Problems

Inappropriately used, PBL will not lead to the potential robust learning.¹¹

As with any change, there are potential problems:

• The mindset and behavioural changes demanded by the shift from an instruction to a learning paradigm that is heavily learner-led and problem-based may cause some initial discomfort.
  
  
• There are implementation issues. PBL will require rethinking of the curriculum, assessment mechanisms, as well as some changes in infrastructure.
  
  
  • Curricular changes may include re-drawing or eliminating existing disciplinary/departmental boundaries, reviewing and re-defining learning outcomes and revaluating content and coverage.
    
  • Assessment is an important but thorny issue. How is group effort to be assessed? Traditional notions of cheating as getting help from others and authenticity of effort will need to be revised. A useful point to keep in mind is that while information is shared, knowledge remains a personal construction and may be individually assessed.

Assessing the process may be done by:

• tutor(s);
  
• peers;
  
• self;
  
• a survey of student attitudes and activities.
  

A study done at McMaster University¹² compared students’ self-evaluations of their performances with the evaluations they received from their tutors in a problem-based course. It found that correlations between students’ and tutors’ evaluations increased over time and the number of evaluations, and interpreted this more as evidence of a negotiation process between students and their tutors than as evidence of improvement in self-evaluation skills.

Methods for assessing outcomes may be done through a number of ways and reliability is enhanced by using various sources of information¹³ such as:

• multiple-choice questions;
  
• short answer questions;
  
• extended-matching items;
  
• progress tests;
  
• essay exams;
  
• oral and structured oral exams;
  
• modified essay questions;
  
• problem-analysis questions;
  
• patient management problems;
  
• clinical reasoning test modules;
  
• clinical reasoning exercises;
  
• standardised patients.
  

• Infrastructural support (e.g. creating suitable new venues for group work and ensuring greater supply/availability of library and other learning resources) and the attendant cost need to be provided for. Hence, commitment and support from the top as well as from the teaching faculty is needed.
  
  
• Writing problems is a new skill that needs to be learnt, and good problems take time and effort to devise.
  
  
• Students need to be adequately trained. Reporting on the experience of implementing PBL into the Ohio State University’s MBA programme, Stinson and Milter shared an experience useful for other PBL tutors:
  
  We were not effectively helping students to make their learning explicit. We were assuming that the students would, as a natural part of the learning process, reflect on their experience and extract abstract knowledge.¹⁴
  
  
• Some fear that this approach is not suitable for our Singaporean—perhaps even generally, Asian—students who tend not to be vocal in class, are socialised into authority-dependency in school and at home, and who may be too competitive to be able to work well cooperatively. These fears have some justification but may be exaggerated. Our students may be passive and quiet in class, but they are also highly motivated and responsive to incentives. For instance, the reward system is a powerful motivation, and if assessment is not based on group effort alone but also distinguishes between differences in individual inputs, students will participate and make the necessary effort. Similarly, the kiasuism attributed to Singaporean students might also mean that they are highly suitable candidates for PBL: being driven, they can be relied on to do the work that is necessary. They will be conscientious in gathering information so that coverage is unlikely to be a serious problem.
  
  

Philosophy | Parameters | Process | Pointers | Problems | Promises

11. J.E. Stinson & R.G. Milter. (1996). ‘Problem-Based Learning in Business Education: Curriculum Design and Implementation Issues’. In LuAnn Wilkerson & Wim H. Gijselaers. (Eds.). Bringing Problem-Based Learning to Higher Education: Theory and Practice (New Directions in Teaching & Learning Series, Vol. 68). San Francisco: Jossey-Bass. pp. 33–42. (c.f. p. 35.)
12. J. Hay. (1995). ‘Investigating the Development of Self-evaluation Skills in a Problem-based Tutorial Course’. Academic Medicine. Vol. 70, No. 8, pp. 733–735.
    
13. M.R. Nendaz & A. Tekian. (1999). ‘Assessment in Problem-based Learning Undergraduate Medical Curricula: An Analysis Based on a Literature Review’. Teaching and Learning in Medicine. Vol. 11, pp. 232–243.
14. Stinson & Milter. op. cit. p. 38.