Group interaction in problem-based learning tutorials: a systematic review

From Slow Shifts to Fast Flips: Unraveling problem-based learning group function dynamics

PURPOSE

Problem-Based Learning (PBL) relies on self-directed learning in small groups in the presence of a tutor. While the effectiveness of PBL is often attributed to the dynamics of group function, change in group function over time and factors influencing group function development are less understood. This study aims to explore the development of PBL group function over time to better understand the factors that give rise to high-functioning groups.

METHOD

We examined time-function graphs of group function and conducted semi-structured focus group discussions in 2023 with medical students enrolled in a PBL curriculum. Students reflected on their experiences in four different PBL groups, creating time-function graphs to characterize development of group function over 8-12-week periods. We analyzed graphs and transcripts in a staged approach using qualitative description and direct content analysis, sensitized by two frameworks: Tuckman's Stages of Group Development and the Dimensions of PBL Group Function.

RESULTS

Three archetypes of PBL group function development were identified: Slow Shifters, Fast Flippers, and Coasters. (1) Slow Shifters were characterized by a complex and extended pattern of growth consistent with Tuckman's model, typically occurring amongst inexperienced groups, or groups faced with a novel task. (2) Fast Flippers were characterized by abrupt state changes in group function arising from internal or external disruptions. (3) Coasters were characterized by plateaus, where maintenance of group function was a frequently cited challenge. Abrupt changes and plateaus occurred more among mature groups and groups with significant PBL experience.

CONCLUSIONS

PBL group function varies over time in 3 different patterns. Classic Tuckman's stages are apparent among inexperienced groups, or groups facing novel tasks, whereas experienced groups often face abrupt change or plateaus. PBL educators and students should consider the need for novelty and disruption in more experienced groups to incite growth.

Adoption of Problem-Based Learning in Medical Schools in Non-Western Countries: A Systematic Review

Phenomenon: In recent decades, medical education practices developed in Western countries have been widely adopted in non-Western countries. Problem-based Learning (PBL) was first developed in North America and it relies on Western educational and cultural values, thereby raising concerns about its 'lift and shift' to non-Western settings. Approach: This review systematically identified and interpretively synthesized studies on students' and teachers' experiences of PBL in non-Western medical schools. Three databases (ERIC, PsycINFO, and MEDLINE) were searched. Forty-one articles were assessed for quality using the Critical Appraisal Skills Program (CASP) checklist and synthesized using meta-ethnography. The final synthesis represented over 5,400 participants from 18 countries. Findings: Findings were categorized into three different constructs: Student Engagement, Tutor Skills, and Organization and Planning. Our synthesis demonstrates that medical students and teachers in non-Western countries have varied experiences of PBL. Students engage variably with PBL, consider knowledge to be better acquired from authoritative figures, and deem PBL to be ineffective for assessment preparation. Student participation is limited by linguistic challenges when they are not native English speakers. Teachers are often unfamiliar with the underlying philosophical assumptions of PBL and struggle with the facilitation style needed. Both students and teachers have developed modifications to ensure that PBL better fits in their local settings. Insights: Given the significant adjustments and resource requirements needed to adopt PBL, medical school leaders and policy makers in non-Western countries should carefully consider possible consequences of its implementation for their students and teachers, and proactively consider ways to 'hybridize' it for local contexts.

Application of problem based learning (PBL) and case based learning (CBL) in the teaching of international classification of diseases encoding

