Problem-based learning and larger student groups: mutually exclusive or compatible concepts - a pilot study

Does your group matter? How group function impacts educational outcomes in problem-based learning: a scoping review

BACKGROUND

Problem-based learning (PBL) is a common instructional method in undergraduate health professions training. Group interactions with and within PBL curricula may influence learning outcomes, yet few studies have synthesized the existing evidence. This scoping review summarized the literature examining the influence of group function on individual student PBL outcomes. Following Kirkpatrick's framework, experiential, academic, and behavioral outcomes were considered. The impacts of three aspects of group function were explored: (1) Group Composition (identities and diversity), (2) Group Processes (conduct and climate, motivation and confidence, and facilitation), and (3) PBL Processes (tutorial activities).

METHODS

A literature search was conducted using Medline, CINAHL, and APA PsychInfo from 1980-2021, with the help of a librarian. English-language empirical studies and reviews that related group function to learning outcome, as defined, in undergraduate health professions PBL curricula were included. Relevant references from included articles were also added if eligibility criteria were met. The methods, results, discussions, and limitations of the sample were summarized narratively.

RESULTS

The final sample (n = 48) varied greatly in context, design, and results. Most studies examined junior medical students (n = 32), used questionnaires for data collection (n = 29), and reported immediate cross-sectional outcomes (n = 34). Group Processes was the most frequently examined aspect of group function (n = 29), followed by Group Composition (n = 26) and PBL Processes (n = 12). The relationships between group function and outcomes were not consistent across studies. PBL experiences were generally highly rated, but favorable student experiences were not reliable indicators of better academic or behavioral outcomes. Conversely, problematic group behaviors were not predictors of poorer grades. Common confounders of outcome measurements included exam pressure and self-study.

CONCLUSIONS

The main findings of the review suggested that (1) group function is more predictive of experiential than academic or behavioral PBL outcomes, and (2) different Kirkpatrick levels of outcomes are not highly correlated to each other. More research is needed to understand the complexity of group function in PBL tutorials under variable study contexts and better inform curricular training and design. Standardized tools for measuring PBL group function may be required for more conclusive findings.

Assessing the Effectiveness of Problem-Based Learning as a New Approach on Health Care Provider Ethical Reasoning Development in Shiraz University of Medical Sciences

Problem-based learning (PBL) has become a distinct approach in learning. To assess the effectiveness of PBL in teaching ethics to medical students and the effect it has on their ethical reasoning, we decided to hold a PBL ethics workshop and then evaluate them based on pretest and posttest. This quasi-experimental comparative study in Shiraz University of Medical Sciences was designed based on pretest-posttest nonequivalent groups. After obtaining their consent, 120 health care providers were randomly selected and assigned in 4 groups and then asked to attend the ethics workshop. For measuring the participants' ethical reasoning through pretesting and posttesting, a case study consisting of 21 multiple-choice questions (cognitive domain-apply level) was performed. Data were then collected using a questionnaire, which was completed by the participants and analyzed using SPSS software (version 17). The comparison between the participants' attitude and knowledge toward ethics before and after the workshop revealed that all indices in the cognitive domain were changed (P < .001). The scores of pretest and posttest were significantly different. As to the results of our study, the PBL groups showed a more positive learning attitude and higher motivation in comparison with the control group who were subjected to traditional-based method of learning. The result of our study suggests that PBL can and should be used as an alternative method in teaching ethics in medical students because it is more effective and motivates the students.

Comparing alternate learning pathways within a problem-based learning speech-language pathology curriculum

PURPOSE

This qualitative study investigated the learning process for speech-language pathology (SLP) students engaging in a problem-based learning (PBL) curriculum and compared the perspectives of students from two pathways.

METHOD

Sixteen final-year SLP students participated in one of four focus groups. Half the participants entered the course directly via an undergraduate pathway and the other half entered via a graduate entry pathway. Each focus group comprised two students from each pathway. Data were generated via a semi-structured interview and analysed thematically.

RESULT

Regardless of participants' pathway, many similar themes about factors that influenced their expectations prior to PBL commencing as well as their actual PBL experiences were raised. Participants believed that PBL was a productive way to learn and to develop clinical competencies. Many were critical of variations in PBL facilitation styles and were sensitive to changes in facilitators. The majority of participants viewed experiential opportunities to engage in PBL prior to commencement of semester as advantageous.

CONCLUSION

Combining students with different backgrounds has many advantages to the PBL learning process. Regardless of prior experiences, all students must be sufficiently prepared. Furthermore, the facilitator has a crucial role with the potential to optimise or detract from the learning experience.

Problem-based learning (PBL) and speech-language pathology: a tutorial

The aim of this tutorial is to provide an introduction to problem-based learning (PBL), particularly as applied to speech-language pathology (SLP) programs. The tutorial is aimed at the reader who is less familiar with this learning approach. Additionally, it serves as a framework for the articles that follow in this special issue on PBL programs in SLP and other clinical education programs. A brief history of PBL is provided and the rationale and context for this approach are identified. PBL is defined and differentiated from related educational approaches. Different models and variations of PBL are outlined. The key components of PBL are further illustrated using the tutorial cycle. Finally, we present one specific case of a PBL-based SLP program in detail. This tutorial will provide a deeper understanding of PBL for many higher educators in SLP. The strengths of this approach are outlined and the challenges are identified, particularly for those contemplating converting an existing "traditional" course or curriculum.

