Concept analysis of collaboration in implementing problem-based learning in nursing education

INTRODUCTION: Problem based learning (PBL) has many benefits; however, research on PBL indicates that students are not quite good at integrating knowledge in basic sciences and clinical aspects. Case-based learning (CBL) might be an alternative method to enhance the integration of this knowledge. No research explored the way these two methods stimulate cognitive skills. This study aimed to explore the differences between PBL and CBL in stimulating cognitive skill by analyzing verbal interaction. MATERIALS AND METHODS: This descriptive research was performed at the Faculty of Medicine, Universitas Islam Indonesia (FM UII). Twenty-one undergraduate students contributed voluntarily to this study. The students were then split up randomly into a PBL Group (n=10) and a CBL group (n=11). Each group performed twice discussion meetings facilitated by an experienced tutor. The discussion processes were video recorded and analyzed using a coding scheme categorizing the verbal interaction into five types: cumulative reasoning, exploratory questioning, procedural interaction, handling conflict about knowledge, off-task/ irrelevant interactions. RESULTS: Students in both PBL and CBL groups spent most of their time-sharing cumulative reasoning and then asking exploratory question. Students in the PBL group were more frequently asking exploratory questions. Students in both groups rarely handled conflict about knowledge since it was a high order thinking skill. Students in the CBL group were more frequent than the PBL group in performing procedural interaction. CONCLUSIONS: Students performed various cognitive skills in both PBL and CBL. Each method has its own strengths in stimulating reasoning skills of students.

The effects of problem-based learning (PBL) were examined by conducting a meta-analysis-type review of the English-language international literature from 1972 to 1992. Compared with conventional instruction, PBL, as suggested by the findings, is more nurturing and enjoyable; PBL graduates perform as well, and sometimes better, on clinical examinations and faculty evaluations; and they are more likely to enter family medicine. Further, faculty tend to enjoy teaching using PBL. However, PBL students in a few instances scored lower on basic sciences examinations and viewed themselves as less well prepared in the basic sciences than were their conventionally trained counterparts. PBL graduates tended to engage in backward reasoning rather than the forward reasoning experts engage in, and there appeared to be gaps in their cognitive knowledge base that could affect practice outcomes. The costs of PBL may slow its implementation in schools with class sizes larger than 100. While weaknesses in the criteria used to assess the outcomes of PBL and general weaknesses in study design limit the confidence one can give conclusions drawn from the literature, the authors recommend that caution be exercised in making comprehensive, curriculum-wide conversions to PBL until more is learned about (1) the extent to which faculty should direct students throughout medical training, (2) PBL methods that are less costly, (3) cognitive-processing weaknesses shown by PBL students, and (4) the apparent high resource utilization by PBL graduates.

Problem based learning (PBL) is based on the idea that learning is “grounded by experience. ” PBL curriculums in medical school highlight the importance of engaging students and allowing students to be the driver of their education. This mimics their work in the hospital where answers are rarely suited to a multiple-choice question, but a myriad of complex clinical questions, ethical decisions, and cost barriers. Teaching medical students from the start of medical school to handle multiple variables is an important aspect of their learning. Studies indicate that PBL students consistently score at or above the national average on board exams compared to their peers. Furthermore, evaluations of competence during clinical rotations show statistically significant advantages for PBL students in areas such as critical thinking, social and cognitive interactions, and patient comfort. Studies highlight a notable advantage in interpersonal skills among PBL students. Additionally, geographical access plays a critical role in enrollment, and personal responsibilities can hinder potential applicants from pursuing medical school. PBL can be utilized to create an environment where location-based barriers are minimized to increase the number of individuals entering the medical profession. This approach could ultimately reduce the healthcare burden and enhance medical services in underserved areas of the country. Here, we present a concise review of resources and approaches including online and digital platforms to facilitate curriculum development and implementation of flipped classrooms and independent learning that are well-suited for PBL.

