Problem-based Learning Students Research Articles

Problem-Based Learning Outcomes: The Glass Half-Full

To compare the characteristics and outcome data of students from a single institution with a two-track, problem based learning (PBL) and standard (STND) curriculum. PBL and STND students from nine graduating classes at Southern Illinois University School of Medicine were compared using common medical school performance outcomes (USMLE Step 1, USMLE Step 2, clerkship mean ratings, number of clerkship honors and remediation designations, and the senior clinical competency exam), as well as common admission and demographic variables. PBL students were older, and the cohort had a higher proportion of women. The two tracks had similar USMLE Step 1 and 2 mean scores and pass rates. Performance differences were significant for PBL students in two clerkships as well as in the clerkship subcategories of clinical performance, knowledge and clinical reasoning, and noncognitive behaviors. In addition, the proportion of PBL students earning honors was greater. The traditional undergraduate educational outcomes for the PBL and STND students are very positive. In several of the clerkship performance measures, the PBL students performed significantly better, and in no circumstance did they perform worse than the STND students.

Comparison of knowledge scores of medical students in problem-based learning and traditional curriculum on public health topics

BackgroundThe purpose of the study was to compare the knowledge scores of medical students in Problem-based Learning and traditional curriculum on public health topics.MethodsWe planned a cross-sectional study including the fifth and sixth year medical students of Dokuz Eylul University in Turkey. The fifth year students (PBL group, n = 56) were the pioneers educated with PBL curriculum since the 1997–1998 academic year. The sixth year students (traditional education group, n = 78) were the last students educated with traditional education methods. We prepared 25 multiple-choice questions in order to assess knowledge scores of students on selected subjects of Public Health. Our data were collected in year 2002.ResultsMean test scores achieved in PBL and traditional groups were 65.0 and 60.5 respectively. PBL students were significantly more successful in the knowledge test (p = 0.01). The knowledge scores of two topics were statistically higher among PBL students. These topics were health management and chronic diseases.ConclusionWe found that mean total evaluation score in the PBL group was 4.5 points higher than in the traditional group in our study. Focusing only on the knowledge scores of students is the main limitation of our study. Upon the graduation of the first PBL students in the 2002–2003 academic year, we are planning additional studies regarding the other functions of a physician such as skill, behaviour and attitude.

Emotional responses of tutors and students in problem-based learning: lessons for staff development

Problem-based learning (PBL) is a method of teaching and learning that is used increasingly in medical and health care curricula worldwide. The literature on PBL is considerable and continues to develop. One important aspect of PBL is that students and tutors spend a lot of time together and this fosters an informal atmosphere that may encourage intimacy. The existing literature on PBL has not considered the emotional and psychological aspects of PBL nor the concomitant need for staff support and development. We present a discussion paper considering the ways in which educationalists using or considering using PBL could be informed by the psychological and psychotherapeutic literature on groups and group dynamics, in particular the work of Wilfred Bion. We discuss how PBL tutorials may arouse emotional responses that could result in unconsidered behaviours that impede student learning. We argue that faculty and PBL tutors need to agree and remain alert to the primary task of the group. Faculty should develop professional standards for tutors to use as reference points to ensure the group stays on course and achieves its intended outcomes. We conclude that greater attention should be paid by educationalists and faculty to identifying possible tutor emotional responses as part of initial PBL tutor training and ongoing staff development. We offer vignettes that have been successfully used in training and staff development at a UK medical school to demonstrate the practical application of our theoretical discussion.

Integrating applied anatomy in surgical clerkship in a problem-based learning curriculum

Little attention has been given to structured teaching of applied anatomy to senior medical students in problem-based learning (PBL) medical schools. A course named "Anatomical Principles in Surgical Practice" was introduced at the Arabian Gulf University (AGU) in 2001 for fifth- and sixth-year medical students during their surgical clerkship rotation. The course aims to emphasize, update and integrate applied anatomical concepts that are essential for surgical practice. The course consists of 15 interactive sessions held weekly to ensure topics coincide with the surgical problem-solving sessions. A questionnaire was administered to students completing their surgical rotations (n = 131) seeking their perceptions about the new course during the academic years 2001, 2002 and 2003. To measure learning outcome, 70 students were also given pre- and post-tests. Positive responses were given by 85.2% of the students for course arrangement, by 92.0% for course content, by 88.3% for clinical correlation, by 95.2% for level of teaching and by 87.2% for overall judgment. The students' mean scores in the post-test (71.7%+/-11.7) was significantly higher than their mean scores in the pre-test (42.3%+/-12.6, p < 0.001). Students liked the course and reported feeling more confident in correlating anatomy with surgery during their rotations. By extending anatomical teaching into the clerkship phase, a link between basic medical and clinical sciences has been established that further enhances vertical integration within a PBL curriculum in a spiral fashion.

