The effectiveness of the problem-based learning in medical cell biology education: A systematic meta-analysis

A 10-Step Process to Align Problem-Based Learning With Accreditation Expectations for Self-Directed and Lifelong Learning

OBJECTIVE

Self-directed and lifelong learning (SDLL) skills are essential skillsets in both undergraduate and graduate medical education (UME and GME). Hence, medical schools' accreditation bodies emphasize the requirements to acquire these skills in their accreditation standards. For example, in the United States, the Liaison Committee on Medical Education (LCME) clearly defines the components of the SDLL process in Element 6.3 of Accreditation Standard Six. Among the active learning pedagogies, problem-based learning (PBL) provides ample learning opportunities where SDLL skills are effectively applied. The aim of this article is to streamline the process of developing, delivering, and evaluating PBL sessions in line with the SDLL accreditation requirements through a 10-step design and implementation process.

METHODS

Our 10-step process, detailed in the article, starts with developing learning objectives that inform the content of the PBL case and the required embedded learning triggers. The process carefully addresses the components of the SDLL process and other aspects of the accreditation needs within the framework of PBL. The approach to implementation, feedback, assessment, and evaluation is explicitly described to meet the regulatory expectations.

DISCUSSION

In addition to the essential role in UME and GME, SDLL skills are vital requisites for continuing medical education of all physicians. Instilling this skillset early in medical students helps to cultivate their ability to apply these skills in their future professional roles. Using accreditation standards as a foundation for creating learning experiences, for example, PBL, requires careful content development and sequencing. Such a process needs explicit standardized steps that should not only be feasible, but also transferable for usage by different medical schools.

CONCLUSION

Our streamlined 10-step process of designing and delivering an SDLL-oriented PBL experience can easily be adopted by other medical schools to address the SDLL skills acquisition as well as meeting the accreditation requirements.

Effects of problem-based learning on delivering medical and nursing education: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

There is still a lack of high-level evidence on the effects of problem-based learning (PBL) in general medical and nursing education.

AIMS

We aimed to summarize current evidence on the effects of PBL in delivering medical and nursing education from randomized controlled trials (RCTs).

METHODS

A systematic search was performed in MEDLINE, EMBASE, Cochrane Central Library, and CINAHL Complete. RCTs that assessed the effects of a PBL module in delivering medical education were eligible. Outcomes included knowledge, performance, and satisfaction. The risk of bias was assessed according to Cochrane handbook guidelines. Standardized mean differences with 95% confidence intervals of each outcome between PBL and control groups were pooled using a random-effects model.

RESULTS

In all, 22 RCTs with 1969 participants were included. Both pooled analyses of changes in scores compared with baseline and absolute post-interventional scores favored PBL module in knowledge and performance. The satisfaction degree was also higher in participants receiving PBL methods. Publication bias might exist in satisfaction; however, not in knowledge and performance. Eleven of the 22 studies were assessed as having a high risk of bias.

LINKING EVIDENCE TO ACTION

Compared with traditional lecture-based modules, PBL delivered medical education in different medical science specialities more efficiently from both theoretical knowledge and practice skill perspectives. The feedback from participants receiving PBL methods was more positive than that from those receiving traditional methods. However, the high heterogeneity and low quality of the included studies prevented drawing definite conclusions.

Application of integrated problem-based learning combined with lecture-based classroom teaching in undergraduate medical education: An effective teaching model in a Medical School in China

The problem-based learning (PBL) is increasingly used in undergraduate education. However, the application of integrated PBL to medical undergraduate education has not been well assessed. An observational study was designed to compare integrated PBL combined with lecture-based classroom (LBC) with traditional LBC teaching in 2 semesters of a Medical School in China. This study was conducted from March 2021 to July 2022. A total of 118 undergraduates majoring in clinical medicine were randomly allocated in 2 groups, 1 group receiving the integrated PBL + LBC teaching (experimental group, n = 60) and another group receiving LBC teaching (control group, n = 58). The experimental group attended the integrated PBL courses for the basic and clinical medicine conducted in the 6th and 8th semesters, respectively, as well as taking the LBC courses. The experimental group was required to preview the course materials before class, make presentations in class and take online feedback questionnaires after class, while the control group was required to preview the textbooks and listen to the traditional LBC courses. The students' scores of these 2 groups were compared, and feedback questionnaires were performed to evaluate the effectiveness of the experimental group over the control group. Results showed that the experimental group scored significantly higher than the control group in Clinical Skills (95% confidence interval [CI] 4.19-5.89), Internal Medicine I (95% CI: 1.85-9.93), Internal Medicine II (95% CI: 8.07-15.90), Introduction to Surgery (95% CI: 5.08-10.25), Surgery (General Surgery) (95% CI: 7.82-12.72), Surgery (Specialty) (95% CI: 6.47-9.97), and Clinical Medical Level Test (95% CI: 1.60-5.15) (all P < .01). In the feedback questionnaires of integrated PBL, up to 80% and 90% of students were satisfied with the teaching methods and lecturers, respectively. More than 80% of students agreed that the integrated PBL improved their abilities to learn independently, understand knowledge, and to raise, analyze and solve problems. In terms of stress in and out of class, a small number of students, <36.7%, felt stressed. The integrated PBL combined with LBC is an effective teaching approach, which may provide new ideas for teaching research and reform on undergraduate medical education in clinical medicine specialty and other medical majors.

The effectiveness of problem-based learning compared with lecture-based learning in surgical education: a systematic review and meta-analysis

BACKGROUND

This meta-analysis was conducted to systematically evaluate the impact of problem-based learning (PBL) and lecture-based learning (LBL) teaching models on students' learning in surgical education.

METHODS

We systematically searched the publications related to the application of PBL and LBL in surgical courses in PubMed, Embase, Web of Science and Cochrane Library databases, the last retrieval time is September 20, 2022. After screening the literature according to the inclusion and exclusion criteria, extracting data and evaluating the methodological treatment of the included studies, Stata 17.0 software was used to perform meta-analysis.

RESULTS

Nine studies were included totally. The results showed that compared with LBL, PBL was superior in clinical competence (SMD = 0.81, 95% CI: 0.12 ~ 1.49, P = 0.020) and student satisfaction (SMD = 2.13, 95% CI: 1.11 ~ 3.15, P < 0.0001) with significant differences. But the comprehensive scores (SMD = 0.26, 95% CI: -0.37 ~ 0.89, P = 0.421) and theoretical knowledge (SMD=-0.19, 95% CI: -0.71 ~ 0.33, P = 0.482) to PBL and LBL had no significant difference.

CONCLUSION

This study showed that the PBL teaching model is more effective than the LBL teaching model in surgical education on the aspects of enhancing clinical competence and student satisfaction. However, further well-designed studies are needed to confirm our findings.