Problem Based Learning
Introduction[edit | edit source]
Problem Based Learning (PBL) is a learner - centred pedagogical approach in which the person learns about a subject by working in groups to solve an open-ended problem. When looking at the literature, one may find various descriptions of PBL and variability in what people understand by this methodology.  In general terms, the problem is presented first rather than teaching relevant material and then having people apply the knowledge to solve a real-life problem. Learners must first examine the problem and explore what they already know about underlying issues related to it. Then, they need to identify knowledge gaps, sources of potential information and tools necessary to solve the problem. Evaluating possible ways to solve the problem is also an important step to the process. Finally, learners report on their findings and solutions.
For a brief introduction on PBL, you can watch this video: 
History of PBL[edit | edit source]
Identifying the best learning methods has always been of strong interest in education. As a result, in 1932, Edgar Dale proposed actions that would lead to deeper learning compared to traditional methods and published the a controversial paper named “Cone of Experience or Cone of Dale”.  Each level of the cone corresponded to different learning methods. At the apex of the cone were oral presentations (e.g. verbal descriptions, written descriptions, etc.) and at the base was direct experience (i.e. a person carrying out the activity that they aim to learn), reflecting the greatest depth of learning. In other words, the base represented the most effective participative methods (what we do and what we say) and the apex involved the least effective abstract methods (what we read and what we hear). 
A few decades later, psychologist George Miller proposed his own framework for assessing clinical competence.  In his pyramid, the lowest level reflected knowledge, followed by competence, execution and action. According to Miller's proposal, the learning curve passes through various levels, from the acquisition of theoretical knowledge to putting this knowledge into practice and demonstrating it. 
Various university education models have tried to integrate teaching with learning, according to the principle that students should lead their own learning process. In medicine, the PBL approach was initiated at McMaster University (Canada) in 1969, leaving aside the traditional methodology. Medical education in McMaster did not separate the basic sciences from the clinical sciences, and partially abandoned theoretical classes, which were taught after the presentation of the problem. 
Theoretical Basis of PBL[edit | edit source]
PBL relies on the process of discovery of knowledge, where there is not only a single correct answer but several possible options. Thus, the PBL model is based on the constructivist learning theory, where discovery learning and cultivation of thinking are more important than the accuracy of materials.  In the constructivist view of learning, meaningful learning occurs when people construct knowledge with the help of existing schemas and the viewpoints of others. Assessments used in a constructivist approach allow for diversity of answers best captured in a reflection, participation in discussion, or debate rather than the transmission of knowledge.
Learning Outcomes of PBL[edit | edit source]
Learning outcomes associated with PBL relate to the development of the following skills: 
- Self-directed learning
- Independent work
- Critical thinking and analysis
- Team work
- Project management
- Leadership in a team
- Improvement of oral and written communication
- Self-awareness and evaluation of group processes
- Explaining concepts
- Real-world application of knowledge
- Research and information literacy
- Problem solving across disciplines.
PBL and Health Education[edit | edit source]
PBL is a pedagogical approach that has been adopted in undergraduate and postgraduate studies of medical and other health professionals. A systematic review has argued for the use of PBL in developing student interpersonal and social skills whilst maintaining knowledge levels, clinical skills and reasoning.  Another systematic review concluded that PBL is effective in developing different competencies and is particularly useful in promoting early EBP. 
Despite not being universally widespread, PBL demonstrates a high level of satisfaction among students.  Compared to traditional lecture-based methods, PBL is more effective at improving social and communication skills, problem-solving and self-learning skills.  PBL and traditional methods did not demonstrate any difference on factual knowledge or clinical knowledge.   The only exception are simulation methods, where results for the acquisition of specific clinical skills are neutral  or superior. 
Nevertheless, there is limited research on the application of skills developed through PBL in clinical practice. A study on qualified physiotherapists with experience of placement supervision of students following a PBL physiotherapy undergraduate degree showed that proactive students applied transferable skills related to PBL to clinical practice, but variation of application of skills was noted.
Restrictions in human resources and continuous training for its implementation may limit its popularity in health educational settings.  Suprisingly, and despite its apparent difficulties on implementation, PBL curriculums have been successfully implemented in resource-constrained settings.  
PBL in the Digital Age[edit | edit source]
There are Digital Innovation Problem-Based Learning Open Educational Resources (PBL OERS) for Higher Education Institutions and Educators for effective innovation through digital tools within the service sector. Through their use, learners can have a more profound theoretical understanding of digital tools for innovation.
Resources[edit | edit source]
Design a Problem-Based Learning Experience - by Sanford Inspire
References[edit | edit source]
- Bodagh N, Bloomfield J, Birch P, Ricketts W. Problem-based learning: a review. Br J Hosp Med (Lond). 2017;78:C167–70.
- Yeo Kee Jiar Fp. Problem-based learning. Available from: https://www.youtube.com/watch?v=kWTMKtC-MIk [accessed 10/9/2023]
- Dale E. Methods for analyzing the content of motion pictures. J Educ Sociol. 1932;6:244–50.
- Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990;65(9 Suppl):S63–7.
- Trullàs JC, Blay C, Sarri E. Pujol R. Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review. BMC Medical Education 2022; (22): 104.
- Hendry G, Frommer M, Walker R. Constructivism and Problem‐based Learning. Journal of Further and Higher Education. 1999; 23(3):369-71.
- Trixy EJ, Benny T. A Theory of Learning Based on Constructivism and Problem Based Learning to Develop Higher Order Thinking Skills. IJRDO. 2018; 3(5): 41-51.
- Nilson LB. Teaching at its best: A research-based resource for college instructors (2nd ed.). San Francisco, CA: Jossey-Bass, 2010.
- Williams SM, Beattie HJ. Problem based learning in the clinical setting--a systematic review. Nurse Educ Today. 2008 Feb;28(2):146-54.
- Pathmanathan C, Maddumage S, Rajasinghe U. Problem based learning in Physiotherapy undergraduate curriculum: A systematic review. Research Square 2022 Sep 7. Available from: https://assets.researchsquare.com/files/rs-1817388/v1/cd73f6d4-2fd8-4047-8342-8f9eb6bf229b.pdf?c=1671537577 [accessed 5/12/2023]
- Vernon DT, Blake RL. Does problem-based learning work? A meta-analysis of evaluative research. Acad Med. 1993;68:550–63.
- Wenk M, Waurick R, Schotes D, Wenk M, Gerdes C, Van Aken H, Popping D. Simulation-based medical education is no better than problem-based discussions and induces misjudgment in self-assessment. Adv Health Sci Educ Theory Pract. 2009;14:159–71.
- Steadman RH, Coates WC, Huang YM, Matevosian R, Larmon B, McCullough L, Ariel D. Simulation-based training is superior to problem-based learning for the acquisition of critical assessment and management skills. Crit Care Med. 2006;34:151–7.
- Gunn H, Hunter H, Haas B. Problem Based Learning in physiotherapy education: a practice perspective. Physiotherapy. 2012 Dec;98(4):330-5.
- Carrera LI, Tellez TE, D’Ottavio AE. Implementing a problem-based learning curriculum in an Argentinean medical school: implications for developing countries. Acad Med. 2003;78:798–801.
- Amoako-Sakyi D, Amonoo-Kuofi H. Problem-based learning in resource-poor settings: lessons from a medical school in Ghana. BMC Med Educ. 2015;15:221.