Problem-based Learning Program Research Articles

Problem-Based Learning, Part 3: Making Sense of and Managing Disjunction

This is the third of three papers which explores the growing influence of problem-based learning (PBL) within professional curricula. Part 1 documented the emergence of PBL in a climate of world-wide change. Part 2 presented the model of Dimensions of Learner Experience and argued that it offers a framework for broadening current understandings of learner experience on diverse PBL programmes. Part 3 discusses the findings of the study, which extend earlier work around the concept of disjunction in learning, and the notion of enabling and disabling forms in relation to three different understandings of learner stance. Disjunction is a concept seen by many as a starting point for learning and, in this study, particular issues appeared to arise from PBL, often in the form of paradoxes, which prompted different forms of disjunction. The study concludes by suggesting that the concept of learner stances offers a framework that challenges current understandings of learner experience on programmes that adopt PBL. It argues that PBL may prompt new forms of transition in relation to students' past, present and future constructions of learning and of themselves as learners.

Problem-Based Learning, Part 1: An Innovation Whose Time Has Come?

This is the first of three papers which explores the growing influence of problem-based learning (PBL) within professional curricula. A qualitative study was undertaken to examine the expectations and experiences of staff and students in different professional and educational environments who were involved in using PBL (Savin-Baden, 1996). What emerged from this work was a new model -Dimensions of Learner Experience – for understanding the nature of learner experience on PBL programmes, characterised by significant diversity between espoused aims and values, and what happened in practice and in relationships between staff and students. Part 1 documents the emergence of PBL in the climate of worldwide change in order to contextualise the growing influence of PBL within professional curricula.

Problem-based learning: measurable outcomes.

Problem-based learning (PBL) could potentially contribute to four key objectives in the education of doctors. (1) Motivating learning. Three studies show that students studying PBL problems choose fewer topics to study than those identified by the faculty, but one study of a critical care rotation showed that students were motivated to learn over a wider range of basic science topics than had been included in the basic science curriculum. (2) Developing clinical reasoning. One study compared methods of solving problems in PBL and conventional track curricula and suggested that PBL students work backwards from clinical information to theory, while conventional curriculum students tend to reason forward from theory. One study showed that computer searches provide knowledge for helping solve some PBL problems, and another study showed that specific knowledge in emergency medicine correlated with test scores. (3) Structuring knowledge in clinical contexts. A few studies show that PBL students perform less well on basic science examinations but better on clinical examinations. Educational outcomes, however, have been assessed quantitatively mainly by the U.S. National Boards of Medical Examiners Examinations or by clinical examinations with small samples. Only one study includes a power computation to assess type II error. There are no studies that examine how much variance occurs between PBL programmes in their curricular methods and outcomes. (4) Developing self learning skills. PBL students use a much wider range and number of resources than conventional track students. There is only one study comparing the knowledge of doctors trained by PBL and conventional curricula after the doctors have been in practice for a substantial number of years, and no studies of patient outcomes. Patient outcomes need to be assessed with randomized controlled trials, and sample sizes should be determined by power computations to avoid Type II error. Four possible methods of improving PBL would be to derive national and internationally accepted PBL curricula; to organize internationally accepted and psychometrically validated methods of evaluation; to develop attitudes among students and tutors to facilitate co-operative PBL teamwork; and to teach group process diagnostic skills.

A practical guide to implementing problem-based learning in anesthesia

In recent years, there has been a tremedous increase in the use of the problem-based learning (PBL) format in anesthesia education. This article describes the philosophy of PBL and its use in anesthesiology, and provides a foundation for the implementation of a PBL program. The advantages and disadvantages of PBL are discussed and pertinent educational literature cited. The importance of faculty development in organizing a successful PBL program is emphasized. Moderating and facilitating skills in discussion leadership are highlighted. The responsibilities of learners in a PBL format are discussed. After studying this article, readers should understand the goals of PBL and be able to utilize the PBL format in an anesthesia education endeavor.

Problem‐based learning at the University of Southern California School of Dentistry

Responding to the recent Institute of Medicine report on dental education, the Center for Craniofacial Molecular Biology (CCMB) of the University of Southern California School of Dentistry has developed a parallel track program in dental education leading to the D.D.S. degree. This program was proposed in May of 1995, and the first class of twelve students was admitted in September of that year. Currently two classes are enrolled and plans to admit a further twelve students (Class of 2001) are in place. The educational strategy for this program is totally problem-based. Students work in groups of six with a faculty facilitator, not necessarily a content expert. Facilitators are largely drawn from the multidisciplinary pool of research faculty at the center. All learning is mediated through biomedical and biodental problem cases. No formal lectures or classes are scheduled. The learning of clinical dental skills is promoted through focussed dental patient simulations in which students review clinical charts, radiographs, medical reports and then explore identified, hands-on learning needs using patient simulators in a clinical context. Early patient exposure is obtained through dental office visits and other special patient clinics. Initial experience with this program suggests that the problem-based learning (PBL) students learn as well (if not better) than their traditional program peers and develop excellent group and cognitive analytical skills. The absence of a pool of dentally related biomedical cases suitable for a PBL program has necessitated the use of innovative approaches to their development and presentation. It is believed that this educational approach will produce dental clinicians equipped with the self-motivated, life-long learning skills required in the ever-changing world of bio-dental sciences in the twenty-first century.