Background:Medical students are prone to burnout, and several stressors have been associated with it. From the literature, it is yet unclear if type of curricula in medical schools plays a role in burnout among students.Aims:To assess the prevalence of burnout and its associated stressors in medical students in problem-based learning and traditional curricula at Imam Abdulrahman Bin Faisal University.Subjects and Methods:The analytical, cross-sectional study was conducted between February and May 2017 and included all third- to sixth-year medical students of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. In the 2016–2017 academic year, third- and fourth-year students were in problem-based learning, whereas fifth- and sixth-year students were in traditional learning. All eligible students were verbally invited to complete a 56-item questionnaire comprising three sections eliciting sociodemographic information, level of burnout (using a modified Copenhagen Burnout Inventory with personal, medical school- and faculty-related subsections) and stressors associated with burnout. Burnout was measured using a Likert-type scale, and scores of >50 were considered as high burnout. Chi-square and logistic regression analysis were used for statistical analysis.Results:Of 947 eligible students, 593 (62.6%) completed the questionnaire: 317 (53.5%) were in problem-based learning and 276 (46.5%) in traditional learning. Of these, 329 (55.5%) had high burnout, with no difference between type of curricula (problem-based learning = 178 [56.2%]; traditional = 151 [54.7%]; P = 0.73). All measured stressors were significantly associated with high burnout, including lack of sleep (odds ratio [OR] = 2.139, P = 0.005) and perceiving teaching staff as inflexible and unsupportive (OR = 2.995, P < 0.001).Conclusions:This study found high prevalence of burnout among medical students in a university from Saudi Arabia, but no significant difference between students in problem-based learning and traditional curricula. A longitudinal study is recommended to better understand the long-term effect of type of curricula on burnout.

The recent trend in medical education has been toward problem-based learning (PBL) and performance-based testing. An attractive alternative to traditional lecture-based instruction, problem-based learning emphasizes knowledge acquisition and its application in the clinical setting. In conjunction, performance-based testing offers a means of assessing student performance that measures not only the mastery of factual information, but also the application of knowledge in solving clinical problems often encountered in patient care. Since the installation of an undergraduate PBL surgery clerkship at the University of Kentucky (UKY) in 1989, several studies have shown that the performance of PBL students equals or exceeds that of students in lecture-based instruction on tests of factual knowledge. More importantly, PBL students perform significantly better on examinations designed to measure the clinical application of knowledge. The UKY studies also show that PBL students develop better clinical reasoning skills, increase their medical knowledge base significantly, and learn important time-management skills during the course of their PBL instruction. Moreover, the UKY data reveal clearly that performance-based testing provides an accurate and reliable method of assessing areas of student learning that traditional testing techniques (i.e. multiple-choice tests) fail to evaluate adequately.

Objective To conduct the visualization analysis of literatures about problem-based learning (PBL) teaching in nursing based on the Web of Science database, so as to comprehend the development vein, main research power and knowledge foundation in this field. Methods The relevant literatures retrieved from Web of Science TM Core Collection were statistically analyzed through the website and uploaded into the CiteSpace software to generate knowledge mapping for visualization analysis. Results A total of 259 relevant literatures were included and the annual publication volume showed a remarkable rising trend. Among those literatures, the work of Professor Barrows had the biggest influence in this field; the United States was the country with the largest publication; the Hong Kong Polytechnic University had the top publication amount; PBL teaching literatures included by Journal of Advanced Nursing, Medical Education and Nurse Education Today were able to reflect the research foundation of this field to some extent. In addition, our study also found four classic literatures, which discussed the scientific rationality of PBL teaching in nursing education from different angles and had significance for laying foundations. Conclusion PBL teaching receives more and more attention in nursing education, but high-yielding authors are few, the distribution of national and institutional research power is uneven, and the overall research foundation is relatively weak, which still needs to be further explored. Key words: Problem-based learning; Nursing education; Scientific knowledge mapping; Visualization; CiteSpace software

The increasing use of mobile devices among health sciences students presents both opportunities and challenges to problem-based learning (PBL) in face-to-face tutorials and during self-directed learning. The purpose of the present study was to find out how common the use of mobile devices is among students in PBL, how they are used, and whether some general recommendations can be made to help students make more effective use of mobile devices during PBL. Based on the findings of focus interviews of students and facilitators (Chan et al., 2015), the authors developed a self-administered online questionnaire to examine students’ usage of mobile devices in PBL. The students from three healthcare professional programmes in a university in Hong Kong were invited to take part in the online survey. A total of 346 students (response rate of 31.89 %) completed the online questionnaire. It was found that almost all of them (99 %) own one or more mobile devices. Most of them (98 %) used their mobile devices in PBL, usually for educational purposes, such as the search and synthesis of information and the use of specific software on these devices, especially those for the visualization of knowledge (like atlases or software for creation of concept maps). There was a small percentage of students who never used mobile devices in PBL. The reasons included the facilitators’ explicit discouragement of their use, and the desire to focus on the discussion instead of searching for information. Based on the findings of the survey, the authors arrived at four recommendations aiming at more effective use of mobile devices in PBL: students should be free to choose to use mobile devices; mobile devices should be used for educational purposes only, such as the search for factual information or multimedia files; PBL tutorial time should mostly be spent on discussion, instead of searching for information; students should be encouraged to use cloud-based services for collaborative activities such as note-making and concept mapping in PBL.

