable for internship teaching in the department of gastroenterology for full-time undergraduates of clinical medicine.PBL can improve students' clinical comprehensive analysis capabilities and helps to develop the ability to take the initiative to solve practical problems. Key words: Problem-based learning; Medical education; Clinical internship

A river runs through it: enhancing learning via emotional connectedness. Can problem-based learning facilitate this?

The ability to undertake therapeutic work either directly or indirectly is central to many Clinical Psychology posts. This paper focuses on the acquisition of skills and knowledge gained through experiential learning components of a clinical psychology doctoral training programme following the introduction of Problem-Based Learning (PBL) into its academic curriculum in 2006. At UH, PBL began life for many trainees as a content-focused exercise developed to highlight how one might assess, formulate and intervene with issues presented within a case. Over time the task has increasingly incorporated a process focus, in which the content facilitates PBL groups to reflect on a broad range of concurrent processes, including personal contexts, interactions with others, and the influence of wider systems. This paper explores the overall learning experiences of PBL for trainees within one PBL group and how the exploration of underlying personal and group processes may facilitate a personal and emotional connection with the ‘client’. Further, we consider modes of conveying this information to enable an audience to emotionally connect with the case and the experiences of the group members. We conclude with a consideration of what we may learn for the benefit of future PBL groups within other disciplines.

Can PBL Group Assignment Affect Examination Performance?

Medical student examination performance in an integrated problem-based learning (PBL) curriculum related to group and faculty facilitator (tutor) assignment has not been well studied. The aim of this study is to investigate whether the PBL group and tutor to which a student is assigned affect examination performance. We found that only 3.6% of all groups had non-Gaussian student examination score distributions. Tutorial group average scores varied by less than 10% from the examination mean. Faculty tutor experience in PBL or expertise by either clinical or basic science background did not appear to have a significant effect upon student knowledge based examination performance, as measured within an integrated basic science PBL curriculum.

Midterm peer feedback in problem-based learning groups: the effect on individual contributions and achievement

Even though peer process feedback is an often used tool to enhance the effectiveness of collaborative learning environments like PBL, the conditions under which it is best facilitated still need to be investigated. Therefore, this study investigated the effects of individual versus shared reflection and goal setting on students' individual contributions to the group and their academic achievement. In addition, the influence of prior knowledge on the effectiveness of peer feedback was studied. In this pretest-intervention-posttest study 242 first year students were divided into three conditions: condition1 (individual reflection and goal setting), condition2 (individual and shared reflection and goal setting), and condition3 (control group). Results indicated that the quality of individual contributions to the tutorial group did not improve after receiving the peer feedback, nor did it differ between the three conditions. With regard to academic achievement, only males in conditions1 and 2 showed better academic achievement compared with condition3. However, there was no difference between both ways of reflection and goal setting with regard to achievement, indicating that both ways are equally effective. Nevertheless, it is still too early to conclude that peer feedback combined with reflection and goal setting is not effective in enhancing students' individual contributions. Students only had a limited number of opportunities to improve their contributions. Therefore, future research should investigate whether an increase in number of tutorial group meetings can enhance the effectiveness of peer feedback. In addition, the effect of quality of reflection and goal setting could be taken into consideration in future research.

