Learning outcomes and tutoring in problem based-learning: how do undergraduate medical students perceive them?

Perceptions of radiography students toward problem-based learning almost two decades after its introduction at Makerere University, Uganda

Introduction

Problem-based learning (PBL) has been reported to be a valuable student-centred learning approach across the globe. In PBL students first encounter a problem, which triggers discussion, followed by student-centred inquiry. Makerere University College of Health Sciences has been using PBL for radiography students since 2002. Over the years, the learning landscape may have changed, including the significant disruption of learning by the coronavirus disease 2019 global pandemic. The study aimed at exploring the perceptions of undergraduate radiography students about the PBL curriculum at Makerere University almost two decades after its introduction.

Methods

This exploratory qualitative study involved 18 radiography students sampled purposively, from whom data were gathered using focus group discussions. Thematic analysis was subsequently used.

Results

Three key themes emerged from the data: (1) quality of teaching, (2) curriculum efficiency, and (3) curriculum expectations and rating. All students were generally positive about the curriculum. Most agreed that the curriculum was efficient to a greater extent and had met their expectations and desired objectives. Students, however, faced challenges; for example, with limited learning resources during the learning process.

Conclusion

This study highlights the significant role of PBL in enhancing student's problem-solving, critical thinking, literature search, and, most of all, their practical skills. Prioritization of teaching based on practical relevance and learning objectives is of great importance. The radiography students believed that their curriculum program was generally beneficial to them; however, it was affected by limited resources and limited availability of teaching personnel, which needs to be addressed.

Attitude and perception of undergraduate medical students toward the problem-based learning in Chitwan Medical College, Nepal

BACKGROUND

Problem-based learning (PBL) was introduced into Basic Medical Sciences early in the 1980s at Tribhuvan University (TU), Nepal, followed by other universities where didactic lecture method was still followed as the main teaching strategy. Despite gaining its popularity worldwide as integrated teaching learning method, PBL is not given importance in Nepal. This study aimed to assess the attitude and perceptions of undergraduate medical students regarding learning outcomes of PBL and to know their views about role and qualities of effective tutors for its successful implementation.

METHODS

This descriptive study was based on a self-administered questionnaire. The first part of the questionnaire measured students' perception and attitude toward benefits of PBL and the second part measured students' perception about role of PBL tutor. Bachelor of Medicine and Bachelor of Surgery (MBBS) first year (2014/2015 academic year) students at Chitwan Medical College, TU, were asked to express their opinions about the importance of learning outcomes by rating each statement on a five-point Likert scale and the responses were combined into three categorical variables: "agree" (strongly agree plus agree), "neutral", and "disagree" (strongly disagree plus disagree). Data were analyzed using SPSS version 21.0.

RESULTS

Approximately 85.5% participants agreed that PBL is an interesting method of teaching learning. Most of them (86.7%) accepted that PBL is an interactive and a mutual learning method and improves self-directed learning (83.2%). Although 78% had recommended it better than lecture, many (54.2%) pointed it out as a time-consuming method. The participants were also highly rated (80.5%) to the statement - the tutor's role in enhancing the constructive active learning and maintaining good intra-personal behavior.

CONCLUSION

Student's attitude toward PBL was positive. They highly appreciated the roles of a tutor as facilitators and motivators for proper activities in PBL session. PBL sessions were considered effective in improving students professional knowledge and refining problem-solving and self-directed learning skills along with enriching teamwork experience.

Kakovost problemov, obravnavanih pri problemskem učenju: ocena študentov zdravstvene nege

