Verbal and nonverbal indices of learning during problem-based learning (PBL) among first year medical students and the threshold for tutor intervention

Does prior knowledge affect interaction dynamics and learning achievement in digital problem-based learning? A pilot study

Objective

Previous research on problem-based learning (PBL) describes that videotaped observations develop meaningful insights into cognitive processes in tutorial groups. Analysis regarding the amount of prior knowledge on learning achievement has not been investigated in medical education so far, although both are key factors of PBL success. Thus, we intended to analyse videos of digital problem-based learning (dPBL) sessions, focusing on knowledge acquisition and interaction dynamics among groups with different levels of prior knowledge to reveal any distinctions.

Methods

This study employed a pilot design by dividing 60 dental students into twelve subgroups with less or more prior knowledge, determined by a pre-semester multiple choice test (MCQ). The groups engaged in videotaped dPBL cases, which were examined regarding group interactions and tutor effectiveness. The learning achievement was assessed through a post-semester MCQ, an oral and practical exam.

Results

The video analysis showed that dPBL groups with less prior knowledge achieved significantly higher tutor effectiveness and group interaction utterances, but that the percentage of time in which utterances occurred was similar in both groups. Related to the MCQ results, the students with less prior knowledge learned four times more than those with profound previous abilities, but no significant difference was found in the results of the oral exam and practical exam.

Conclusions

The interaction dynamics in dPBL depend on the group's amount of prior knowledge. Especially groups including participants with less prior knowledge seemed to benefit from dPBL in comparison to groups with more prior knowledge. The dPBL groups acquired knowledge in different ways during the courses but, finally, all students arrived at a similar level of knowledge.

When and how teachers intervene in group discussions on experiences from practice in postgraduate medical education: an interactional analysis

Medical educators constantly make decisions on when and how to intervene. Current literature provides general suggestions about types of teacher interventions. Our study aims to specify that knowledge by describing in detail the actions teachers do when intervening, the interactional consequences of those actions, and how these relate to teacher roles in group discussions. We collected all first teacher interventions (n = 142) in 41 videorecorded group discussions on experiences from practice at the Dutch postgraduate training for General Practice. We analyzed the interventions using Conversation Analysis. First, we described the timing, manner, actions, and interactional consequences of each intervention. Next, we inductively categorized actions into types of actions. Finally, we analyzed the distribution of these types of actions over the group discussion phases (telling, exploration, discussion, conclusion). First teacher interventions were done at observably critical moments. Actions done by these interventions could be categorized as moderating, expert, and evaluating actions. Moderating actions, commonly done during the telling and exploration phase, are least directive. Expert and evaluator actions, more common in the discussion phase, are normative and thus more directive. The placement and form of the actions done by teachers, as well as their accounts for doing those, may hint at a teacher orientation to intervene as late as possible. Since the interventions are occasioned by prior interaction and responded to in different ways by residents, they are a collaborative interactional accomplishment. Our detailed description of how, when and with what effect teachers intervene provides authentic material for teacher training.

Design and Validation of the Non-Verbal Immediacy Scale (NVIS) for the Evaluation of Non-Verbal Language in University Professors

Knowledge and awareness of how to use non-verbal language is essential for the educational field. For this reason, the aim of this study was to develop a validation that validly and reliably measures the analysis of non-verbal language in university teachers. Content validation was carried out by applying the Delphi technique and through an exploratory and confirmatory analysis. The validity of understanding is given by the application of the scale to 1316 university teachers between 24 and 67 years of age. The initial data collected through the Delphi technique provided some modifications. The final scale, called Non-verbal immediacy, was composed of a total of 26 items that presented satisfactory adjustments in both comprehension and outcome validity. Confirmatory factor analysis determined three dimensions (kinesics, paralanguage, and proxemics). These factors will be a new element for future lines of research related to the teaching-learning process, as high relationships have been demonstrated between non-verbal language and psychosocial aspects implicit in teaching practice, as well as comprehension and student learning.

Transforming a cookbook undergraduate microbiology laboratory to inquiry based using a semester-long PBL case study

Microbial physiology is a basic course taught throughout biomedical science disciplines. Students study the structure, growth, and metabolism of microorganisms and often find it difficult to learn the information, usually because they fail to see the wider applications. The current microbiology laboratory series describes how to transform a "cookbook" undergraduate laboratory to an inquiry-based one by incorporating problem-based learning. The students use a food poisoning case study that develops over a series of seven experiments and take on the role of the microbiology technician who is responsible for coming up with the answer and submitting a report to a clinician. The case provides coherence to the sessions, and the students are given the opportunity to learn about, and practice, common techniques they would encounter in a clinical microbiology laboratory. Those include the aseptic method, cultivation of bacteria, quantification of bacteria in culture, isolation of pure culture, morphological observation by light microscopy, Gram staining, the use of selective and differential media, and the effectiveness of a variety of antimicrobials and antibiotics. This laboratory series has been designed so that it can be implemented in any setting, using simple materials and inexpensive, nonspecialized equipment. The experiments are carried out in small groups, and a facilitator may tutor up to two groups of 10 students at a time. The current method has been successfully implemented for the past 2 yr, and the students demonstrated greater motivation in learning and understanding.

