Trabalhando com estratégias de ensino-aprendizado por descoberta na área da saúde: a problematização e a aprendizagem baseada em problemas  <span class="so-article-trans-title" dir="auto"> Translated title: Discovery-based teaching and learning strategies in health: problematization and problem-based learning </span>

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Abstract

Considerando os processos de mudança no ensino em saúde e a demanda por novas formas de trabalhar com o conhecimento no ensino superior, discutem-se dois caminhos metodológicos inovadores no ensino na área da saúde: a aprendizagem baseada em problemas (ABP) e a problematização. Descrevendo suas raízes teóricas, procura-se identificar os seus princípios orientadores. Enquanto propostas distintas, ambas contribuem para rever o processo de ensino-aprendizagem: a problematização, voltando-se para a construção do conhecimento no contexto de uma formação crítica; a ABP, voltando-se para os aspectos cognitivos do processo de construção de conceitos e apropriação dos mecanismos básicos da ciência. Tanto a problematização como a ABP levam a rupturas com a forma tradicional de ensinar e aprender, estimulando gestão participativa dos protagonistas da experiência e reorganização da relação teoria/prática. A crítica às possibilidades e limites de cada proposta, valendo-se da análise de seus fundamentos teórico-metodológicos, leva-nos a concluir que experiências pedagógicas apoiadas na ABP e/ou na problematização, podem representar um movimento inovador no contexto da educação na área da saúde favorecendo rupturas e processos mais amplos de mudança.

Translated abstract

Considering the changes in teaching in the health field and the demand for new ways of dealing with knowledge in higher learning, the article discusses two innovative methodological approaches: problem-based learning (PBL) and problematization. Describing the two methods' theoretical roots, the article attempts to identify their main foundations. As distinct proposals, both contribute to a review of the teaching and learning process: problematization, focused on knowledge construction in the context of the formation of a critical awareness; PBL, focused on cognitive aspects in the construction of concepts and appropriation of basic mechanisms in science. Both problematization and PBL lead to breaks with the traditional way of teaching and learning, stimulating participatory management by actors in the experience and reorganization of the relationship between theory and practice. The critique of each proposal's possibilities and limits using the analysis of their theoretical and methodological foundations leads us to conclude that pedagogical experiences based on PBL and/or problematization can represent an innovative trend in the context of health education, fostering breaks and more sweeping changes.

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Most cited references 29

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Effectiveness of problem-based learning curricula: research and theory.

J Colliver (2000)

This article provides a critical overview of problem-based learning (PBL), its effectiveness for knowledge acquisition and clinical performance, and the underlying educational theory. The focus of the paper is on (1) the credibility of claims (both empirical and theoretical) about the ties between PBL and educational outcomes and (2) the magnitude of the effects. The author reviewed the medical education literature, starting with three reviews published in 1993 and moving on to research published from 1992 through 1998 in the primary sources for research in medical education. For each study the author wrote a summary, which included study design, outcome measures, effect sizes, and any other information relevant to the research conclusion. The review of the literature revealed no convincing evidence that PBL improves knowledge base and clinical performance, at least not of the magnitude that would be expected given the resources required for a PBL curriculum. The results were considered in light of the educational theory that underlies PBL and its basic research. The author concludes that the ties between educational theory and research (both basic and applied) are loose at best.

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Problem-based learning: why curricula are likely to show little effect on knowledge and clinical skills.

M. Albanese (2000)

A recent review of problem-based learning's effect on knowledge and clinical skills updated findings reported in 1993. The author argues that effect sizes (ES) seen with PBL have not lived up to expectations (0.8-1.0) and the theoretical basis for PBL, contextual learning theory, is weak. The purposes of this study were to analyse what constitutes reasonable ES in terms of the impacts on individuals and published reports, and to elaborate upon various theories pertaining to PBL. Normal theory is used to demonstrate what various ESs would mean for individual change and a large meta-analysis of over 10 000 studies is referred to in identifying typical ESs. Additional theories bearing upon PBL are presented. Effect sizes of 0.8-1.0 would require some students to move from the bottom quartile to the top half of the class or more. The average ES reported in the literature was 0.50 and many commonly used and accepted medical procedures and therapies are based upon studies with ESs below 0.50. Effect sizes of 0.8-1.0 are an unreasonable expectation from PBL because, firstly, the degree of changes that would be required of individuals would be excessive, secondly, leading up to medical school, students are groomed and selected for success in a traditional curriculum, expecting them to do better in a PBL curriculum than a traditional curriculum is an unreasonable expectation, and, thirdly, the average study reported in the literature and many commonly used and accepted medical procedures and therapies are based upon studies having lesser ESs. Information-processing theory, Cooperative learning, Self-determination theory and Control theory are suggested as providing better theoretical support for PBL than Contextual learning theory. Even if knowledge acquisition and clinical skills are not improved by PBL, the enhanced work environment for students and faculty that has been consistently found with PBL is a worthwhile goal.