Developing Integrated Education Programmes for Occupational Therapy: The Problem of Subject Streams in a Problem-Based Course

Much has been written in the past 15 years by medical educators on problem-based learning (PBL) in medical schools. The other health professions, such as occupational therapy, social work and nursing, have been slow in taking up the challenge and developing PBL programmes to suit their professional needs. The purpose of this article is to summarise previous developments and offer a schema for the preparation of curricula in occupational therapy. No schema for PBL has previously been published, so it is proposed that this attempt will be able to be adapted to a wide range of courses using the acknowledged educational concepts implicit in integrated, problem-based programmes.

Developing and evaluating the student assessment system in the preclinical problem-based curriculum at Sherbrooke

Students' learning was used as an outcome measure in the first phases of the major curriculum reform started in 1987 by the Université de Sherbrooke Faculty of Medicine, which shifted from a traditional to a student-centered, problem-based learning (PBL) and community-oriented program. The system for evaluating preclinical students' learning is intended to reinforce the integration of basic and clinical sciences. To discover whether the evaluation system was fulfilling its intended goals, the authors used data from the classes of 1991-1993 to assess the reliability and validity of three evaluation instruments. The three instruments were (1) written examinations composed of multiple-choice questions (MCQs), short-answer questions (SAQs), and problem-analysis questions (PAQs); (2) PBL tutor rating forms that evaluate students' reasoning skills, communication and group-interaction skills, and autonomy and humanism; and (3) clinical skills evaluations, including objective structured clinical examinations (OSCEs). The weights allocated to the instruments reflected how the faculty valued each evaluation dimension in each of the three phases of the preclinical curriculum. Reliability indexes improved throughout the system implementation. The written examinations proved to have content validity according to the PBL learning objectives. As evaluated by students, the PAQs were found to be at a taxonomic level that assessed ability to analyze information a third of the time in the first year of implementation of the PBL curriculum and 17% in the second year. Variations and correlations of students' mean performances across instructional units and between the evaluation instruments led to the development of a student longitudinal performance profile to be used before yearly promotion decisions are proposed. The profile was introduced in the fifth year of PBL implementation. The system allows students to learn higher-taxonomic-level content and fulfills the institution's social responsibility of judging program outcomes and promoting qualified students, although evaluation by PBL tutors is still psychometrically questionable and the measurement of students' reasoning and ability to analyze problems is still an unfinished evaluation task.

Attitudes and opinions of faculty tutors about problem-based learning

There has been little systematic attention to the opinions of faculty in evaluating problem-based learning (PBL). The purpose of this report is to describe the attitudes and opinions of tutors in PBL programs about the relative merits of PBL and traditional medical education, and to examine the influences of selected variables on these attitudes. Questionnaires containing both Likert-type and open-ended questions were sent to 1,287 faculty members who had served as PBL tutors at 22 U.S. and Canadian medical schools during the 1992-93 academic year. All schools with identifiable PBL programs (broadly defined) were included in the survey. The overall response rate was 69% (882 of 1,287). As a group, the respondents were experienced in both PBL and traditional curricula, with an average of 3.75 years of experience in the former and 11.41 years of experience in the latter. Regarding both their overall attitudes and their opinions about seven of nine specific areas, the respondents evaluated PBL more positively than traditional methods. This was especially evident in the ratings of student interest and enthusiasm, faculty interest and enthusiasm, the respondents' personal satisfaction, student reasoning, and preparation for clinical rotations. The two methods were judged to be approximately equally efficient for learning. Traditional methods were judged to be superior for teaching factual knowledge of basic sciences. PBL was particularly popular with faculty in PBL-track programs, with faculty in both the newest and the oldest PBL programs, and with faculty in either primary care or "nontraditional" specialties. The findings confirm and extend the picture of PBL strengths and weaknesses that can be derived from prior anecdotal program descriptions and small sample studies. Experienced faculty seem to prefer PBL in most respects, although they have some serious reservations. The present findings also agree with prior outcome studies of PBL, suggesting that the most strongly held faculty opinions may have a factual basis.

Development of self‐directed learning behaviors in a partially teacher‐directed problem‐based learning curriculum

Data from three sources (self‐reports of students, review of accreditation and program evaluation documents, and library circulation statistics) supported the hypothesis that students in a problem‐based learning (PBL) curriculum with significant teacher‐centered components nevertheless acquire behaviors reflecting self‐directed learning skills. These PBL students exhibited differences in the extent to which their learning was self‐directed when compared to lecture‐based students. The learning process and features of this partially teacher‐directed, PBL program that fostered the development of self‐directed learning are discussed. Development of these skills depended on the curriculum's adherence to the use of student‐generated learning issues as a guide for defining content to be learned, but also on several other factors.