To study the application of PBL combined with CBL teaching mode in the teaching of international classification of diseases (ICD) encoding, so as to improve students' grasp of ICD encoding knowledge. From March 2020 to June 2020, 50 students majoring in health information management who were interns in a Grade A general hospital were selected as the research participants and randomly divided into experimental group and control group, 25 in each group. The experimental group and the control group adopted the PBL combined CBL teaching mode and the traditional teaching mode respectively to carry out the classification and coding teaching. The academic achievement of the two groups of students was evaluated by means of achievement assessment and questionnaire survey based on information processing theory. The scores of theoretical knowledge in the experimental group and the control group were 79.78 ± 8.55 and 70.92 ± 10.81, respectively, and the scores of skill operation in the two groups were 79.76 ± 8.28 and 70.00 ± 10.41, respectively. The test scores of the experimental group were higher than those of the control group, and the difference was statistically significant (P < 0.05). The scores of knowledge acquisition ability of experimental group and control group were 16.72 ± 1.79 and 16.60 ± 2.36, the scores of knowledge sharing ability were 24.20 ± 2.61 and 21.00 ± 2.65, the scores of knowledge storage ability were 20.80 ± 2.47 and 17.24 ± 4.90, respectively. The scores of knowledge application ability were 14.00 ± 1.80 and 11.00 ± 2.69, the scores of knowledge innovation ability were 20.16 ± 2.34 and 18.08 ± 3.70, and the total scores were 95.88 ± 6.08 and 83.92 ± 11.30, respectively. The scores of all questionnaires in the experimental group were higher than those in the control group. The scores of knowledge sharing ability, knowledge storage ability, knowledge application ability, knowledge innovation ability and total score between the two groups were higher than those of the control group, and the differences were statistically significant (P < 0.05). PBL combined with CBL teaching model has good academic achievement in ICD encoding teaching, which can significantly improve academic performance and learning ability, and is worthy of promotion.

Online case-based learning in medical education: a scoping review

BACKGROUND

Case-Based Learning (CBL) in medical education is a teaching approach that engages students as learners through active learning in small, collaborative groups to solve cases from clinical patients. Due to the challenges afforded by the COVID-19 pandemic, small group learning such as CBL, transitioned quickly to include technology-enhanced learning to enable distance delivery, with little information on how to apply pedagogical frameworks and use learning theories to design and deliver online content.

METHODS

To extend understanding of online CBL a scoping review protocol following the PRISMA-ScR framework explored the literature that describes the use of online CBL application in medical education and the outcomes, perceptions, and learning theories. A literature search was conducted in January 2022 followed by a subsequent review in October 2022. After peer review using the PRESS guidelines, the CASP appraisal tool was used to assess the rigor of each study design.

RESULTS

The scoping review identified literature published between 2010 and 2022 (n = 13 articles), on online CBL in the field of medical education with 11 observational studies describing student and facilitator perceptions and two randomized controlled studies. Positive perceptions of online learning included a flexible work-life balance, connection with learners, and improved accessibility. Negative experiences of online CBL included poor internet access, a distracting learning environment, and loss of communication. In the studies that collected student performance data, results showed equivalent or improved outcomes compared to the control. The CASP appraisal tool highlighted the deficiencies in most study designs, lack of framework or learning theory, and poor reproducibility of the methods to answer the research questions.

CONCLUSION

This scoping review identified literature to describe the academic outcomes, and student and facilitator perceptions of online CBL in medical education. However, the CASP tool uncovered deficiencies in study descriptions and design leading to poor quality evidence in this area. The authors provide recommendations for frameworks and learning theories for the future implementation of online CBL.

Dental Education: A Guide for Novice Tutors

The primary objective of undergraduate-level dental education is to produce proficient dental practitioners who can effectively address the oral health needs of the community and enhance the overall oral health of the population. The field of dental education is subject to continuous change that is shaped by many factors, including changing societal norms, shifting responsibilities of dental practitioners, changing healthcare environments, and rapidly evolving dental science. Learning theories significantly impact the advancement of dental education, and educators must recognize and acknowledge their influence. Dental faculties must be adequately prepared and motivated to use innovations, which enable them to impart knowledge in a practical and organized manner. This review provides an overview of teaching methodologies that have gained acceptance in recent years. It highlights the importance of their implementation in facilitating an effective teaching and learning process in consideration of their history, style, and core focus. A clearer understanding of these techniques can enhance education standards, help establish dental instructors' responsibilities and career advancement, and provide insights for future research.