Project Management in Local Nonprofit Organizations: Engaging Students in Problem-Based Learning

This article describes problem-based learning (PBL) at the subsystem level, namely, the application of PBL in a project management course that empowers student teams to solve problems in nonprofit organizations. Faculty members teaching in project-based disciplines can employ the authors’ approach to introduce PBL and document its effectiveness, possibly using this to move their university toward system-wide PBL. Faculty members teaching in other disciplines can adapt portions of the authors’approach to their courses. This article explains the course objectives, the project selection, the deliverables, and how students direct their own learning. The authors describe their assessment process in which expert judges evaluate completed projects and award a prize to the best team project.

A Comparison of Students Who Chose a Traditional or a Problem-Based Learning Curriculum After Failing Year 2 in the Traditional Curriculum: A Unique Case Study at the Nelson R. Mandela School of Medicine

Purpose: To canvas perceptions and experiences of students who had failed Year 2 of a traditional medical program and who chose to remain in the conventional program (n = 6) or had swapped to Curriculum 2001 (C2001), a problem-based learning (PBL) curriculum (n = 14).Methods: A year after their decision regarding curriculum choice, students were canvassed (largely open-ended survey) about this decision and about their perceptions of their curricular experiences.Results: C2001 students were positive about their PBL experiences. Overwhelmingly, their decision to swap streams had been a good one. They identified PBL features as supporting their learning. Repeating traditional curriculum students were, however, more circumspect in their opinions.Conclusions: C2001 students had clearly embraced PBL. They were now medical students, largely because of PBL activities underpinned by a sound educational philosophy. This unique case study has provided additional evidence that PBL students are generally more content with their studies than their conventional curriculum counterparts.

Effects of a problem‐based learning program on engineering students’ academic achievements in a Mexican university1

The aim of this paper is to report on a three‐year follow‐up evaluation of an experimental problem‐based learning (PBL) integrated curriculum directed to second‐year engineering students. The PBL curriculum brought together the contents of physics, mathematics and computer science courses into a single course. Instead of the students having to enroll in each course separately, they had the opportunity to enroll in a single course in which they learned the contents of those subjects by solving real‐life engineering problems. In order to evaluate the effects of the program on the students’ academic achievement, three data sources were taken: pre‐test–post‐test scores on two physics tests: students’ grade point average (GPA); and students’ grades in advanced engineering courses. With respect to the first source of data, results showed that while PBL students’ improvements in scores were significantly higher than control students’ improvements on the Mechanics Baseline Test, improvements were similar in both groups on the Force Concept Inventory. With regard to the second source of data, PBL students’ GPA was significantly higher than control students’ GPA. Finally, when PBL and control students’ performance on advanced courses were compared, PBL students graded higher than control students on the five courses assessed. However, on only two of them (‘Probability and Statistics’ and ‘Oral Communication’) were the differences significant.

Fostering Collaboration Among Students in Problem‐Based Learning

AbstractTo foster positive interaction among students in collaborative groups, professors can establish behavioral norms by the way they form groups and train students to work effectively in goups.

Problem-based Learning in Medical Education:Its Effects on Learning Attitude and Long-term Memory

Problem-based learning (PBL) is an innovative educational approach to enhance student-centered and integrated learning through small group tutorials. In 1998, PBL tutorial was introduced to the medical curriculum of Kinki University. The purpose of this study is to examine the effect of PBL on learning outcome, in comparison with the traditional lecture-based education. Students’ view on PBL was surveyed on a yearly basis. Generally students felt that PBL results in an improvement of self-directed learning skills and has a positive effect on their learning attitude. A more detailed comparative study (PBL versus lecture-based) on the learning outcome of the locomotion system block was also undertaken. The PBL students performed significantly better in the test than the lecture-based students. One year later, the PBL students performed better in the pre-and post-clinical clerkship tests on the Locomotion System. It therefore appears that the knowledge acquired through PBL is better retained after one year, in comparison with the lecture-based students. This preliminary study suggests that PBL promotes long-term memory and has beneficial effects on learning attitude.

