How a problem-based learning approach could help Japanese primary care physicians: a qualitative study

Problem-Based Learning in Medical Education: A Global Research Landscape of the Last Ten Years (2013-2022)

Background

Problem-based learning (PBL) constructs a curriculum that merges theory and practice by employing clinical scenarios or real-world problems. Originally designed for the pre-clinical phase of undergraduate medicine, PBL has since been integrated into diverse aspects of medical education. Therefore, this study aims to map the global scientific landscape related to PBL in medical education in the last ten years.

Methods

We combined bibliometrics and network analysis to analyze the metadata of related research articles published between 2013 and 2022 and indexed in the Web of Science Core Collection.

Results

Our results show an annual publication rate of 9.42%. The two main journals disseminating research on this subject are BMC Medical Education and Medical Teacher. Education & Educational Research and Health Care Sciences & Services are the two most frequent research areas, and also the two most central nodes of the related network. The USA and China are the most publishing countries, while the Netherlands and Canada are the most collaborative. The Maastricht University holds the position of most publishing and collaborative research organization. The University of California ranks second in publications, while the University of Toronto is the second most central research organization.

Conclusions

Our study provides an overview of the last ten years of publications related to PBL and medical education, and we hope it can be of interest to educators, researchers, and students involved with this subject.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-024-02003-1.

Experience of residents learning about social determinants of health and an assessment tool: Mixed-methods research

Background

Educating healthcare professionals about the social determinants of health is important in improving health outcomes of marginalized patients. Residents' experience of learning about the social determinants of health and a clinical assessment tool remains unclear.

Methods

Residents participated in an online session about the social determinants of health and the assessment tool. Using the New World Kirkpatrick Model, we obtained data about participants' experience from various perspectives. The data were analyzed using a concurrent triangulation mixed-methods design.

Results

The study included 20 out of 30 residents. Their response was good, and self-reported learning scores were increased by the session. They learned when to ask about patients' social conditions, what to ask, and how to coordinate medical care appropriately. Participants reported reflecting on their role as medical professionals and implementing new practices based on their learning, as well as concerns about addressing patients' social conditions.

Conclusion

Through learning about the social determinants of health, and assessment tools, residents both acquired knowledge and skills, and reflected on their previous practice, accepted patients as they are, understood difficult patients better, and developed interprofessional collaboration. Medical education about the social determinants of health can trigger changes in residents' views.

Use of a 2-year continuing professional development programme to change Japanese physicians' attitudes to learning primary care: a qualitative study

OBJECTIVE

To evaluate changes in the learning attitudes of primary care physicians.

DESIGN

Qualitative study through one focus group interview with the programme's participants. Analysis of the focus group content using the Steps for Coding and Theorization method.

SETTING

Japan.

PARTICIPANTS

Eight primary care physicians who completed a 2-year continuing professional development (CPD) programme using a problem-based learning (PBL) approach, focused on acquiring the skills needed to practise as primary care physicians in the community.

RESULTS

Participants described positive changes in their attitudes and behaviours as a result of the training programme. These changes were grouped into three main themes: 'changes in learning methods regarding medical practice', 'encounters with diverse perspectives and values, and confidence gained from those encounters', and 'showing one's attitude towards learning and its influence on others'. The experienced practitioners participating in this study reported that the programme helped them apply their skills more broadly; for example, searching the literature for psychosocial aspects of practice and engaging more comfortably with diverse perspectives. They reported the positive impact of their learning on their coworkers.

CONCLUSION

A 2-year CPD programme using PBL can influence primary care physicians' attitudes and learning-related behaviours. Further research is needed to determine which specific aspects of the programme are the most effective and whether the changes in attitudes and behaviours described affect patient care.

International trainer perceptions of simulation-based learning: a qualitative study

OBJECTIVES

 This study examined trainer perceptions of simulation-based learning for Continuing Professional Development in international settings.

METHODS

A qualitative research methodology was used to gain insight into trainer perceptions. Seventeen international physician trainers involved in simulation training in cardiovascular catheterization and intervention were interviewed. An inductive thematic analysis was performed following steps described by Braun and Clarke; researchers inductively approached, and then carefully dissected the transcripts into individual stories, grounded the problems, and explored themes.

RESULTS

Trainer perceptions are largely aligned with learning theories, even though they were not specifically educated in simulation-based learning and program design principles in advance. Trainers perceive their primary role as facilitators to be most important and consider structuring sessions, facilitating group learning, and stimulating reflection to be crucial themes in simulation-based learning. They believe that building trust is an underlying principle to function in their role and feel responsible for being prepared to improve trainee satisfaction as adult learners. Trainers believe that learning from making mistakes is an important mechanism in simulation-based learning, but they give less attention to giving feedback.

CONCLUSIONS

Trainers with basic training in facilitation skills in a classroom may unconsciously follow teacher-student instructional models with which they are familiar. This study confirms that trainers in simulation-based learning need pedagogical and facilitating skills to guide trainees and facilitate group processes. Educational training for trainers should include building trust and giving feedback in a more explicit place. In future studies, a mixed-method methodology is suggested to evaluate multi-layered complexities of educational practices.