Evaluation of Problem-Based Learning implementation in a College of Medicine, Kingdom of Saudi Arabia: a cross sectional comparative study

BACKGROUND

Problem-Based Learning (PBL) is an innovative student-centered learning method that has been implemented in numerous medical colleges worldwide. However, the newly adopting PBL institutes may face challenges during its implementation. This study aims to evaluate PBL implementation in the medical college of Imam Abdulrahman bin Faisal University (IAU) from the facilitators' and students' perspectives.

METHODS

This is a cross-sectional study using a quantitative self-administered online questionnaire. The questionnaire evaluated PBL implementation using the three scales: small group learning, problem case scenario, and facilitator role. A total of 52 facilitators and 1289 students (from second to sixth years) were invited to participate in the study at the end of the 2019-2020 academic year.

RESULTS

Forty-six facilitators (88.46%) and 324 students (25.13%) responded to the questionnaire. There was an overall positive evaluation of PBL implementation. However, the facilitators' rating was significantly higher than the students' rating across the three scales. Regarding the small group learning, a significant difference was found between types of facilitation status (p = 0.017) and between trained and not trained facilitators (p = 0.029). In respect to the problem case scenario, there was a significant difference based on the types of facilitation status (p = 0.017) and facilitating tutorials related to the facilitator's specialty (p = 0.004). Regarding the facilitator role, a significant difference was found between the academic year they had facilitated (p = 0.032). Female students rated the three scales significantly higher than male students (p < 0.001). Students aged between 24 and 25 years old and sixth years students also rated the three scales significantly higher than other students (P < 0.05).

CONCLUSIONS

The participants rated PBL implementation positively as measured by the three scales rating. However, specific concerns have been highlighted that are related to group dynamics, training before starting PBL, relevancy of the case scenarios, and the facilitator's role in nominating group members and providing feedback.

The Relationship Between Self-Control and Internet Addiction Among Students: A Meta-Analysis

As past studies of self-control and Internet addiction showed mixed results, this meta-analysis of 83 primary studies with 80,681 participants determined whether (a) these students with less self-control had greater Internet addiction, and (b) age, culture, gender, Internet addiction measures, or year moderated these relations. We used a random-effects meta-analysis of Pearson product-moment coefficients r with Fisher’s z-transformation and tested for moderation with the homogeneity tests. The results showed a positive link between impulsivity and Internet addiction (r = 0.371, 95% CI = [0.311, 0.427]) and a negative link between restraint and Internet addiction (r = −0.362, 95% CI = [−0.414, −0.307]). The moderation analysis indicated that the correlation between impulsivity indicators and greater Internet addiction was stronger among undergraduates (18–22 years old) than among adolescents (10–17 years old). Furthermore, the negative link between a restraint indicator and Internet addiction was greater (a) among students in East Asia than those in Western Europe/North America, (b) among males than females and (c) when using the Internet addiction measures GPIUS or IAT rather than CIAS. Hence, these results indicate a negative link between self-control and Internet addiction, and this link is moderated by age, culture, gender, and Internet addiction measure.

Use of bile acids as potential markers of liver dysfunction in humans: A systematic review

OBJECTIVE

This study aimed to determine the effectiveness of using total, individual serum, or urinary bile acids (BA) as potential markers of liver dysfunction.

METHODS

We searched the PubMed and Web of Science databases using the following keywords- "serum bile acids," "liver dysfunction," "liver injury," "liver disease," "traditional liver function tests," "Chronic liver disease," "acute liver injury". The search was complemented by manual screening of the list of references for relevant articles. We selected only English-language manuscripts for adult patients based on predetermined inclusion and exclusion criteria. Animal studies and studies on neonates and children were not included.

OUTCOME MEASURES

Changes in BA concentrations or ratios at or prior to changes in liver function tests.

