Student's Evaluation of Problem-BasedLearning Curriculum in Medical School

Background: Teaching and learning are fundamentally different between conventional and problem based learning (PBL) curricula. There is a transformation in the College of Medicine, Taibah University, Saudi Arabia (CMTU) from the conventional to a PBL curriculum. Aim: To compare students’ approaches to learning and their perception of learning environment between conventional and PBL curricula at CMTU. Method: A cross sectional study was conducted through a self-administered questionnaire on a convenience sample from the third year undergraduate male and female medical students enrolled in both PBL and conventional curricula during the academic year 2015- 2016. Students' approaches to learning and perception of learning environment were measured using the “Approaches and Study Skills Inventory for Students (ASSIST)” and the “Dundee Ready Education Environment Measure (DREEM)” instruments, respectively. Results: A total of 101 questionnaires (49 (48.5%) and 52 (51.5%) from traditional and PBL curricula, respectively) were analyzed. When compared to conventional curriculum students, PBL curriculum students showed a significantly higher overall DREEM (136.98 ±21.45 vs. 111.59 ±27.93; p <0.001) as well as all its subscales. Significantly higher ratings for strategic approach towards learning (60.77 ±9.12 vs. 56.35 ±9.93; p=0.02) and net learning orientation (deep approach + strategic approach - surface apathetic approach; 85.60 ±17.32 vs. 77.76 ±20.63; p=0.04) were seen in PBL curriculum students. Conclusion: The transformation to a PBL curriculum at CMTU was accompanied by a tilt in the learning style towards a desired deep and strategic learning styles and a definite improvement in the perception of learning environment among students.

Globalization of Problem-based Learning (PBL): Cross-cultural Implications

Many medical schools are shifting to a problem-based learning (PBL) curriculum, some without any transition period, others using periods of parallel-track curricula. The authors report on and discuss a third strategy for implementing PBL: using a pilot course as a model to facilitate the transition. After the Université de Montréal Faculty of Medicine chose to switch PBL, one course in the third year of the traditional curriculum was changed to PBL format 11 months before the new curriculum was to start in September 1993. This was done to develop local expertise, to gain confidence, to test the feasibility of the method, to produce a showcase, to assess more accurately the resources required, and to provide a practice ground for the curriculum planners and managers and the faculty-development training team. The authors discuss the planning of the pilot course, the training of the faculty in various aspects of PBL (writing problems, tutoring methods, etc.), the course implementation, and the course evaluation. Overall, the pilot course was well received by both the faculty and the students and provided much beneficial information that assisted the university in its transition to a new PBL curriculum.

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.

Status of Medical Education Reform at Saga Medical School 5 Years After Introducing PBL

Problem-Based Learning Curriculum as a Tool to Increase Medical Student Exposure to Radiation Oncology

Objectives: A comprehensive evaluation plan was designed to investigate the effect of curricular change from a lecture-based to a problem-based learning (PBL) curriculum. The objective of this paper is to describe the results of three surveys that examined perceptions of preparation for practice by three stakeholder groups. Method: Three survey instruments were designed to obtain opinions regarding preparation for practice from graduating students, preceptors and supervisors/employers from three curricula that were in place as the PBL curriculum was being implemented. Results: The students graduating from the PBL curriculum perceived themselves to be equally or better prepared than did the students graduating from the other two curricula in a number of activities/competencies. Results from the preceptors and supervisors/employers did not identify any significant differences among the curricula. Conclusions: The survey results provide some data suggesting that the outcomes-based, integrated, hybrid PBL curriculum prepares students for practice as well as, or better, in a number of areas than the lecture-based curriculum.