Comparison of tutored group with tutorless group in problem-based mixed learning sessions: a randomized cross-matched study

BACKGROUND

Problem-based learning (PBL) involves discussions among students who resolve loosely-structured problems to facilitate learning. In the PBL curriculum, faculty tutors are employed as facilitators for small groups of students. Because of lack of time and staff shortage, the effectiveness of tutorless PBL has been discussed as an alternate option.

METHODS

Sessions in which tutored and tutorless PBL groups are mixed were presented by 1st-year medical students, who experienced both tutored and tutorless groups alternately in the two sessions of a year. To examine the effectiveness of tutored and tutorless PBL, written examination scores (WES) and self-contentment scores (SCS) were statistically analysed.

RESULTS

WES averages did not significantly differ between the tutored and tutorless groups; however, a significantly greater variation was observed in WES in the tutorless group. SCS averages tended to be higher in the tutored PBL than in tutorless PBL groups.

CONCLUSIONS

Students in these tutorless PBL groups performed well in their written examinations, whereas those in the tutored PBL groups, achieved this and reported better self-contentment with their learning experience. Tutorless PBL sessions were considered to be comparable to tutored PBL sessions at least in the early stages.

Feedback on and knowledge, attitude, and skills at the end of pharmacology practical sessions

Concern has been raised about inadequate pharmacology teaching in medical schools and the high incidence of prescribing errors by doctors in training. Modifications in pharmacology teaching have been carried out in many countries. The present study was carried out using a semi-structured questionnaire to obtain students' perceptions of their knowledge, attitudes, and skills with regard to different subject areas related to rational prescribing at the end of two-year activity-based pharmacology practical learning sessions in a private medical school in Nepal. The effectiveness of the sessions and strengths and suggestions to further improve the sessions were also obtained. The median total knowledge, attitude, skills and overall scores were calculated and compared among different subgroups of respondents. The median effectiveness score was also calculated. Eighty of the 100 students participated; 37 were male and 43 female. The median knowledge, attitude, and skills scores were 24, 39, and 23, respectively (maximum scores being 27, 45, and 36). The median total score was 86 (maximum score being 108). The effectiveness score for most subject areas was 3 (maximum 4). The strengths were the activity-based nature of the session, use of videos and role-plays, and repeated practice. Students wanted more sessions and practice in certain areas. They also wanted more resources and an internet connection in the practical room. The skills scores were relatively low. The immediate impact of the sessions was positive. Studies may be needed to assess the long term impact. Similar programs should be considered in other medical schools in Nepal and other developing countries.

Application of problem-based learning in a large class in stomatology course

PURPOSE

To determine the feasibility of implementing problem-based learning (PBL) in a large class and whether previous PBL experience is necessary.

MATERIALS AND METHODS

A total of 236 students from 2 large classes at China Medical University were enrolled. One class (118 students) had had a previous small-group PBL experience and another class (113 students) had not. Each class was subdivided into 15 groups (7 to 8 students/group) and took 2 separate 100-minute PBL sessions per week with the same teaching faculty. Each PBL class had 2 facilitators, 1 content expert facilitator, and 1 nonexpert facilitator. The results of the theoretical examination and case analysis examinations were analyzed using the t test. Questionnaires were used to evaluate both student and facilitator perceptions.

RESULTS

The feedback from both students and facilitators was positive. According to the questionnaires, both experienced and non-experienced students acknowledged that the teaching method was enjoyable and functional. The test results showed students had achieved the learning objectives. The results of the theoretical and case analysis examinations showed no significant difference between the PBL experienced class and the non-experienced class. The mean study hours spent weekly by the students after class on the course were about 6.3 +/- 1.1 hours for the non-experienced students and 4.7 +/- 0.981 hours for the experienced students (t = 11.94, P < .001). The non-experienced students showed more preference for the content expert tutor.

CONCLUSION

Implementing PBL in a large class is feasible without extracting great demand on limited educational resources. Previous PBL experience is helpful but not necessary.

The financial costs of delivering problem-based learning in a new, graduate-entry medical programme

CONTEXT

In discussions of the merits and limitations of problem-based learning (PBL) as an educational methodology, the cost of its delivery is often cited as a significant issue. Although there appears to be no shortage of opinion as to the perceived cost of PBL, we know of no institution that has accurately measured its cost, even in financial terms. Where factual information is lacking, opinion and misconception tend to proliferate. In setting up a new, graduate-entry medical programme on a greenfield site at the University of Limerick, we took the opportunity to calculate both the initial and recurring costs of our particular approach to the delivery of PBL.

METHODS

We calculated the initial cost of providing purpose-built facilities to deliver PBL to 240 students in the first 2 years of our 4-year programme. We also calculated the annual recurring costs of delivering PBL, based on having a student : tutor ratio of 8 : 1 and on having tutors who are all medically qualified, who are reasonably well remunerated for their work and who each deliver 5 hours of PBL tutoring per week.

RESULTS

The initial cost of delivering PBL was calculated as euro 1,526,952 (equivalent to pound sterling 1,369,138 or US$2,050,375). The annual recurring cost of PBL approximates euro 664,000/year (at time of writing equivalent to pound sterling 527,000 and US$988,000). This recurring cost equates to euro 2767/student/year, 89% of which relates to tutor salaries.

CONCLUSIONS

Although the cost of delivering PBL will be greatly influenced by the approach taken at different institutions, we hope that a breakdown of costs at our institution will contribute to the ongoing debate on the strengths and weaknesses of PBL.