Independent Learning: Problem-based Learning (PBL)

Problems

As a problem-centred, competency-driven and inquiry-based approach, there are some projected—perhaps even predictable—outcomes in PBL. PBL is likely to:

  • teach learners to learn how to learn by taking them through the process: defining problems, framing a hypothesis, determining what information is needed, analysing and assessing the information gathered and deciding what/how best to use it for the purpose at hand;
  • enable lifelong learning;
  • build confidence; since by doing rather than only observing, by searching out and constructing their own knowledge, learners know what they know with confidence; what they do not know, they are confident of being able to find out and learn;
  • strengthen motivation by investing learners with greater responsibility and ‘impact factor’ in terms of deriving solutions;
  • encourage deep learning as opposed to surface processing; meaning rather than acquisition of facts is emphasised;
  • ensure mastery and increase retention;

    I hear and I forget. I see and I believe. I do and I understand.

    —Confucius
  • stimulate higher cognitive skills—analytical, critical and creative thinking—by focusing the learner on finding what he/she considers to be the most effective solution rather than second-guessing at the answer that the teacher has in mind;
  • increase relevance of learning by the applicability to real-life scenarios and the obvious connection between inquiry and outcome;
  • encourage integrative learning since instead of the traditional compartmentalising—sometimes artificially compartmentalising—learning, various disciplines and domains are drawn on and synthesised in the attempt at grappling with the problem and identifying the solution(s);
  • prepare for life by familiarising the learner with real-life scenarios and providing practice in how to function within it, as well as developing interpersonal, negotiation and team working skills so necessary for the work place;
  • make learning more interesting and enjoyable.

PBL is also gaining increasing credibility in other institutions. An evaluation of the ‘New Pathway Program’ at Harvard Medical School, for instance, indicated that:

…students in the new curriculum learned differently, acquired distinctive knowledge, skills, and attitudes, and underwent a more satisfying and challenging preclinical medical school experience without the loss of biomedical competence.15

Generally, positive results have been reported; but as PBL originated—and is in the most mature stage of usage—in medical schools, evaluations have so far been done largely in that field. From their experience, PBL has improved the quality of the learning experience as well as increased learner and teacher motivation. Albanese and Mitchell (1993)16 reported that in terms of acquisition of factual knowledge, there is no significant difference between the traditional and PBL approaches, which supports the assumption that students can learn the facts for themselves. A more recent study by Blake, et al. (2000) supported a positive gain:

The mean scores were higher on USMLE Step 1 for classes in the problem-based learning curriculum than for classes in the traditional curriculum…Major PBL revisions of the curriculum did not compromise the performances of medical students on the licensing examinations; in fact, they may have contributed to higher scores.17

Further, Schmidt, et al. (1996)18 found that:

  • in terms of problem-solving skills, there is no difference;
  • PBL medical students made more accurate diagnosis than those taught in the traditional mode; but this could be the result of integration of basic and clinical sciences rather than the PBL methodology.

There is, however, some reservation about its efficiency in terms of knowledge acquisition, a reservation echoed by others. For instance, McGregor, et al. (1995) reported that:

A PBL curriculum generates both student and faculty enthusiasm. Unfortunately, this does not translate into more efficient transmission of knowledge.19

A Canadian study also found that:

Centres that have adopted a PBL approach have found improved student motivation and enjoyment, but there has been no convincing evidence of improved learning. An intelligent combination of both traditional and PBL approaches will likely provide the most effective training for undergraduate surgical clerks.20

That there is as yet ‘no convincing evidence of improved learning’ should not make us lose sight of it merits. Albanese (2000) reminds us that:
Even if knowledge acquisition and clinical skills are not improved by PBL, enhancing the work environment for students and faculty is a worthwhile goal in and of itself.21

There are sufficient grounds for implementing PBL, though perhaps more will have to be done to make PBL not only as good as but ‘more efficient’ before it gains more widespread endorsement and adoption. PBL does require a fairly radical shift with a number of important issues to be thought through. Both the Yong Loo Lin School of Medicine and the Faculty of Dentistry have introduced PBL to a significant degree at NUS. There is also growing interest in PBL in other faculties. Perhaps further deliberations will usher in an increasing level of usage since in concept PBL is pedagogically sound, even if there are difficulties in the details and implementation.

Philosophy | Parameters | Process | Pointers | Problems | Promises

  1. G.T. Moore, S.D. Block, C.B. Style, & R. Mitchell. (1994). ‘The Influence of the New Pathway Curriculum on Harvard Medical Students’. Academic Medicine. Vol. 69, No. 12, pp. 983–989. See also earlier study: G. Moore, S. Block & R. Mitchell. (1990). A Randomized Controlled Trial Evaluating the Impact of the New Pathway Curriculum at Harvard Medical School Final Report. No. 141. Harvard University Medical School. (Eric Document Reproduction Service No. 359 866).
  2. M.A. Albanese & S. Mitchell. (1993). ‘Problem-based Learning: A Review of Literature on Its Outcomes and Implementation Issues’. Academic Medicine. Vol. 68, No. 1, pp. 52–81.
  3. Robert Blake, Michael Hosokawa & Shari Riley. (January 2000). ‘Student Performances on Step 1 and Step 2 of the United States Medical Licensing Examination Following Implementation of a Problem-based Learning Curriculum’. Academic Medicine. Vol. 75, No. 1, pp. 66–70.
  4. H. Schmidt, M. Machiels-Bongaerts, H. Hermans, T. ten Cate, R. Venekamp & H. Boshuizen. (1996). ‘The Development of Diagnostic Competence: Comparison of a Problem-based, an Integrated, and a Conventional Medical Curriculum’. Academic Medicine. Vol. 71, No. 6, pp. 658–664.
  5. D. McGregor, T. Arcomano & A. Little. (1995). ‘Problem Orientation Is a New Approach to Surgical Education’. American Journal of Surgery. Vol. 170, No. 6, pp. 656–659.
  6. G. Chang, D. Cook, T. Maguire, E. Shakun, W. Yakimets & G. Warnock. (1995). ‘Problem-based Learning: Its Role in Undergraduate Surgical Education’. Canadian Journal of Surgery. Vol. 38, No. 1, pp. 13–21.
  7. Mark Albanese. (2000). ‘Problem-based Learning: Why Curricula are Likely to Show Effect on Knowledge and Clinical Skills’. Medical Education, Vol. 34, pp. 729–738.