Problem-Based Learning (PBL) has emerged as a promising strategy for teaching Evidence-Based Practice (EBP) to nursing and midwifery professionals. However, its effectiveness remains insufficiently synthesized, with few studies directly addressing its impact on EBP competencies. To systematically review and synthesize evidence on the efficacy of Problem-Based Learning as a teaching approach for developing Evidence-Based Practice competencies among nursing and midwifery students and professionals. This systematic review with narrative synthesis was conducted in accordance with the Cochrane Handbook and reported following PRISMA 2020 guidelines. The protocol was registered in PROSPERO (CRD42023390989). A comprehensive search of MEDLINE, CINAHL, PubMed, EMBASE, Web of Science, ERIC, PsycINFO, and Cochrane CENTRAL was performed from inception through August 2025. Two reviewers independently screened and appraised studies using JBI-SUMARI tools and ROBINS-I. Eighteen studies met inclusion criteria, but only three (16.7%) specifically examined PBL for EBP education among nursing students in Iran, Japan, and South Korea. These consistently demonstrated significant improvements in knowledge, attitudes, critical thinking, and clinical decision-making compared with traditional methods, with all rated at low risk of bias. Broader EBP education studies reported highly variable implementation rates (13–100%), with higher educational levels linked to greater uptake of evidence-based behaviours. Across studies, factors supporting success included adequate time, access to technological resources, faculty preparation, and organizational support. Common barriers were limited infrastructure, faculty workload, and students’ initial resistance to active learning. Preliminary evidence suggests PBL enhances EBP-related competencies, but the current evidence base is small, heterogeneous, and lacks midwifery-specific studies. Rigorous comparative research using standardized outcomes and evaluating long-term practice impact is needed to establish optimal strategies for integrating PBL into nursing and midwifery education.

Problem-based learning (PBL) has been shown to be effective for promoting student competencies in self-directed and collaborative learning, critical thinking, self-reflection and tackling novel situations. However, the need for face-to-face interactions at the same place and time severely limits the potential of traditional PBL. The requirements of space and for meeting at a specific location at the same time create timetabling difficulties. Such limitations need to be tackled before all potentials of PBL learning can be realized. The present study aimed at designing and implementing an online PBL environment for undergraduate speech/language pathology students, and assessing the associated pedagogical effectiveness. A group of eight PBL students were randomly selected to participate in the study. They underwent 4 weeks of online PBL using Adobe Connect. Upon completion of the experiment, they were assessed via a self-reported questionnaire and quantitative comparison with traditional PBL students based on the same written assignment. The questionnaire revealed that all participating students enjoyed online PBL, without any perceived negative effects on learning. Online PBL unanimously saved the students travel time to and from school. Statistical analysis indicated no significant difference in assignment grades between the online and traditional PBL groups, indicating that online PBL learning appears to be similarly effective as traditional face-to-face PBL learning.

Problem-based learning (PBL) has been adopted as an innovative model of learning in nursing education for many years in some western countries. The purpose of this study was to evaluate students' learning experiences in a Fundamental Nursing course adopting PBL during their second year at nursing school in Taiwan. A total of 96 students answered a structured questionnaire before and after studying four PBL cases the last eight weeks of this semester-long course. The questionnaire included items asking students to self-assess themselves in self-directed learning, discussion skills and group cooperation. The questionnaire also contained questions to obtain qualitative data from the students. Eighty-five students (88.5%) completed the pre-and post tests. The results of the posttest showed significantly higher levels of self-directed learning and group cooperation and higher satisfaction with both self and group performance. This study showed that PBL had a positive influence on learning attitudes and could be of reference for the extended implementation of PBL in nursing education in Taiwan.

The influence of problem-based learning (PBL) and open-book tests on long-term knowledge retention is unclear and subject of discussion. Hypotheses were that PBL as well as open-book tests positively affect long-term knowledge retention. Four progress test results of fifth and sixth-year medical students (n = 1,648) of three medical schools were analyzed. Two schools had PBL driven curricula, and the third one had a traditional curriculum (TC). One of the PBL schools (PBLob) used a combination of open-book (assessing backup knowledge) and closed-book tests (assessing core knowledge); the other two schools (TC and PBLcb) only used closed-book tests. The items of the progress tests were divided into core and backup knowledge. T tests (with Bonferroni correction) were used to analyze differences between curricula. PBL students performed significantly better than TC students on core knowledge (average effect size (av ES) = 0.37–0.74) and PBL students tested with open-book tests scored somewhat higher than PBL students tested without such tests (av ES = 0.23–0.30). Concerning backup knowledge, no differences were found between the scores of the three curricula. Students of the two PBL curricula showed a substantially better long-term knowledge retention than TC students. PBLob students performed somewhat better on core knowledge than PBLcb students. These outcomes suggest that a problem-based instructional approach in particular can stimulate long-term knowledge retention. Distinguishing knowledge into core and backup knowledge and using open-book tests alongside closed-book tests could enhance long-term core knowledge retention.