RESULTS

A total of 547 studies were identified, of which 28 were included after reading the entire manuscript. These studies included 1630 patients and 836 controls published between 1990 and 2017. The methods used in BA assays varied significantly, and the studies did not agree. on specific individual BA or BA ratios as biomarkers of specific liver injury or dysfunction. Except for the prognostic value of BA in intrahepatic cholestasis of pregnancy (ICP), studies have failed to provide evidence for BA as a liver biomarker.

CONCLUSIONS

Despite the research conducted on BA for over 27 years, there are inconsistencies in the reported results and a lack of solid evidence to support the use of individual BA or BA ratios as biomarkers of liver injury. Adequately conducted studies needed to resolve this limitation in the literature.

Perception and outcomes after implementation of problem-based learning in predoctoral pediatric dentistry clinical education

PURPOSE

Problem-based learning (PBL) has been a useful addition to health-based curricula by supporting learning with contributory discussion, research, and critical analysis of evidence in a peer-supported learning format. The aim of this study was to determine the impact of PBL on pediatric dentistry clinical education.

METHODS

First-time pass-rates in clinical and objective structured clinical examinations were measured in student cohorts receiving pediatric curricular formats with (PBL+) or without a PBL (PBL-) experience. Student perceived learning outcomes were measured through a voluntary survey. The numbers of each competency attempt were compared between the study groups (PBL+ or PBL-) using Wilcoxon Rank-Sum tests or Fisher's exact tests. Mantel-Hanzel ordinal chi-square tested for differences in rates of agreement on survey responses from students in the PBL+ or PBL- groups. Significance was set at 0.05.

RESULTS

There was a significant improvement in the first-time pass-rates in five of seven competencies in the PBL+ group. A significantly higher proportion of students in the PBL+ group perceived that their predoctoral pediatric dentistry rotation improved their diagnostic skills compared to the students in the PBL- group (p < 0.001). However, there was no significant difference (p > 0.05) between the perceptions on satisfaction of clinical or non-clinical staff support, perceived self-improvement in radiographic or clinical skills or overall benefits of the predoctoral pediatric dentistry rotation.

CONCLUSION

The addition of a PBL component to a traditional curricular format in a pediatric dentistry clinical rotation had a positive impact on learning in a predoctoral dental program.

What makes an online problem-based group successful? A learning analytics study using social network analysis

BACKGROUND

Although there is a wealth of research focusing on PBL, most studies employ self-reports, surveys, and interviews as data collection methods and have an exclusive focus on students. There is little research that has studied interactivity in online PBL settings through the lens of Social Network Analysis (SNA) to explore both student and teacher factors that could help monitor and possibly proactively support PBL groups. This study adopts SNA to investigate how groups, tutors and individual student's interactivity variables correlate with group performance and whether the interactivity variables could be used to predict group performance.

METHODS

We do so by analyzing 60 groups' work in 12 courses in dental education (598 students). The interaction data were extracted from a Moodle-based online learning platform to construct the aggregate networks of each group. SNA variables were calculated at the group level, students' level and tutor's level. We then performed correlation tests and multiple regression analysis using SNA measures and performance data.

RESULTS

The findings demonstrate that certain interaction variables are indicative of a well-performing group; particularly the quantity of interactions, active and reciprocal interactions among students, and group cohesion measures (transitivity and reciprocity). A more dominating role for teachers may be a negative sign of group performance. Finally, a stepwise multiple regression test demonstrated that SNA centrality measures could be used to predict group performance. A significant equation was found, F (4, 55) = 49.1, p < 0.01, with an R2 of 0.76. Tutor Eigen centrality, user count, and centralization outdegree were all statistically significant and negative. However, reciprocity in the group was a positive predictor of group improvement.