3C3R Modified PBL Pediatric Teaching of Chinese Medical Students

A Content, Context, Connection and Researching, Reasoning, Reflecting (3C3R) model is a conceptual framework for problem-based learning (PBL) problem design. We introduced the 3C3R-PBL method into a pediatric teaching plan, and evaluated its effectiveness and feasibility. The 3C3R model was applied in a pediatric problem design teaching plan “why the lips turn purple when a baby is crying”. All students were assigned either into a traditional PBL course or into a 9-step 3C3R model PBL course (3C3R-PBL). The performance outcomes of both groups were compared. For the PBL group, the proportion of students scoring ≥4 for content, context, and problem design connection, was 90.8%, 80.3%, and 64.5% respectively, while for tutors, it was 71.4%, 71.4%, and 28.6%; for researching, reasoning, and reflecting, the proportion of students scoring ≥4 was 81.6%, 55.3%, and 40.8%, while for tutors, it was 71.4%, 100%, and 57.1%. The learning difficulty was not considered high with only 31.6% of students and 42.9% of tutors rating the task as difficult. For the 3C3R-PBL group, the proportion of students scoring content, context, and connection, ≥4 was 100%, 98.4%, and 90.5%, while for tutors it was 100%, 100%, 83.3%; for researching, reasoning, and reflecting, the proportion of students scoring ≥4 was 95.2%, 88.9%, and 76.2%, while for tutors it was 100% for all 3 R components. Students and tutors were convinced by the content, case context, research process and reasoning process of both teaching plans, while scores for connection and reflecting were significantly improved when the PBL plan was amended by a 3C3R model (p<0.05) and the case learning difficulty was statistically increased (p<0.05). The 3C3R model, evaluated for the first time in China, was helpful for effective and reliable problem design in a pediatric PBL teaching plan for Chinese students.

Sandra's Dyspnea

Abstract Introduction This case is a problem-based learning (PBL) tutorial intended for use in a first-year medical school human gross anatomy course during anatomical dissections and discussion se...

Effects of problem-based learning vs. traditional lecture on Korean nursing students' critical thinking, problem-solving, and self-directed learning

Problem-based learning (PBL) is a method widely used in nursing education to develop students' critical thinking skills to solve practice problems independently. Although PBL has been used in nursing education in Korea for nearly a decade, few studies have examined its effects on Korean nursing students' learning outcomes, and few Korean studies have examined relationships among these outcomes. The objectives of this study are to examine outcome abilities including critical thinking, problem-solving, and self-directed learning of nursing students receiving PBL vs. traditional lecture, and to examine correlations among these outcome abilities. A quasi-experimental non-equivalent group pretest-posttest design was used. First-year nursing students (N=90) were recruited from two different junior colleges in two cities (GY and GJ) in South Korea. In two selected educational programs, one used traditional lecture methods, while the other used PBL methods. Standardized self-administered questionnaires of critical thinking, problem-solving, and self-directed learning abilities were administered before and at 16weeks (after instruction). Learning outcomes were significantly positively correlated, however outcomes were not statistically different between groups. Students in the PBL group improved across all abilities measured, while student scores in the traditional lecture group decreased in problem-solving and self-directed learning. Critical thinking was positively associated with problem-solving and self-directed learning (r=.71, and r=.50, respectively, p<.001); problem-solving was positively associated with self-directed learning (r=.75, p<.001). Learning outcomes of PBL were not significantly different from traditional lecture in this small underpowered study, despite positive trends. Larger studies are recommended to study effects of PBL on critical student abilities.

Comparing problem based learning with lecture based learning on medicine giving skill to newborn in nursing students

Purpose: Compare the effects of problem-based learning (PBL) method with traditional lecture in the skill of giving medicine to newborns in nursing students. Background: PBL has attained a high educational level, because PBL is now generally believed to be an effective educational method, which can have a profound effect on enhancing students competency in practical and theoretical skills. Methods: In this quasi experimental study, 29 fourth and fifth semester female students who were passing training in the neonatal ward were selected randomly in to PBL (n=14) and LBL group (n=15) and trained regarding the skill of giving medicine to newborns. Data were collected using two checklists for cognitive and psychomotor skills and two question- naires regarding the students’ viewpoints about self-assessment and self-improvement also students' satisfaction. Results: The level of knowledge in the PBL group was significantly higher than that of students in the lecture group ( p &lt;0.001). There was a significant difference between the students’ cognitive and psychomotor skills scores in the lecture based learning group before and after learning ( p =0.000, p =0.001, respectively). However for the PBL group there was only a significant difference between performance before and after learning ( p =0.002). Also, there was a significant difference between cognitive learning scores before learning as well as a significant difference between post learning performance scores in the two groups ( p =0.008). We found a significant difference in the post learning phase between students’ viewpoints ( P &lt;0.001) and a significant difference between students’ satisfaction in the pre- and post-learning phase in the PBL group (0.002). Conclusion: Students in the PBL group gained more knowledge and had higher motivation toward learning compared to students in the lecture group. Therefore it is suggested that with more deep studies, changes of using the method of teaching upon PBL instead of common method, could be re considered.