Tutors in a Problem-Based Learning (PBL) curriculum are thought to play active roles in guiding students to develop frameworks for use in the construction of knowledge. This implies that both subject-matter expertise and the ability of tutors to facilitate the learning process must be important in helping students learn. This study examines the behavioural effects of tutors in terms of subject-matter expertise, social congruence and cognitive congruence on students’ learning process and on their final achievement. The extent of students’ learning at each PBL phase was estimated by tracking the number of relevant concepts recalled at the end of each learning phase, while student achievement was based on students’ ability to describe and elaborate upon the relationship between relevant concepts learned. By using Analysis of Covariance, social congruence of the tutor was found to have a significant influence on learning in each PBL phase while all of the tutor-related behaviours had a significant impact on student achievement. The results suggest that the ability of tutors to communicate informally with students and hence create a less threatening learning environment that promotes a free flow exchange of ideas, has a greater impact on learning at each of the PBL phases as compared to tutors’ subject-matter expertise and their ability to explain concepts in a way that is easily understood by students. The data presented indicates that these tutor-related behaviours are determinants of learning in a PBL curriculum, with social congruence having a greater influence on learning in the different PBL phases.

BackgroundThe relationship between large-group classroom attendance by students and test achievement in problem-based learning (PBL) curricula is unclear. This study examined the correlation between attendance at resource sessions (hybrid lectures in the PBL curriculum) and test scores achieved in pharmacology and determined whether the score achieved was related to student gender.MethodsA cross-sectional observational study over one academic year of 1404 pre-clerkship medical students was performed. Class attendance during pharmacology resource sessions and MCQ test scores achieved in pharmacology were analysed.ResultsThe percentage of students’ attendance in resource sessions declined over three years of the programme, from 78.7 ± 27.5 in unit I to 22.1 ± 35.6 (mean ± SD) in unit IX. A significant but weakly positive correlation was evident between attendance and achievement in pharmacology (r = 0.280; p < 0.0001). The mean score of the students who attended > 50% of the resource sessions was significantly higher (p < 0.0001). Students who attended ≤50% were more likely to achieve lower tertile scores. The mean score achieved and the number of higher tertile scorers were higher among students who attended > 50% of the resource sessions. Although female students’ attendance was significantly higher, no significant gender-related differences in either mean scores or top grades achieved were found.ConclusionsIn a PBL curriculum, the classroom attendance of students in pharmacology declined during the pre-clerkship phase. A weak positive correlation was found between attendance and academic achievement, as measured by MCQ test scores. Factors other than motivation and attendance may confound gender-based academic performance and merit further research.

Systematic research on faculty attitudes toward problem-based learning (PBL) has focused exclusively on the opinions of tutors. The purpose of the present study was to examine the attitudes of faculty at a single medical school who either (1) did not participate in the first year of a new PBL curriculum or (2) participated in ways other than as PBL tutors. In 1993-94, at the end of the first year of a new PBL curriculum, a questionnaire used in an earlier, larger study of PBL tutors was sent to all 494 faculty at the University of Missouri-Columbia School of Medicine. The response rate was better for participants (76%, 115 of 151) than for non-participants (28%, 96 of 343). Overall, nonparticipants judged the new curriculum to be approximately equal to the "old" curriculum that preceded it. In contrast, participants were significantly more positive and judged the new PBL curriculum to be superior in most respects. For both groups the new curriculum received its highest ratings in the areas of student interest, clinical preparation, and medical reasoning and its lowest ratings in the teaching of factual knowledge in the basic sciences and efficiency of learning. The attitudes of participating faculty varied with their teaching roles in the new curriculum. Those whose primary roles were as PBL tutors or as leaders of other small discussion groups were more favorable to the new curriculum than those who primarily served as lecturers. Faculty who served in several different roles were more positive than faculty who served in only one role. There were also plausible qualitative differences among the teaching-role groups in what they liked and disliked about the new curriculum. In general, the attitudes and opinions of the faculty varied with the degrees and types of participation in the new curriculum. The attitudes and opinions of faculty with different teaching roles were plausibly related to differences in these roles. The opinions of the faculty about the strengths and weaknesses of PBL that emerged in this survey are much like those found in prior research. In addition, student performances on Step 1 of the United States Medical Licensing Examination suggest that the faculty may have underestimated the value of the new PBL curriculum for helping students acquire factual knowledge in the basic sciences.