CONCLUSIONS

The findings of this study emphasized the importance of interactions, equal participation and inclusion of all group members, and reciprocity and group cohesion as predictors of a functioning group. Furthermore, SNA could be used to monitor online PBL groups, identify important quantitative data that helps predict and potentially support groups to function and co-regulate, which would improve the outcome of interacting groups in PBL. The information offered by SNA requires relatively little effort to analyze and could help educators get valuable insights about their groups and individual collaborators.

Deep learning with convolutional neural networks for identification of liver masses and hepatocellular carcinoma: A systematic review

BACKGROUND

Artificial intelligence, such as convolutional neural networks (CNNs), has been used in the interpretation of images and the diagnosis of hepatocellular cancer (HCC) and liver masses. CNN, a machine-learning algorithm similar to deep learning, has demonstrated its capability to recognise specific features that can detect pathological lesions.

AIM

To assess the use of CNNs in examining HCC and liver masses images in the diagnosis of cancer and evaluating the accuracy level of CNNs and their performance.

METHODS

The databases PubMed, EMBASE, and the Web of Science and research books were systematically searched using related keywords. Studies analysing pathological anatomy, cellular, and radiological images on HCC or liver masses using CNNs were identified according to the study protocol to detect cancer, differentiating cancer from other lesions, or staging the lesion. The data were extracted as per a predefined extraction. The accuracy level and performance of the CNNs in detecting cancer or early stages of cancer were analysed. The primary outcomes of the study were analysing the type of cancer or liver mass and identifying the type of images that showed optimum accuracy in cancer detection.

RESULTS

A total of 11 studies that met the selection criteria and were consistent with the aims of the study were identified. The studies demonstrated the ability to differentiate liver masses or differentiate HCC from other lesions (n = 6), HCC from cirrhosis or development of new tumours (n = 3), and HCC nuclei grading or segmentation (n = 2). The CNNs showed satisfactory levels of accuracy. The studies aimed at detecting lesions (n = 4), classification (n = 5), and segmentation (n = 2). Several methods were used to assess the accuracy of CNN models used.

CONCLUSION

The role of CNNs in analysing images and as tools in early detection of HCC or liver masses has been demonstrated in these studies. While a few limitations have been identified in these studies, overall there was an optimal level of accuracy of the CNNs used in segmentation and classification of liver cancers images.

A review to identify key perspectives in PBL meta-analyses and reviews: trends, gaps and future research directions

In the past 50 years, the original McMaster PBL model has been implemented, experimented, revised, and modified, and is still evolving. Yet, the development of PBL is not a series of success stories, but rather a journey of experiments, failures and lessons learned. In this paper, we analyzed the meta-analyses and systematic reviews on PBL from 1992 to present as they provide a focused lens on the PBL research in the past 5 decades. We identified three major waves in the PBL research development, analyzed their impact on PBL research and practice, and offered suggestions of research gaps and future directions for the field. The first wave of PBL research (polarization: 1990-mid 2000) focused on answering the question "Does PBL work?" and the outcomes. The results were conflicting. The researchers took polarizing positions and debated over the merits of PBL throughout this wave. However, the contradictory results and the debates in fact pushed the researchers to look harder for new directions to solve the puzzle. These efforts resulted in the second wave (from outcomes to process: mid 2000-mid 2010) that focused on the question "How does PBL work?" The second wave of PBL research targeted at investigating the effects of implementation constituents, such as assessment formats or single versus curriculum wide implementations. The third wave (specialization: mid 2010 and onward) of PBL research focused on "How does PBL work in different specific contexts?" These research widened our perspectives by expanding our understanding of how PBL manifests itself in different contexts. Given the diversification of PBL and more hybrid PBL models, we suggest "Why does PBL with particular implementation characteristics for specific outcomes work or not work in the condition where it is implemented?" to be the question to answer in the next wave of PBL research.