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

INTRODUCTION

This review aimed at identifying studies on group interaction in problem-based learning (PBL) and elucidate methods used, factors affecting group interaction and the relationship between interaction and student's learning.

MATERIALS AND METHODS

PubMed, EMBASE, PsycINFO and HighWire were searched (January 1999 to June 2013) using a combination of pre-specified search terms. The search words were also used in searching nine journals in dental and medical education. Also edited research books on PBL were searched. Both qualitative and descriptive studies of group interaction were selected and critically appraised.

RESULTS

Finally, 42 of 10,606 papers were included (35 journal articles and seven from research books). The materials used in assessing group interaction varied depending on the methodology design. Forty-three percent of the studies used video recording to evaluate group interaction. Other studies used indirect approaches such as focus groups, interviews and questionnaires. Factors affecting group interactions were students' and tutors' perceptions, tutor's subject-matter expertise, training students, tutor's group dynamics. There was no conclusive evidence about the impact of interaction in PBL on learning. Most studies were from medicine (64%), and 35 papers were published in the last 10 years. The majority of studies were conducted in Europe, North America and Asia.

CONCLUSIONS

Although there is a progressive increase in publications on PBL group interaction during the last 10 years, there are knowledge gaps and deficiencies in this area and most studies are lacking solid theoretical basis and are descriptive. There is a deficiency in the literature in this area from dentistry and other allied health disciplines.

How do tutors intervene when conflicts on knowledge arise in tutorial groups?

Recent research on problem-based learning (PBL) has shown that students need support when dealing with conflicting ideas in PBL-tutorial discussions. In the present study, we examined tutor facilitation during tutorial discussions, and particularly how the facilitation helped students to collaboratively resolve conflicts on knowledge. The study involved four PBL-tutorial sessions that included altogether 33 first-year medical and dental students. The sessions were videotaped and analysed using qualitative interaction analysis. Our aim was to find out how the tutor interventions encouraged students to elaborate on conflicting ideas, and how the interventions differed between conflict and non-conflict situations. We also examined how the tutors intervened during conflicts about factual or conceptual knowledge. The tutorial discussions included 92 tutor intervention episodes and 43 conflict episodes. The tutors intervened during 24 of the conflict episodes and resolved 13 of these episodes. Generally, the tutors often intervened by confirming what the students had said or by giving explanations, but they rarely asked questions that would stimulate the elaboration of knowledge. During conflicts on knowledge the tutors gave more explanations, but did little to encourage the students to deal with conflicting ideas. The tutors more often resolved conflicts on factual knowledge than conceptual knowledge. The findings suggest that tutor training should focus on promoting tutors' understanding on when to give direct explanations, and when and how to encourage students to collaboratively elaborate on conflicting ideas.

How experienced tutors facilitate tutorial dynamics in PBL groups

BACKGROUND

Problem-based learning (PBL) tutorial are conducted in small groups, and successful learning in such groups requires good group facilitating skills. There is a lack of research on actual skills employed by tutors in facilitating the group dynamics.

AIM

To explore the process of PBL tutorial small groups, focusing on the tutors' actual behavior in facilitating group dynamics.

METHODS

Eight experienced tutors from various departments in medical colleges participated in this research. Forty tutorial group sessions were videotaped. Among the 636 tutorial intervention episodes, 142 of them were associated with facilitating group dynamics. Tutors interventions as well as their recalls were transcribed verbatim. Qualitative research methods were utilized to analyze the data.

RESULTS

There were 10 tutorial group dynamic situations and 48 tutorial skills. Analysis of the tutors' intentions employing these skills in the 10 situations showed that tutors were trying to achieve the following aims: (1) iteration of PBL principles, (2) delegation of responsibility to the students, (3) creation of a good discussion forum, and (4) the generation of a good learning atmosphere.

CONCLUSION

Results from this study provide PBL tutors with a practical frame of reference on group dynamic facilitating skills and stimulate further research on this topic.

The process of problem-based learning: what works and why

OBJECTIVES

In this review, we portray the process of problem-based learning (PBL) as a cognitive endeavour whereby the learner constructs mental models relevant to problems. Two hypotheses are proposed to explain how learning is driven in PBL; an activation-elaboration hypothesis and a situational interest hypothesis.

METHODS

Research relevant to these hypotheses is discussed. In addition, research studying the effects of various support strategies used in PBL is reviewed. Finally, we summarise a number of recent studies in which a new 'micro-analytical' methodology was used to trace the process of PBL in the natural classroom setting.

CONCLUSIONS

We conclude that there is considerable support for the idea that PBL works because it encourages the activation of prior knowledge in the small-group setting and provides opportunities for elaboration on that knowledge. These activities facilitate the comprehension of new information related to the problem and enhance its long-term memorability. In addition, there is evidence that problems arouse situational interest that drives learning. Flexible scaffolding provided by cognitively and socially congruent tutors also seems to be reasonably effective, as opposed to 'hard' scaffolding represented by, for instance, worksheets or questions added to problems. Small-group work protects against dropout and encourages students to study regularly. Initially, students do not study much beyond the learning issues generated; the development of personal agency in self-study needs time to develop. The extent of learning in PBL results from neither group collaboration only (the social constructivist point of view) nor individual knowledge acquisition only; both activities contribute equally to learning in PBL.