Background: Retaining lectures in problem-based learning (PBL) curriculum places new demands on lecturers. In addition to subject knowledge, the lecturers must know the overall aims of the lectures, their context in the course, their relation to the subsequent examinations and the underlying educational philosophy.Aim: Aim of this communication is to propose ways that will transform the traditional didactic lectures into PBL-compliant teaching/learning sessions.Methods: Insights from the self-experience and that of colleagues and the feedback from students are synthesised with current literature regarding best teaching practices to develop these tips.Results: These tips, ranging from involving students in the learning process to a routine practice of reflection after delivering a lecture, highlight methods of preparing and delivering lectures that follow the educational philosophy underpinning the PBL approach.Conclusion: We believe that these tips by advancing the driving force for meaningful learning will transform the didactic lectures of traditional curriculum to interactive sessions that would enhance understanding, augment critical thinking and promote self-directed learning among students.

Background: Coaching is a form of supervision which is about unlocking a person’s potential to maximize own performance. Recently, medical education has been bringing such one-to-one developmental activities to the fore. Objective: Is to explore opinions of experts and leaders in a PBL medical school about coaching as a method for students and faculty development. Methods: This is a qualitative study conducted in the Faculty of Medicine, Suez Canal University (FOM-SCU); a Problem-Based Learning (PBL) college in Egypt. A focus group discussion was conducted with 10 faculty members in the Medical Education Department. In addition, interviews were held with 5 faculty members in leadership positions. All sessions were audio recorded then transcribed verbatim. Data were organized around the themes: applications of coaching in medical education, potential benefits, expected outcomes and challenges. Results: Coaching is perceived as applicable within context of the PBL curriculum of FOM-SCU. To institute coaching as an efficient developmental tool, a lot of efforts are still indicated. Furthermore, coaching can comprise a set of other already existing developmental activities in the PBL curriculum. Resistance to change and lack of resources are the most anticipated challenges. Conclusion: Innovative curricula more receptive for coaching. The major against developing a coaching culture are resistance to change and shortage of financial resources.

：University of Manchesterwho first introduced Problem based learning(PBL)to the UK medical education,and adoptedthis new curriculum in 1994.Notably,Cambridge and Oxford have always had a high proportionof student-centred and self-directed learning,and have therefore not introduced PBL.Othermedical schools have followed the example of Manchester,now PBL has become the mainstreamcurriculum in British medical edacation.First,this article is going to introduce how PBLcurriculum is structured at Manchester medical school,and then reflect and give somethoughts on its current practice.

Problem-based learning (PBL) is an educational reform that is now becoming a household word in higher education, particularly in medical schools. Many medical schools have implemented a full problem-based learning curriculum (PBLC) While some have included PBL into selected units of the course in an otherwise conventional curriculum (embedded PBL) and others run their tutorials in a PBL manner within a modified conventional curriculum (hybrid curriculum). Yet there are others who claim that small components of PBL in a conventional curriculum are not PBL at all. Thus amateurs in the subject matter find difficulty in evaluating the logistics and outcome of these variations. This article focuses on the general characteristics of PBL and how this learning method can help enhance independent learning and critical thinking, whether in a full, embedded or hybrid curriculum. The extent of PBL to be included and which of the three types is to be adopted depends on the objective of theundergraduate medical course as determined by the faculty, resources available, limitations, feedback on the existing curriculum and various other factors.

The aim of this study was to track students’ critical thinking performance longitudinally through concept map analysis in a problem-based learning (PBL) curriculum. Concept map analysis has been employed in the assessment of students’ critical thinking in medical education. Little is known concerning concept mapping (CM) in speech-language pathology (SLP) education. In this quantitative study, students in a 4-year SLP education program (N = 38) were followed until the completion of a fully-integrated PBL curriculum from Years 1 to 3. Students’ concept maps were analyzed using a tool developed for this study, the Concept Map Assessment Profile (CMAP). There was an increase in concept map scores across the 3 years at the beginning of the academic year. The CM performance over the 3 years predicted 21.0% to 33.6% of variance in three measures of learning outcomes. The CMAP is a reliable measure, with strong inter-rater and intra-rater reliability (r = 0.85 and r = 0.96, respectively). In addition to its use as an assessment tool, the CMAP might be used to facilitate students’ learning as feedback concerning strengths and weaknesses in the development of critical thinking can be provided.