The role of social network analysis as a learning analytics tool in online problem based learning

BACKGROUND

Social network analysis (SNA) might have an unexplored value in the study of interactions in technology-enhanced learning at large and in online (Problem Based Learning) PBL in particular. Using SNA to study students' positions in information exchange networks, communicational activities, and interactions, we can broaden our understanding of the process of PBL, evaluate the significance of each participant role and learn how interactions can affect academic performance. The aim of this study was to study how SNA visual and mathematical analysis can be sued to investigate online PBL, furthermore, to see if students' position and interaction parameters are associated with better performance.

METHODS

This study involved 135 students and 15 teachers in 15 PBL groups in the course of "growth and development" at Qassim University. The course uses blended PBL as the teaching method. All interaction data were extracted from the learning management system, analyzed with SNA visual and mathematical techniques on the individual student and group level, centrality measures were calculated, and participants' roles were mapped. Correlation among variables was performed using the non-parametric Spearman rank correlation test.

RESULTS

The course had 2620 online interactions, mostly from students to students (89%), students to teacher interactions were 4.9%, and teacher to student interactions were 6.15%. Results have shown that SNA visual analysis can precisely map each PBL group and the level of activity within the group as well as outline the interactions among group participants, identify the isolated and the active students (leaders and facilitators) and evaluate the role of the tutor. Statistical analysis has shown that students' level of activity (outdegree r_s(133) = 0.27, p = 0.01), interaction with tutors (r_s (133) = 0.22, p = 0.02) are positively correlated with academic performance.

CONCLUSIONS

Social network analysis is a practical method that can reliably monitor the interactions in an online PBL environment. Using SNA could reveal important information about the course, the group, and individual students. The insights generated by SNA may be useful in the context of learning analytics to help monitor students' activity.

Role of "Video Assisted Lecture" on Changing Albanian Undergraduate Students' Opinion Regarding Pain-free Dental Injections in Children

AIM

To evaluate the effectiveness of video assisted lecture in changing the opinions of dental students toward pain-free dental injections in children.

METHODS

The fifth-year students (n:62) of University of Medicine of Tirana, Faculty of Dental Medicine participated in the study. The study was conducted in two stages: first a Theoretical lecture (Stage 1), "Pain-free Local Analgesia Techniques in Children" was provided, and was followed by a second lecture supported by video recordings of real clinical cases (Stage 2). Students' opinions were evaluated by means of a short survey administered before the lectures, after the theoretical lecture, and after the video assisted lecture.

RESULTS

Before the study, only 47.9% of students believed in the possibility (agree and definitely agree) of pain-free local anesthesia in children, whereas after the study, the percentage had risen to 67.7% (p=0.0001). Baseline opinions of students changed significantly after the video-assisted lecture (p=0.0001). However, there is no statistical difference between mean scores of theoretical lecture (Stage 1) and video-assisted lecture (Stage 2).

CONCLUSIONS

Theoretical lecture (Stage 1) was found to be significantly effective in changing the opinions regarding "Pain-free dental injections in children," however, a video based dental education (Stage 2) was found to be relatively effective in supporting the change in dental students' opinion.

Using social network analysis to understand online Problem-Based Learning and predict performance

Social network analysis (SNA) may be of significant value in studying online collaborative learning. SNA can enhance our understanding of the collaborative process, predict the under-achievers by means of learning analytics, and uncover the role dynamics of learners and teachers alike. As such, it constitutes an obvious opportunity to improve learning, inform teachers and stakeholders. Besides, it can facilitate data-driven support services for students. This study included four courses at Qassim University. Online interaction data were collected and processed following a standard data mining technique. The SNA parameters relevant to knowledge sharing and construction were calculated on the individual and the group level. The analysis included quantitative network analysis and visualization, correlation tests as well as predictive and explanatory regression models. Our results showed a consistent moderate to strong positive correlation between performance, interaction parameters and students' centrality measures across all the studied courses, regardless of the subject matter. In each of the studied courses, students with stronger ties to prominent peers (better social capital) in small interactive and cohesive groups tended to do better. The results of correlation tests were confirmed using regression tests, which were validated using a next year dataset. Using SNA indicators, we were able to classify students according to achievement with high accuracy (93.3%). This demonstrates the possibility of using interaction data to predict underachievers with reasonable reliability, which is an obvious opportunity for intervention and support.