Uvod: Z vpeljavo problemskega učenja se je spremenil kontekst učenja. Z uporabo kakovostnih problemov v okviru problemskega učenja se spodbuja kritično mišljenje, skupinske interakcije, uporaba teorije v praksi. Namen raziskave je bil ugotoviti oceno študentov zdravstvene nege glede kakovosti problemov, obravnavanih v okviru problemskega učenja. Metode: Uporabljeno je bilo kvantitativno neeksperimentalno raziskovanje, podatki so bili zbrani s tehniko anketiranja. V raziskavi je sodelovalo 196 študentov zdravstvene nege. Za obdelavo podatkov je bila uporabljena deskriptivna statistika, t-test in korelacijska analiza. Statistično značilnost smo preverjali na ravni 5% tveganja. Rezultati: Povprečne ocene vseh trditev, ki so se nanašale na oceno kakovosti problemov, obravnavanih v okviru problemskega učenja, so bile visoke ( > 4 od 5). Glede na način študija zdravstvene nege (redni, izredni študij) (t = –1,333, p = 0,558) in spol (t = 0,236, p = 0,354) ne prihaja do razlik v oceni kakovosti obravnavanih problemov. Ugotovljene so bile razlike v oceni kakovosti obravnavanih problemov glede na zaposlenost v zdravstvu (t = 2,109, p = 0,04) ter pozitivna šibka povezanost (r = 0,190, p = 0,002) med starostjo in oceno kakovosti obravnavanih problemov. Diskusija in zaključek: Raziskava pokaže visoko oceno kakovosti problemov, obravnavanih v okviru problemskega učenja, s čimer se pri študentih spodbuja samousmerjeno učenje, povečuje zanimanje za učno enoto in izboljšujejo motivacija za delo, komunikacijske spretnosti ter kritično razmišljanje. Nadaljnje raziskave bi bilo smiselno usmeriti v spremljanje vpliva problemskega učenja na učne izide ter uvedbo problemskega učenja v vse učne enote v okviru študija zdravstvene nege.

Problem-Based Learning as an Effective Learning Tool in Community Medicine: Initiative in a Private Medical College of a Developing Country

BACKGROUND

Knowledge of community medicine is essential for health care professionals to function as efficient primary health care physicians. Medical students learning Community Medicine as a subject are expected to be competent in critical thinking and generic skills so as to analyze community health problems better. However, current teaching by didactic lectures fails to develop these essential skills. Problem-based learning (PBL) could be an effective strategy in this respect. This study was hence done to compare the academic performance of students who were taught Community Medicine by the PBL method with that of students taught by traditional methods, to assess the generic skills of students taught in a PBL environment and to assess the perception of students toward PBL methodology.

MATERIALS AND METHODS

This study was conducted among seventh-semester final-year medical students between June and November 2014. PBL was introduced to a randomly chosen group of students, and their performance in an assessment exam at the end of postings was compared with that of the remaining students. Generic skills and perception toward PBL were also assessed using standardized questionnaires.

RESULTS

A total of 77 students took part in the brainstorming session of PBL. The correlation between self-assigned scores of the participants and those assigned by the tutor in the brainstorming session of PBL was significant (r = 0.266, P = 0.05). Out of 54 students who took part in the presentation session, almost all 53 (98.1%) had good perception toward PBL. Demotivational scores were found to be significantly higher among males (P = 0.024). The academic performance of students (P < 0.001) and success rates (P = 0.05) in the examination were higher among students who took part in PBL compared to controls.

CONCLUSION

PBL helped improve knowledge of students in comparison to those exposed only to didactic lectures. As PBL enabled students to identify the gaps in their knowledge and enhanced their group functioning and generic skills, we recommend PBL sessions: They would help optimize the training in Community Medicine at medical schools. Good correlation of tutor and self-assessment scores of participants in the brainstorming session suggests that the role of tutors could be restricted to assessment in presentation sessions alone. Demotivation, which hinders group performance in PBL, needs to be corrected by counselling and timely feedback by the tutors.

Perception of content and non-content expert facilitators of PBL according to students' performance levels

OBJECTIVE

Problem-based learning (PBL) is a student-centred learning system that involves multidisciplinary fields focused on problem solving. Facilitators of PBL are not necessarily content experts but little is known on how this concept has affected the outcomes of PBL sessions in learning Medical Biochemistry. We aimed to evaluate the impact of having the content expert as a facilitator in conducting PBL.

METHODS

A total of 150 first and second year medical students from the University Kebangsaan Malaysia were interviewed with a validated set of questions to acquire their views on the roles of facilitators in PBL in learning Medical Biochemistry. Their achievement were evaluated through their essay marks derived from various PBL packages.

RESULTS

All respondents agreed that PBL sessions associated with Medical Biochemistry are best appreciated when conducted by a content-expert facilitator. Their exam marks reflected well on their perception.

CONCLUSION

PBL sessions related to Medical Biochemistry is best facilitated by Biochemistry lecturers as the content experts.

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.

