Problem-based learning is a constructivist instructional strategy. One of the first and most commonly cited examples of problem-based learning was introduced in 1960s medical education in Canada. Problem-based learning approach suggests learning will be more effective if learners are faced with a real-life practical problem they need to solve and
In the 1960s at the McMaster University in Canada it was noted that medical education students were mostly bored during their classes, until they reached a stage where they were supposed to work with patients and try to help them solve their problems. It was then decided that biomedical problems, analyzed in small groups would be introduced into whole educational process, what remained a practice until today2) and has also spread to other medical schools as well as other fields like nursing, law, engineering, management, business administration and other3)4).
Although problem-based learning can be implemented on a variety of ways, its main characteristics are the following5):
A possible flow of a problem-based learning course expects the following tasks from the students:
Problem-based learning can be a helpful method in the educational process, but it can also be viewed as a total education strategy8).
Different experimental results have been obtained using problem-based learning, but generally showing not much difference in declarative knowledge in students learning through problem-based design and those using classical teaching methods. Still, there is evidence that problem-based learning supports development of reasoning skills, problem-solving skills and self-directed learning skills9).
An example of problem-based learning from an introductory course in psychology10):
| Instructional element | Problem-based learning activity |
|---|---|
| Presenting problem | A 15-year-old boy with asthma comes with his father to a clinic visit. The father wants his son tested for drugs because his behavior has changed over the past several months. The father wants a perfect son (like his older son) and doesn’t understand why his son is withdrawn and doing poorly in school. The son is initially sullen, resentful, with poor eye contact. The father is angry and feels that he has been treated poorly because he has HMO insurance. |
| Actual dilemma | The actual dilemma is to establish trust with the son. Specifically, to understand reasons for the son’s behavioral change and to ensure that the son returns for future visits. During the encounter, learners must convince the father to leave the room, to have an open conversation with the son. The son is quite upset that he can’t participate in sports, because he gets short of breath from uncontrolled asthma. His friends have changed because of this, and he feels isolated at school. Once the learner discusses confidentiality, the son reveals that he has tried drugs in the past, but he is not a frequent user. His father is domineering and judgmental. The son doesn’t want his father told about his sporadic drug use. “This is just between us, right?” |
| Time for session | Three hours per session. The SPs arrive about 30 minutes into the session. |
| Faculty training | 50 minutes before each session, plus faculty guide given a week before the session. |
| Student pre-session preparation | None. |
| Initial question to begin discussion | “Why is the patient here?” |
| Student approach | May interrupt, pose questions, provide answers/approaches to dilemmas that occur during the session. |
| Faculty approach to students’ incorrect knowledge or assumptions | Faculty will not interfere, and will allow the students to continue their discussion. Mistakes may be corrected by other students, but only if students recognize the mistake. Otherwise, the mistake or misperception will go undetected by the learners. |
| Faculty approach to “clinical blind-alley” digression | Does not interfere, and allows the students to continue their discussion, unencumbered by learning objectives. |
| Student use of additional resources during the session | The students generate questions during session. Students are given time to look up articles, Web sites, and references based on discussion by the group. |
| Student additional work after the session | The group assigns individuals homework assignments between sessions, because the same case will continue over several sessions. These PBL assignments would require obtaining information about the topic. These assignments would take about the same preparation time as the CBL student pre-session preparation for reading one to two articles. |
| Case continuity | The same case will continue over several consecutive sessions. For instance, a patient presents with abdominal bloating, is found to have a testicular and abdominal masses, is treated for a mixed germ cell tumor, and suffers multiple chemotherapy complications before recovering. In session 1, the students may discuss any number of issues around approaches to abdominal pain. In session 2, the students may discuss any number of issues around testicular cancer (breaking bad news, sexuality, prognosis). In session 3, students may discuss issues surrounding chemotherapy and clinical trials (informed consent, health status measurement, economic impact, stigmatization). |
Problem-based learning was addressed in criticisms of Kirschner et al.11) These criticisms mostly refer to cognitive load imposed by lack of guidance, possible frustration caused by lack of knowing what is important, what should be learned and where these information can be obtained. It also ignores the proved positive effects of worked examples12), can lead to false conclusions or time inefficiency13).
A reply to these criticisms was written by Schmidt et al.14) and Hmelo-Silver et al.15) suggesting positive characteristics/improvements to problem-based learning and compatibility of it with the human cognitive structure like:
Yet most of the proves for these thesis seem not convincing enough, the positive effect of worked examples is still ignored and even though some of the above statements could improve problem-based learning, they oppose the basic assumption that problem-based learning is self-directed16)17)18):
The Interdisciplinary Journal of Problem-based Learning (IJPBL).
International Problem-based Learning Symposium.
Schwartz, Peter. Problem-based learning: case studies, experience and practice. Routledge, 2001.
Savin-Baden, Maggi. A practical guide to problem-based learning online. Taylor & Francis, 2008.