Top-Cited Articles in Problem-Based Learning: A Bibliometric Analysis and Quality of Evidence Assessment

The aims of this study were to identify characteristics of the top-cited articles in problem-based learning (PBL) and assess the quality of evidence provided by these articles. The most frequently cited articles on PBL were searched in April 2015 in the Science Citation Index Expanded database (List A) and Google Scholar database (List B). Eligible articles identified were reviewed for key characteristics. The Oxford Centre for Evidence-Based Medicine guidelines were used in assessing the level of evidence. The number of citations varied (62 to 923 on List A and 218 to 2,859 on List B). Countries that contributed the majority of articles in both lists were the United States, Netherlands, United Kingdom, and Canada. No significant correlations were found between number of citations and number of years since published (p=0.451), number of authors (p=0.144), females in authorship (p=0.189), non-medical authors (p=0.869), number of institutions (p=0.452), and number of grants (p=0.143), but a strong correlation was found with number of countries involved (p=0.007). Application of the Oxford hierarchy of evidence showed that 36 articles were at levels 4 and 5 of evidence. This study found that research articles represented approximately one-third of PBL articles assessed and reported mainly on questionnaire-based studies. The most highly cited articles occupied top-ranking positions in the journals in which they were published. The lower level of evidence observed in most top-cited articles may reflect the significance of innovative ideas or content of these articles. These findings have implications for dental educators and dental researchers.

Differential impact of student behaviours on group interaction and collaborative learning: medical students' and tutors' perspectives

BACKGROUND

Collaboration is of increasing importance in medical education and medical practice. Students' and tutors' perceptions about small group learning are valuable to inform the development of strategies to promote group dynamics and collaborative learning. This study investigated medical students' and tutors' views on competencies and behaviours which promote effective learning and interaction in small group settings.

METHODS

This study was conducted at UNSW Australia. Five focus group discussions were conducted with first and second year medical students and eight small group tutors were interviewed. Data were transcribed verbatim and thematic analysis was conducted.

RESULTS

Students and tutors identified a range of behaviours that influenced collaborative learning. The main themes that emerged included: respectfulness; dominance, strong opinions and openness; constructiveness of feedback; active listening and contribution; goal orientation; acceptance of roles and responsibilities; engagement and enthusiasm; preparedness; self- awareness and positive personal attributes. An important finding was that some of these student behaviours were found to have a differential impact on group interaction compared with collaborative learning. This information could be used to promote higher quality learning in small groups.

CONCLUSION

This study has identified medical students' and tutors' perceptions regarding interactional behaviours in small groups, as well as behaviours which lead to more effective learning in those settings. This information could be used to promote learning in small groups.

Problem-based learning: Dental student's perception of their education environments at Qassim University

Aims:

The objectives of this study were to assess perceptions of the Saudi dental students of the problem-based learning (PBL) curriculum and to compare their perceptions among different sex and academic years.

Subjects and Methods:

Data was collected through a questionnaire-based survey at Qassim College of dentistry. The questionnaire consisted of 19 questions regarding the perception of PBL curriculum and was distributed to 240 students. The chi-square test was used for statistical analysis of the data.