Team-based learning: A practical guide: Guide Supplement 65.1 – Viewpoint

The practical aspects and potential benefits of team-based learning (TBL) are outlined on the recent guide published by Parmelee et al. (2012). TBL provides a strategy for active student-centred collaborative learning which involves multiple small groups in a single classroom setting, incorporating many of the adult approaches to learning, more frequently seen in problem-based learning (PBL). A single teacher who is a content-expert, who need not have any experience in the group processes to deliver a successful session, instructs the student groups. Unlike PBL and traditional small group learning, TBL provides opportunities to hold each student accountable for their own performance and their individual contributions to the team (Parmelee et al. 2012). A limited search of ‘PubMed’ revealed that TBL is being used and evaluated internationally as an educational strategy, with virtually no published papers on TBL from the UK. This may suggest either little current interest on the use of TBL by UK medical educators or that the UK is currently not contributing a great deal to the literature on TBL. There may be a need to research the effectiveness and outcomes of TBL in a UK context of medical education.

Lecture-based Versus Problem-Based Learning Methods in Public Health Course for Medical Students

Introduction: Problem-based learning (PBL) method has progressed as an alternative to lecture-based learning (LBL) method in recent decades. Benefits of PBL clearly supported by researches however several items remain unclear especially in Iranian medical universities. The aim of this paper is to compare the learning outputs of PBL and LBL methods. Methods: In this cross- sectional study public health course was prepared for three groups of students. Group 1 included medical students (n=101), Group 2 dentistry students (n=54), and Group 3 was formed of pharmacy students (n=112). Scores of final exam as well as 10 similar- root questions as a short-term outcome, scores in national basic science exam, recent similar informal exam as a mid-term output in addition to course evaluation by students, and assessment of attitude about PBL were compared between groups. Data analysis was performed by SPSS-11 using means' comparison. Results: Scores of students in PBL group was significantly higher in final exam (P<0.001). The percentage of correct responses to 10 same- root questions in PBL (M= 6.68) were significantly higher (M=6.54). Faculty members were evaluated better in PBL group (P<0.001) in all aspects of teaching. Totally, the students who evaluated teachers in PBL group had 2 points more than LBL group (P<0.001). Scores of students in national exam (after two years) and the recent survey (in the third year) were higher in PBL group (P<0.001). Conclusion: Results of using PBL method indicated the higher rate of scores and better recalling of learned materials in this method.

Perceptions regarding the quality of group interactions during brainstorming session of problem-based learning (PBL) at Melaka Manipal Medical College (Manipal Campus), India

Objective : In PBL, interaction in tutorial group plays a role in stimulating student learning. However, quality of group interactions need not be always in a desired level which will later affect group success. Hence the aim of this study was to ascertain the quality of group interactions during PBL sessions. Method : In this prospective, observational study, to obtain the perceptions of students and faculty (n = 32), a preformed questionnaire was used. Students from I st (n = 129) and 2 nd year (n = 106) of Bachelors of Medicine and Bachelors of Surgery (MBBS) program and faculty were asked to respond in the questionnaire during a PBL brain-storming session. To explore reasons for adequate and inadequate interactions, focus group (n = 10) discussions were conducted. Results : There was no difference in perceptions regarding interactions between 1 st year and 2 nd year students. But there was significant difference between students and faculty perceptions regarding posing critical questions (p = 0.002), counter argument (p = 0.001) and handling conflicts. Factors that drove interactions were the prior knowledge, assessment and motivation and the hindering factor was case scenarios which were not designed based on students’ prior knowledge. Conclusion : Faculty expectations regarding PBL group interaction is different from the students’ understanding of PBL interaction. This study helps us to bridge the gap between the faculty expectations and students’ performance by orienting them regarding an ideal PBL interaction.