Students' perception towards the problem based learning tutorial session in a system-based hybrid curriculum

Objectives:

To evaluate students’ perception towards the problem based learning (PBL) session in a system-based hybrid curriculum.

Methods:

We conducted a cross-sectional study in the College of Medicine, King Saud University, Saudi Arabia at the end of the 2012-2013 academic year. The survey questionnaire was self-administered, and examined perceptions of PBL session benefits, appropriate running of sessions, and tutor’s roles.

Results:

Out of 510 students, 275 (53.9%) completed the questionnaire. Most of the students reported that PBL sessions were helpful in understanding basic sciences concepts (p=0.04). In addition, they agreed that PBL sessions increased their knowledge of basic sciences (p=0.01). Most students reported that PBL sessions encouraged self-directed learning, collaborative learning, and improved decision making skills. However, 54.5% of students reported lack of proper training before starting the PBL sessions, and only 25.1% of students agreed that the teaching staff are well prepared to run the sessions. Most students used the internet (93.1%), lecture notes (76.7%), and books (64.4%) as learning resources. Most students reported repetition of topics between PBL sessions and lectures (p=0.07).

Conclusion:

The study highlighted the significant role of PBL in a system-based hybrid curriculum and helped students improve their knowledge and different learning skills. Students and staff training is required before the utilizing the PBL as an instructional method.

Brazilian medical students' perceptions of expert versus non-expert facilitators in a (non) problem-based learning environment

BACKGROUND

In problem-based learning (PBL), the facilitator plays an important role in guiding the student learning process. However, although content expertise is generally regarded as a useful but non-essential prerequisite for effective PBL facilitation, the perceived importance of content knowledge may be subject to cultural, contextual, and/or experiential influences.

AIM

We sought to examine medical students' perceptions of subject-matter expertise among PBL facilitators in a region of the world (Brazil) where such active learning pedagogies are not widely used in university or pre-university settings.

RESULTS

Of the 252 Brazilian medical students surveyed, significantly (p≤0.001) greater proportions viewed content expert facilitators to be more effective than their non-expert counterparts at building knowledge (95% vs. 6%), guiding the learning process (93% vs. 7%), achieving cognitive learning (92% vs. 18%), generating learning goals (87% vs. 15%), and motivating self-study (80% vs. 15%).

DISCUSSION/CONCLUSION

According to Brazilian medical students, subject-matter expertise among PBL facilitators is essential to the learning process. We believe this widespread perception is due, in large part, to the relative lack of prior educational exposure to such pedagogies.

Student feedback on problem-based learning processes

BACKGROUND

Problem-based learning (PBL) sessions consist of a brainstorming phase, search phase, individual study, and reporting phase. At the Xavier University School of Medicine, Aruba, PBL is a new learning modality first introduced in May 2013.

AIMS

PBL processes have not been studied previously at the Xavier University School of Medicine, hence the present study was carried out to obtain information about the PBL processes and note differences, if any, among different groups of students.

METHOD

The study was conducted among first- to fourth-semester undergraduate medical students during July 2014 using a previously validated PBL processes instrument developed by van den Hurk et al. Information about gender, semester, weekly hours of study, and learning resources used was obtained. Respondents' agreement with a set of 23 statements was noted using a Likert-type scale, which was scored as 1=totally disagree with the statement, 2=disagree, 3=neutral, 4=agree, and 5=totally agree with the statement. Mean scores were compared among different groups of respondents.

RESULTS

Fifty-one of the 58 students (87.9 per cent) participated. The weekly average study time was 29.9 hours. Lecture handouts and textbooks were commonly used information sources. The mean scores (scale 1 to 5) for learning-issue-driven searching, and extensiveness of searching were 3.49 and 3.45, respectively. The score for explanation-oriented preparation was 3.94, while those for breadth and depth of discussion were 3.75 and 3.62, respectively. Most scores were higher among second-semester students, but the difference was not significant.

CONCLUSION

The self-reported scores were comparable to those reported in previous studies done using the same PBL processes instrument in other medical schools. At Xavier University School of Medicine interactive lectures are the major teaching method and topics covered during PBL are also likely to be covered during lectures, which could influence the scores. The findings of our study providing information about how students function during PBL brainstorming and presentation sessions and how they use different learning resources would be of interest to other medical schools worldwide following a hybrid curriculum. Further studies are required.