Activity and Interaction of Students in an Electronic Learning Environment for Problem-Based Learning

This paper contains the results of an experimental study in which students used a collaborative learning tool in the time between regular meetings of a tutorial group in problem-based learning. The analysis of the learning situation for which this tool was developed, as well as the evaluation of the experiment, is based on a model of collaborative learning that covers three sections. The first is the learning environment that mediates the second section learning behaviour and the third section learning mechanisms . From the perspective of the stimulation of productivity in collaborative learning, the relation between characteristics of the problem task (learning environment) and interactions (learning behavior) was explored. In problem-based learning students formulate learning issues after a brainstorm discussion in the group. Students formulate theoretical and practical learning issues. Two research questions are presented in this study: What types of learning issues generate most interactions? and What types of learning issues generate the highest level of information processing? The first question is concerned with an analysis of the number of interactions and the second with the quality of these interactions. Practical learning issues generated more interactions, as well as a higher level of information processing. These results are discussed in the context of social factors in learning.

Student perceptions of tutor skills in problem-based learning tutorials.

The problem-based learning (PBL) tutor plays a role that is different from the role of a teacher in a conventional teaching format. In the Faculty of Medicine and Health Sciences, United Arab Emirates, all students are Arab nationals and tutors are expatriates with different sociocultural backgrounds from the students. This study was designed to investigate how students evaluate tutors in PBL tutorials and whether student evaluations of tutors change with the progress of students in PBL tutorials. Differences in tutor performance evaluation by male and female students were also analysed. The students evaluated 12 tutor skills in a scale of 1-3, 1 being 'below average' and 3, 'outstanding'. Student responses from a total of 314 (98.1%) completed forms collected over 2 academic years were analysed statistically. A total of 14 tutors participated in the PBL programme. The analysis revealed that tutors as a group were rated as having average to outstanding tutor skills in 10 items of the evaluation form. Students and faculty perceptions were different for the tutor skills of guiding students for information management. The students expected more support from tutors, whereas the tutors tried to emphasize self-learning in the PBL curriculum. Lower scores to the tutors in the 'problem' bringing sociocultural and religious issues for discussion showed that a gap in sociocultural/religious understanding between students and tutors might influence tutor skills. Differences in tutor evaluation by male and female students indicate necessity of adopting different strategies by tutors in a different sociocultural background. The results of the study have direct implications for faculty development.

The role of basic sciences in a problem-based learning clinical curriculum.

Very little is known about the use of problem-based learning (PBL) during the later years of the undergraduate medical course and how it influences further acquisition of basic science knowledge. Similarly to many other Faculties, the PBL approach is used at Manchester in years 1 and 2, but more unusually, the curriculum continues to be centred on PBL in the clinical modules. To explore whether and how basic science learning was continued in year 3 of the PBL clinical curriculum. 10 of the weekly problems from the two core modules in year 3 were analysed to determine: (a) whether the design teams were using basic science objectives in devising the problems, and (b) whether PBL student groups were setting basic science learning objectives. The basic science knowledge of year 3 and 4 students was also measured. Similar numbers of objectives were being set by the management groups for each weekly problem (Heart, lung and blood (HLB) module, median 15, range 11-20; Nutrition, metabolism and excretion (NME) module, median 13, range 9-21). In the basic sciences, there was a median of 3 objectives per problem (range 0-6) in the NME module, but only 1 objective (0-2) per problem in the HLB module. The objectives set by six PBL groups in each module were analysed. Overall, agreement was reached on 130 occasions (62%) between the design team basic science objectives and those set for themselves by the student groups. In addition, there was a median of 2 (range 1-8) new basic science objectives brought out by the PBL groups that were not listed by the HLB module design team. In the NME module, there was again a median of 2 new objectives (range 0-6). The performance of year 3 and year 4 students in the multiple-choice questions progress test was analysed. For the 65 basic science questions, the year 3 mark was 40.8 +/- 12.3% compared with 57.1 +/- 12.3% for year 4 (P < 0.0001). (a) The design teams are setting basic science objectives; (b) the working problems are triggering students to set learning objectives in the basic sciences; (c) most of the objectives being set by the design teams are being triggered in the majority of group sessions; (d) the students knowledge of basic sciences increases in years 3-4.