The effect of problem-based learning in patient education after an event of CORONARY heart disease--a randomised study in PRIMARY health care: design and methodology of the COR-PRIM study.

BackgroundEven though there is convincing evidence that self-care, such as regular exercise and/or stopping smoking, alters the outcomes after an event of coronary heart disease (CHD), risk factors remain. Outcomes can improve if core components of secondary prevention programmes are structurally and pedagogically applied using adult learning principles e.g. problem-based learning (PBL). Until now, most education programs for patients with CHD have not been based on such principles. The basic aim is to discover whether PBL provided in primary health care (PHC) has long-term effects on empowerment and self-care after an event of CHD.Methods/DesignA randomised controlled study is planned for patients with CHD. The primary outcome is empowerment to reach self-care goals. Data collection will be performed at baseline at hospital and after one, three and five years in PHC using quantitative and qualitative methodologies involving questionnaires, medical assessments, interviews, diaries and observations. Randomisation of 165 patients will take place when they are stable in their cardiac condition and have optimised cardiac medication that has not substantially changed during the last month. All patients will receive conventional care from their general practitioner and other care providers. The intervention consists of a patient education program in PHC by trained district nurses (tutors) who will apply PBL to groups of 6–9 patients meeting on 13 occasions for two hours over one year. Patients in the control group will not attend a PBL group but will receive home-sent patient information on 11 occasions during the year.DiscussionWe expect that the 1-year PBL-patient education will improve patients’ beliefs, self-efficacy and empowerment to achieve self-care goals significantly more than one year of standardised home-sent patient information. The assumption is that PBL will reduce cardiovascular events in the long-term and will also be cost-effective compared to controls. Further, the knowledge obtained from this study may contribute to improving patients’ ability to handle self-care, and furthermore, may reduce the number of patients having subsequent CHD events in Sweden.Trial registrationNCT01462799

Comparison of three problem-based learning conditions (real patients, digital and paper) with lecture-based learning in a dermatology course: A prospective randomized study from China

Background: The precise effect and the quality of different cases used in dermatology problem-based learning (PBL) curricula are yet unclear.Aim: To prospectively compare the impact of real patients, digital, paper PBL (PPBL) and traditional lecture-based learning (LBL) on academic results and student perceptions.Methods: A total of 120 students were randomly allocated into either real-patients PBL (RPBL) group studied via real-patient cases, digital PBL (DPBL) group studied via digital-form cases, PPBL group studied via paper-form cases, or conventional group who received didactic lectures. Academic results were assessed through review of written examination, objective structured clinical examination and student performance scores. A five-point Likert scale questionnaire was used to evaluate student perceptions.Results: Compared to those receiving lectures only, all PBL participants had better results for written examination, clinical examination and overall performance. Students in RPBL group exhibited better overall performance than those in the other two PBL groups. Real-patient cases were more effective in helping develop students’ self-directed learning skills, improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition, compared to digital and paper cases.Conclusion: Both real patient and digital triggers are helpful in improving students’ clinical problem-handling skills. However, real patients provide greater benefits to students.

How experienced tutors facilitate tutorial dynamics in PBL groups

Background: Problem-based learning (PBL) tutorial are conducted in small groups, and successful learning in such groups requires good group facilitating skills. There is a lack of research on actual skills employed by tutors in facilitating the group dynamics.Aim: To explore the process of PBL tutorial small groups, focusing on the tutors’ actual behavior in facilitating group dynamics.Methods: Eight experienced tutors from various departments in medical colleges participated in this research. Forty tutorial group sessions were videotaped. Among the 636 tutorial intervention episodes, 142 of them were associated with facilitating group dynamics. Tutors interventions as well as their recalls were transcribed verbatim. Qualitative research methods were utilized to analyze the data.Results: There were 10 tutorial group dynamic situations and 48 tutorial skills. Analysis of the tutors’ intentions employing these skills in the 10 situations showed that tutors were trying to achieve the following aims: (1) iteration of PBL principles, (2) delegation of responsibility to the students, (3) creation of a good discussion forum, and (4) the generation of a good learning atmosphere.Conclusion: Results from this study provide PBL tutors with a practical frame of reference on group dynamic facilitating skills and stimulate further research on this topic.