Results:

Out of the 240 students recruited for this study, 146 returned a complete questionnaire (the response rate was 60.8%). The majority of the students perceived that PBL enhances the ability to speak in front of people (91.1%); improved the ability to find the information using the internet/library (81.5%); enhances the problem-solving skills (71.3%); increases the practice of cooperative and collaborative learning (69.2%); improves the decision-making skills (66.4%). Sixty-five percent (n = 96) noted that some students dominate whereas others are passive during PBL discussion session. Statistically, significant differences were found in the following variables according to the academic year students assuming before responsibility for their own learning (P < 0.037) and the role of facilitator in the process (P < 0.034). Moreover, according to gender; there were statistically significant differences in the following variables, assuming responsibility for own learning (P < 0.003); activating prior knowledge and learning to elaborate and organize their knowledge (P < 0.009); enhancing the ability to find the information using the Internet/library (P < 0.014); PBL is effective without having lecture of the same topic (P < 0.025); helping in identifying the areas of weakness for improvement (P < 0.031); student understanding the objectives of the PBL session better than the conventional way (P < 0.040); and enhancing the ability to speak in front of people (P < 0.040).

Conclusions:

Perceptions of Saudi dental students regarding their education environments at Qassim College of dentistry using PBL hybrid curriculum were more positive than negative. However, improvements are still required to provide students with stimulating favorable learning environment and to take the students recommendations into consideration.

Improving competencies in evidence-based dementia care: Results from a pilot study on a novel inter-professional training course (the KOMPIDEM project)

OBJECTIVE

In order to address well-known challenges in dementia care, an inter-professional course was developed to improve medical students' and nursing students' competencies in the provision of evidence-based care for people with dementia. The course comprises lectures, problem-based learning (PbL) tutorials and visitations to care facilities. A pilot study was conducted to evaluate the acceptance and feasibility of the inter-professional course.

METHODOLOGY

Alongside preliminary implementation of the newly developed course, a pre-post survey was carried out involving all participating students. The questionnaire contained standardized and open-ended questions on participants' views regarding the quality and relevance of several course components and characteristics. The data were analyzed by means of descriptive statistics.

RESULTS

When the course was offered the first time, multiple barriers became evident, leading to premature course termination and subsequent revision of the curriculum. When the revised course was offered, 10 medical students and 8 nursing students participated. The course proved feasible, and the median overall quality was rated as "2" (IQR 2-3) at a rating scale ranging from 1 (very good) to 6 (inadequate). Following aspects were most frequently judged positively: the course's inter-professional scope, the visitations to care facilities and the PbL tutorials. Potential for improvement was particularly noted with regard to a more distinct focus on well-defined, mainly practical learning outcomes. There were no indications of systematic between-group differences in the medical and nursing students' perceptions of the course program.

CONCLUSIONS

The results confirmed the feasibility of the inter-professional course on dementia care and the relevance of its inter-professional scope. However, to ensure sustainable course implementation in the long term, further program adaptations based on current findings and further evaluation studies focusing on objective parameters of the process and outcome quality are required.

What are the most important tasks of tutors during the tutorials in hybrid problem-based learning curricula?

BACKGROUND

In problem-based learning, a tutor, the quality of the problems and group functioning play a central role in stimulating student learning. This study is conducted in a hybrid medical curriculum where problem-based learning is one of the pedagogical approaches. The aim of this study was to examine which tutor tasks are the most important during the tutorial sessions and thus should be promoted in hybrid (and in maybe all) problem-based learning curricula in higher education.

METHODS

A student (N = 333) questionnaire was used to obtain data about the problem-based learning process, combined with the achievement score of the students on a multiple-choice exam. Structural equation modeling was used to test the fit of different models (two existing models and a new simplified model) representing the factors of interest and their relationships, in order to determine which tutor characteristics are the most important in the present study.

RESULTS

A new simplified model is presented, which demonstrates that stimulation of active and self-directed learning by tutors enhances the perceived case quality and the perceived group functioning. There was no significant effect between the stimulation of collaborative learning and perceived group functioning. In addition, group functioning was not a significant predictor for achievement.

CONCLUSIONS

We found that stimulating active and self-directed learning are perceived as tutors' most important tasks with regard to perceived case quality and group functioning. It is necessary to train and teach tutors how they can stimulate active and self-directed learning by students.