An initial experiment in haematology instruction using the problem-based learning method in third-year medical training in France.

We present an initial experiment in the teaching of haematology using the problem-based learning technique in the third year of medicine at the Bobigny Faculty of Medicine (Université Paris-Nord). This new approach to the clinical and bioclinical teaching of medicine is used in several hundred medical faculties throughout the world. It is based on students' integrated learning of concepts (scientific, clinical, psycho-social) through patient problems. The method alternates group meetings with a tutor and individual learning. Sixty-eight students with no previous training in haematology and eight tutors (eight groups) took part in this experiment, which lasted five weeks (with no other teaching) and enabled them to study ten patient problems representing the bulk of the objectives pursued in this discipline. The preparation of students and teachers for this experiment is described, as well as its conduct and the results obtained. These show that the problem-based learning students performed better in their clinical problem-solving examinations than did students from a previous year who had been taught using traditional methods for the same period of time. The comparison does not indicate, however, that problem-based learning students had any advantage in the acquisition of factual information. The high degree of satisfaction of the students beginning their third year and of tutors in respect of this experiment constitutes a very favourable point. The limitations of the experiment and the teaching method itself are also discussed.

Comparing achievement on the Medical Council of Canada Qualifying Examination Part I of students in conventional and problem-based learning curricula

To compare the levels of achievement on the Medical Council of Canada (MCC) Qualifying Examination Part I of students in conventional and problem-based learning (PBL) curricula. Students in three classes (1995, 1996, and 1997) took the MCC Qualifying Examination Part I upon completing their MD degrees. This examination tests core knowledge in the major disciplines and clinical reasoning skills. Candidates' scores were masked to protect confidentiality. Total scores, individual discipline scores, and pass/fail proportions were compared among the classes. The PBL classes of 1996 and 1997 performed better on the psychiatry component than did the 1995 conventional class (p = .001); the 1997 class also exceeded the 1995 and 1996 classes in preventive medicine and community health scores (p = .001). No difference emerged in other disciplines, clinical reasoning scores, total multiple-choice question scores, or the proportions of successful candidates. PBL and conventional curriculum graduates performed similarly, except in psychiatry and preventive medicine and community health, where PBL graduates scored higher.

Exploring the Use of Problem-Based Learning for Developing Collaborative Leadership Skills

This paper examines the implementation of two Problem-Based Learning (PBL) seminars at a university administrative credential program for graduate students preparing to become administrators. PBL is an instructional strategy that focuses students on a relevant problem to solve within a collaborative group. It explores in what ways PBL contributes to their development as administrators, ability to work in groups, and to use reflection as a part of their practice. Students worked in small groups to complete a relevant job-related problem. They were expected to apply theory to a real situation, use problem-solving skills, witness the impact of those skills, and reflect on their actions and those of others. Throughout the two seminars, a variety of data were collected including journal notes, videotapes, and process papers. When analyzed, the data provided important insights about the use of PBL for students as an instructional strategy. Analysis of data revealed that students found the content and process relevant to their work as administrators, saw patterns in their own growth, and gained an understanding of the importance of identifying implicit theories. The faculty also learned important lessons from this action research about the use of PBL as a pedagogical strategy. First, students need time to develop and practice both problem-solving as well as group process skills. Second, faculty needed to take an active role in teaching group process and reflective skills. This is important learning given the dynamic context of schools where collaboration with others and group work are essential components of effective organizations. The data indicate that in the HRM Seminar, Group 1 and Group 2 present a stark contrast to how well each group functioned. In Group 1, the lack of attention to group process, member's primary focus on individual achievement, lack of joint leadership, presence of conflict, and perception of not being heard led to low satisfaction with the task and process. Almost the opposite pattern occurred in Group 2. Members reported both high task and process focus and primary attention on group rather than individual achievement. In addition, they reported a sense of being valued and heard, minimal conflict between group members, and a balance between solitary and joint leadership. In addition, group members were more satisfied with the task and process. Group 3 experienced some difficulties and conflict; however, group members felt they accomplished the task well. In the UTE Seminar, the data indicate that Groups A and C functioned well with minimal conflict, and they were satisfied with the product and enjoyed the process. Group B struggled and was not fully satisfied with the product produced by the group and was only marginally satisfied with the group process.