Training Australian general practitioners in rural public health: Impact, desirability and adaptability of hybrid problem-based learning

Context and Objective: Australian rural general practitioners (GPs) require public health knowledge. This study explored the suitability of teaching complex public health issues related to Aboriginal health by way of a hybrid problem-based learning (PBL) model within an intensive training retreat for GP registrars, when numerous trainees have no PBL experience. Methods: A mixed method evaluation. Pre-training surveys on PBL experience and post-training semi-structured telephone interviews exploring the impact of the model and its desirability. Thematic and discourse analysis of interview statements, coded independently by two researchers. Results: Seventeen GP trainees and four tutors participated. Six main themes emerged: experience; PBL impact; learning modalities; educational needs; educational expectations; and educational planning. Discussion: No discernable differences were identified between Australian and international graduates, the knowledge impact of the hybrid model or desirability of the problem. While scabies offers a suitable scenario to explore rural public health complexities, a tension regarding the desire for intensive learning and PBL format needs to be addressed to increase trainees’ satisfaction. A reduction in the number of PBL sessions, PBL instruction and highly structured PBL groups will assist. Trainees value mixed modality education, including PBL, so a tailored hybrid PBL is worth consideration.

Educational interventions to improve the effectiveness in clinical competence of general practitioners: problem-based versus critical reading-based learning

BackgroundEvidence suggests that continuing medical education improves the clinical competence of general practitioners and the quality of health care services. Thus, we evaluated the relative impact of two educational strategies, critical reading (CR) and problem based learning (PBL), on the clinical competence of general practitioners in a healthcare system characterized by excessive workload and fragmentation into small primary healthcare centers.MethodsClinical competence was evaluated in general practitioners assigned to three groups based on the educational interventions used: 1) critical reading intervention; 2) problem based learning intervention; and 3) no intervention (control group, which continued clinical practice as normal). The effect on the clinical competence of general practitioners was evaluated in three dimensions: the cognitive dimension, via a self-administered questionnaire; the habitual behavioral dimension, via information from patient’s medical records; and the affective dimension, through interviews with patients. A paired Student´s t-test was used to evaluate the changes in the mean clinical competence scores before and after the intervention, and a 3 x 2 ANOVA was used to analyze groups, times and their interaction.ResultsNine general practitioners participated in the critical reading workshop, nine in the problem-based learning workshop, and ten were assigned to the control group. The participants exhibited no significant differences in clinical competence measures at baseline, or in socio-demographic or job characteristics (p > 0.05). Significant improvements in all three dimensions (cognitive, 45.67 vs 54.89; habitual behavioral, 53.78 vs 82.33; affective, 4.16 vs 4.76) were only observed in the problem-based learning group after the intervention (p > 0.017).ConclusionsWhile no differences in post-intervention scores were observed between groups, we conclude that problem-based learning can be effective, particularly in a small-group context. Indeed, problem-based learning was the only strategy to induce a significant difference between pre– and post- intervention scores for all three CC dimensions.