Critical thinking plays a crucial role in the learning process. Critical thinking should become the focus of learning since it encourages the development of knowledge and includes the act of contemplating subjects, content, and problems. The current study aimed to investigate the effectiveness of Problem-Based Learning (PBL) and Digital Mind Maps-Integrated PBL (DMM-Integrated PBL) in improving students’ critical thinking. This quasi-experiment study employed a pretest-posttest control group design, involving 103 university students from the Biology Department of University in Riau, Indonesia, as the sample. The details of each group consist of 31 students in conventional, PBL (37 students), and DMM-Integrated PBL (35 students) classes. The research data was collected using an essay test. The data obtained were analyzed using ANCOVA at a significance level of 5% and an LSD test. Essay test developed based on critical thinking indicators: basic clarification, bases for a decision, inference, advanced clarification, supposition and integration, and strategies and tactics. All the instruments had been validated. The ANCOVA analysis results proved that PBL and DMM-Integrated PBL affected the students' critical thinking. However, the LSD test showed no significant difference between PBL and DMM-Integrated PBL in promoting students' critical thinking. Finally, to promote students’ critical thinking, educators are recommended to use PBL or DMM-Integrated PBL in the classroom.

Este estudo tem por objetivo investigar o aproveitamento dos estudantes do Curso de Engenharia Civil em que foi aplicado o método Aprendizagem Baseada em Problemas – Problem Based Learning (PBL) como parte de inovações pedagógicas implementadas em uma disciplina de Engenharia de Transportes. Para analisar o aproveitamento da amostra submetida às alternativas instrucionais foram utilizadas as respostas dos estudantes a um questionário para avaliação do aprendizado, elaborado pelo professor. Este instrumento contribuiu para avaliar e comparar o aprendizado da amostra com uma turma de alunos submetida ao modelo tradicional de ensino. As respostas foram agrupadas e analisadas por meio de mapas cognitivos, contribuindo para a investigação dos efeitos do método PBL e da ocorrência de aproveitamentos diferenciados entre os alunos. Os resultados indicam que os estudantes obtiveram maior envolvimento, desenvolvimento de comportamentos e atitudes, comprometimento com a própria aprendizagem e um aproveitamento significativamente melhor com o novo desenho da disciplina.Palavras-chaveAprendizagem Baseada em Problemas; Mapas cognitivos; Ensino; Avaliação

Evolving as Nurse Educators in Problem-Based Learning Through a Community of Faculty Development

BackgroundIdentification and assessment of professional competencies for medical students is challenging. We have recently developed an instrument for assessing the essential professional competencies for medical students in Problem-Based Learning (PBL) programs by PBL tutors. This study aims to evaluate the reliability and validity of professional competency scores of medical students using this instrument in PBL tutorials.MethodsEach group of seven to eight students in PBL tutorials (Year 2, n = 46) were assessed independently by two faculty members. Each tutor assessed students in his/her group every five weeks on four occasions. The instrument consists of ten items, which measure three main competency domains: interpersonal, cognitive and professional behavior. Each item is scored using a five-point Likert scale (1 = poor, 5 = exceptional). Reliability of professional competencies scores was calculated using G-theory with raters nested in occasions. Furthermore, criterion-related validity was measured by testing the correlations with students’ scores in written examination.ResultsThe overall generalizability coefficient (G) of the professional competency scores was 0.80. Students’ professional competencies scores (universe scores) accounted for 27% of the total variance across all score comparisons. The variance due to occasions accounted for 10%, while the student-occasion interaction was zero. The variance due to raters to occasions represented 8% of the total variance, and the remaining 55% of the variance was due to unexplained sources of error. The highest reliability measured was the interpersonal domain (G = 0.84) and the lowest reliability was the professional behavior domain (G = 0.76). Results from the decision (D) study suggested that an adequate dependability (G = 0.71) can be achieved by using one rater for five occasions. Furthermore, there was a positive correlation between the written examination scores and cognitive competencies scores (r = 0.46, P < 0.01), but not with the other two competency domains (interpersonal and professionalism).ConclusionsThis study demonstrates that professional competency assessment scores of medical students in PBL tutorials have an acceptable reliability. Further studies for validating the instrument are required before using it for summative evaluation of students by PBL tutors.