A Comparison of Problem-Based Learning and Standard Curriculum Students: Three Years of Retrospective Data

Background: Many, many studies, including three major reviews, that compare problem-based curricula to more traditional curricula, have been published in the last 10 years. No study, however, has looked specifically at a closed-loop or reiterative problem-based approach. Purpose: A 3-year retrospective study was done to compare the academic performance of students in a reiterative problem-based learning (PBL)curriculum with that of their counterparts in the standard curriculum to ensure that the PBL students were not disadvantaged. Methods: Three graduating classes' performance on a number of outcome measures, including the United States Medical Licensing Examination, clinical clerkship, and clinical practice examination performance, were compared. Results: Analyses indicate that students in the PBL curriculum performed at least as well as, and in some instances better than, their counterparts in the standard curriculum. Conclusion: Students in the PBL curriculum, a student-directed curriculum, were not disadvantaged. Of note is their strong clinical performance.

Cognitive Consequences of Problem-Based Learning for the Early Development of Medical Expertise

Background: Problem-based learning (PBL) is used by many medical schools as either a full-time curriculum or an addition to a traditional curriculum. Purposes: The effects of PBL are examined using frameworks derived from theories of expertise and PBL' s goals. Methods: Students in full-time PBL, elective PBL, and full-time traditional curricula at two schools were compared on a series of pathophysiological explanation tasks over the course of the 1st year of medical school. The students' explanations were analyzed using written protocol analysis techniques derived from cognitive science research. Results: PBL students generate explanations that are more accurate, coherent, and comprehensive than non-PBL students. They transfer the reasoning strategies that they are taught and are more likely to use science concepts in their explanations. This effect is stronger for the full-time PBL students. Conclusion: The results demonstrate strong benefits of PBL, particularly for the full-time students.

An analysis of progress test results of PBL and non-PBL students

This study compares the academic achievement of students from two Dutch medical schools, one employing problem-based learning (PBL) and one non-PBL methods. Two progress tests were administered to 1904 PBL students and 1089 non-PBL students. No systematic differences were found on total test scores. After the test was split into three categories (basic, clinical and social sciences), a few, non-systematic differences were found. To some extent the basic sciences favoured the non-PBL curriculum and the social sciences the PBL curriculum, but this was not consistent for both test administrations. Also, the profiles for both schools at the level of disciplines show remarkable resemblances. Only at the level of individual questions could differences between PBL and non-PBL be demonstrated. The results obtained in this study strongly agree with those of previous comparisons between medical schools but indicate that effects of PBL and non-PBL instructional methods on medical factual knowledge are even more similar than we had previously thought.

A Lesson from Our Elders

To investigate whether the incorporation of women's health into problem-based learning (PBL) cases affects students' tendency to identify learning issues related to women's health as they encounter patients in an ambulatory care setting. Students in the PBL curriculum at the Allegheny University of the Health Sciences, MCP-Hahnemann School of Medicine, participate in a nine-week primary care practicum at the end of their first year, during which they spend three half-days per week in an ambulatory setting examining patients and completing patient logs that include any learning issues identified. Patient logs from 23 first-year PBL students who had not been exposed to a new women's health education program prior to their practicum in 1993 and from 22 first-year PBL students who had been exposed to the program prior to their practicum in 1994 were reviewed. For each women's health learning issue identified, the sex of the student and the sex, specialty, and practice setting of the student's preceptor were recorded. Data were analyzed with several statistical methods. There was no statistically significant difference in the numbers of men and women students or preceptors between the two years. In 1993 an average of 59% of the patients seen per student were women; in 1994 the average was 61%. The mean numbers of total learning issues identified (including women's health learning issues) were similar in the two years, but the mean percentage of clinical women's health learning issues identified increased significantly between 1993 and 1994, as did the mean percentage of community/preventive health women's health learning issues identified. There was a significant student-sex-by-preceptor-sex interaction for the total number of women's health learning issues identified (p = .024): for both years, the students paired with a preceptor of the same sex identified a higher number of women's health learning issues than did the students paired with a preceptor of the opposite sex. The results suggest that PBL is an effective way to increase students' awareness of women's health issues in a primary care clinical setting. More studies are needed to define the effect of PBL on the kind of reading and learning students will do when they get to the clinical setting.

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.