Problem Based Learning in Medical Education: Handling Objections and Sustainable Implementation

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

The introduction of problem-based learning (PBL) in 1969 is considered the greatest innovation in medical education of the past 50 years. Since then, PBL has been implemented in different educational settings across virtually all health professions. However, some PBL schools gradually faced resistance from academic staff who were more familiar with traditional teacher-centred curricula. At times this has resulted in reversion to tradition or compromise whereby PBL is implemented within a lecture-based curriculum. Resistance can also emerge in a traditional school when a PBL curriculum is being considered for implementation. One of the first signs of this erosion is doubts about PBL raised in the form of objections or criticisms. This perspective review describes eight objections raised to assert why PBL is inferior or untenable. The background to each objection is provided together with evidence-informed rebuttals derived from professional practice and the published literature. Best practices are discussed for sustainable management of a PBL-based curriculum. A well-implemented PBL curriculum with appropriate and cost-effective infrastructure, training, teaching-learning activities, and assessment will position schools to harness the full benefit of PBL in training medical and health professionals.

Video Abstract

Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use:

https://youtu.be/rewUDNF5kpc

Related collections

Most cited references 52

Record: found
Abstract: found
Article: not found

Active learning increases student performance in science, engineering, and mathematics.

Scott Freeman, Sarah L. Eddy, Miles McDonough … (2014)

To test the hypothesis that lecturing maximizes learning and course performance, we metaanalyzed 225 studies that reported data on examination scores or failure rates when comparing student performance in undergraduate science, technology, engineering, and mathematics (STEM) courses under traditional lecturing versus active learning. The effect sizes indicate that on average, student performance on examinations and concept inventories increased by 0.47 SDs under active learning (n = 158 studies), and that the odds ratio for failing was 1.95 under traditional lecturing (n = 67 studies). These results indicate that average examination scores improved by about 6% in active learning sections, and that students in classes with traditional lecturing were 1.5 times more likely to fail than were students in classes with active learning. Heterogeneity analyses indicated that both results hold across the STEM disciplines, that active learning increases scores on concept inventories more than on course examinations, and that active learning appears effective across all class sizes--although the greatest effects are in small (n ≤ 50) classes. Trim and fill analyses and fail-safe n calculations suggest that the results are not due to publication bias. The results also appear robust to variation in the methodological rigor of the included studies, based on the quality of controls over student quality and instructor identity. This is the largest and most comprehensive metaanalysis of undergraduate STEM education published to date. The results raise questions about the continued use of traditional lecturing as a control in research studies, and support active learning as the preferred, empirically validated teaching practice in regular classrooms.

0 comments Cited 815 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

The effects of problem-based learning during medical school on physician competency: a systematic review.

Gerald Choon-Huat Koh, Hoon Eng Khoo, Mee Lian Wong … (2008)

Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.

0 comments Cited 140 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Challenges and opportunities facing medical education.

Peter Densen (2011)

Medical education is at a crossroads. Although unique features exist at the undergraduate, graduate, and continuing education levels, shared aspects of all three levels are especially revealing, and form the basis for informed decision-making about the future of medical education.This paper describes some of the internal and external challenges confronting undergraduate medical education. Key internal challenges include the focus on disease to the relative exclusion of behavior, inpatient versus outpatient education, and implications of a faculty whose research is highly focused at the molecular or submolecular level. External factors include the exponential growth in knowledge, associated technologic ("disruptive") innovations, and societal changes. Addressing these challenges requires decisive institutional leadership with an eye to 2020 and beyond--the period in which current matriculants will begin their careers. This paper presents a spiral-model format for a curriculum of medical education, based on disease mechanisms, that addresses many of these challenges and incorporates sound educational principles.

0 comments Cited 117 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Adv Med Educ Pract

Journal ID (iso-abbrev): Adv Med Educ Pract

Journal ID (publisher-id): amep

Title: Advances in Medical Education and Practice

Publisher: Dove

ISSN (Electronic): 1179-7258

Publication date (Electronic): 28 December 2023

Publication date Collection: 2023

Volume: 14

Pages: 1453-1460

Affiliations

[1 ]Department of Paraclinical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak , Kota Samarahan, Sarawak, 94300, Malaysia

Author notes

Correspondence: William K Lim, Email kslim@unimas.my

Author information

William K Lim http://orcid.org/0000-0003-3829-537X

Article

Publisher ID: 444566

DOI: 10.2147/AMEP.S444566

PMC ID: 10758192

PubMed ID: 38164409

SO-VID: dbc61931-4f32-45bf-8627-72a73e094d43

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 14 October 2023

Date accepted : 17 December 2023

Page count

Figures: 0, Tables: 1, References: 54, Pages: 8

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

Cited by 5

See all cited by

Most referenced authors 362

See all reference authors

Problem Based Learning in Medical Education: Handling Objections and Sustainable Implementation

Read this article at

Abstract

Video Abstract

Related collections

Multimodal Learning Material

Most cited references 52

Active learning increases student performance in science, engineering, and mathematics.

The effects of problem-based learning during medical school on physician competency: a systematic review.

Challenges and opportunities facing medical education.

Author and article information

Journal

Affiliations

Author notes

Author information

Article

History

Page count

Categories

Comments

Comment on this article

Similar content 143

Cited by 5

Most referenced authors 362