Simulation-Based Learning Versus Problem-Based Learning in an Acute Care Pharmacotherapy Course

There is a lack of comparative data with simulation-based learning (SBL) and other types of learning. The objective of the study was to determine whether high-fidelity simulation is superior to problem-based learning (PBL) for training pharmacy students in an acute care elective. Twenty-nine pharmacy students enrolled in the Acute Care Pharmacotherapy Simulation course over 2 years voluntarily participated in this randomized, crossover study. Students were randomized to group 1 or 2. The SBL group consisted of students in group 1 who had SBL during study week 1 and group 2 students who had SBL in week 2. The PBL group consisted of students in group 1 who had PBL cases during study week 2 and group 2 students who had PBL cases in week 1. The topics covered were management of dysrhythmias (week 1) and heart failure (week 2). The SBL group significantly improved compared with the PBL on postquiz scores. The SBL group performed at least 15% better in the clinical assessment (P = 0.013). Students in the SBL group performed significantly better in their critical thinking skills for problem list, pharmacotherapy plan, and monitoring plan. Learning was enhanced with the use of SBL compared with PBL.

Comparison of problem-based learning and lecture-based learning in midwifery

Lecturing is the most common teaching method in the medical education. Problem-based learning (PBL) is one of the active and student-oriented learning strategies which have gained attention in the recent decades. To compare the effect of PBL and lecture-based learning (LBL) on the satisfaction and learning progress of undergraduate midwifery students. Quasi-experimental study. Hamadan University of Medical Sciences, Hamedan, Iran. Fifty-six undergraduate midwifery students in two different classes participated in the study. Randomly, one class (experimental group) received PBL in addition to LBL and the other one (control group) received traditional LBL. "Pregnancy and childbirth", a 2-credit course, was selected for this purpose. Scientific pre-test and post-tests were performed and satisfaction questionnaire was filled in for both groups. A questionnaire to compare PBL and LBL was filled in only for the experimental group. The instruments used in the study were "Demographic data form", "Students' learning progress test", "Student's satisfaction of teaching method", and the "Teaching method evaluation". Learning progress in PBL group was significantly more than control group. PBL improved application of theory lesson in clinical practice, increased learning motivation and enhanced educational activity in class. There was more satisfaction with PBL method. There was no relationship between the students' satisfaction and learning progress. 81.8% of students considered PBL the more suitable and better method. PBL should be applied more in undergraduate midwifery courses. According to these advantages, the quality of midwifery education can be improved via this method.

Team-based learning: A practical guide: AMEE Guide No. 65

Team-based learning™ (TBL) is an instructional strategy developed in the business school environment in the early 1990s by Dr Michaelsen who wanted the benefits of small group learning within large classes. In 2001, a US federal granting agency awarded funds for educators in the health sciences to learn about and implement the strategy in their educational programs; TBL was put forward as one such strategy and as a result it is used in over 60 US and international health science professional schools. TBL is very different from problem-based learning (PBL) and other small group approaches in that there is no need for multiple faculty or rooms, students must come prepared to sessions, and individual and small groups of students (teams) are highly accountable for their contributions to team productivity. The instructor must be a content-expert, but need not have any experience or expertise in group process to conduct a successful TBL session. Students do not need any specific instruction in teamwork since they learn how to be collaborative and productive in the process. TBL can replace or complement a lecture-based course or curriculum.

MATTERS OF TASTE: BLENDING MOLECULAR PHYSIOLOGY AND THE HUMANITIES

Taste perception was the focus of an undergraduate course in the health sciences that bridged the sciences and the humanities. A problem‐based learning (PBL) approach was used to deal with the biological issues whereas the cultural transmutations of these molecular mechanisms were explored using a variety of sources (novels, cook‐books, films). Multiple evaluation procedures were used; problem summaries and problem‐solving exercises (TRIPSEs) for the PBL component and group tasks and individual exercises for the cultural issues. Self‐selected groups chose specific tasks from a prescribed list (setting up a journal in molecular gastronomy, developing an electronic tongue, organizing a farmer's market or a culinary tour, framing hedonic scales etc). Individual tasks were selected from a menu of options (book reviews, films reviews, conversations, creative writing). A few guest lecturers (wine making, cultural anthropology) added more flavor. The course was rated highly for its learning value (8.95 ±1.02, n=36) and helped students relate biological mechanisms to cultural issues (8.3 ± 1.38, n=35).