Title: Problem-Based Learning in Higher Education
Author Name: Yolanda Travis
1. Introduction
Problem-based learning began at the McMaster University in Hampton during the 1960’s with the work of Barrows and Tamblyn, centered around observations made by medical students after three years of medical school. The students realized that the material taught in medical classes had little or no relevance to practicing medicine in the field. Problem-based learning was adopted to increase the learning experience of the medical students through collaboration and real-world applications that promote cooperative learning.
Problem-based learning is a student-centered learning approach and comprises “the learning that results from the process of working toward the understanding or resolution of a problem.” (Barrows, Tamblyn, 1980). Sometimes referred to as cooperative learning, it “encourages active engagement by the students in learning, and it also builds critical skills needed in today’s workplace.” (Goodman, Brandon, & Stivers, 2010). Problem-based learning supports the goals of producing a concrete understanding of the subject-matter that is presented; and developing the learners’ high order thinking skills through active engagement and collaboration. “Despite many studies showing the benefits of problem-based learning, there is still debate about whether problem-based learning can effectively replace traditional pedagogy.” (Nyemb, 2017)
In a problem-based learning environment, students are able to focus on using the information that they are given, as opposed to storing and memorizing data that is never used. PBL presents opportunities for students to work with professionals in the field and connect with real-world scenarios using the information learned. The students are able to reflect on their own ideas and opinions, contributing to the projected outcomes and the learning process. The skills and knowledge acquired through PBL, allows the students to be better prepared for employment in their field.
There are several resources available to assist teachers with developing problem-based learning. Project-Based Learning Professional Development Guide and PBLWorks provide support with launching new or existing problem-based learning environments.
2. Overview of the Case
This case study attempts to address the gap between learning anatomy in the classroom and using anatomy in the medical workforce. This obvious gap is common in many of the basic sciences. In some cases, problem-based learning has been used to narrow the gap between learning and practicing. However, there is controversy as to whether or not PBL is effective. “We recommend a hybridized approach for teaching/learning anatomy in the PBL schools,” (Nayak, Ramnarayan, Somayaji, & Bairy, 2006). is a true perspective of some anatomy professionals. In addition, anatomy is viewed as discipline that is modern and very much alive. There is constant debate among anatomy instructors and professionals where the challenge becomes balancing the modern anatomy with the traditional anatomy while teaching the basic foundations of medicine.
This case study supports the learning of anatomy through the problem-based learning approach. This learning technique has been used at Harvard Medical school for over twenty years with the goal of increasing the learners’ motivation and embracing their responsibility for learning. There is existing controversy over whether anatomy, a basic science, can be taught effectively using PBL. In addition, the curriculum associated with anatomy is highly influenced by other disciplines of the medical field, leading to great debate as to what should be included in teaching this subject.
The first eight weeks of the anatomy course curriculum included group discussions of clinical cases and general laboratory work and engagement. Although lectures were delivered during this time, they were minimal, focusing on general concepts and limited to one hour per day.
A student-centered environment was created, encouraging the students to define the objectives based on acquiring knowledge that was valuable in solving clinical problems. The curriculum was planned daily, with the mornings scheduled for tutorials, lectures, and laboratories. The afternoons were reserved for gaining practical experience in one of the laboratories.
The tutorials were designated times to accommodate discussion of the nine clinical cases that context specific and presented at the start of the course. Students were divided into groups of eight with scheduled one-hour meetings with the tutor or instructor present. The discussion usually begins with hypotheses being drawn from the symptoms and facts given relating to the case. The students develop a driving question and research answers independently. These answers are shared and discussed during the next session, expounding on symptom’s and how they relate to concepts of anatomy. The instructor (tutor) introduces more information from the case leading to students having new questions and drawing new hypotheses that can only be addressed through reviewing clinical anatomy.
The lectures present general concepts of anatomy by using media and limiting the time to one hour.
Four tutors oversaw the laboratories. Students were provided the session goals at the beginning of the course, allowing them they opportunity to prepare for each session. There were cadaver sessions, histology sessions using microscopes connected to a video camera, radiology sessions analyzed by students in assigned groups.
“Studying anatomy through a problem-based learning approach” presents a similar case study using the problem-based learning approach yielding interesting results.
3. Solutions Implemented
Reducing the lectures to one hour a day seemed to be an effective solution for implementing problem-based learning in the anatomy courses. This option prevented the students from becoming overloaded with information that they would not be able to use effectively in the labs.
Students were also able to define the objectives for the anatomy course, motivated to use the limited information from the lectures and tutorials to solve clinical anatomy problems. Defining the objectives helped the students to remain solution-focused and prepared for the hypotheses and questions that developed during the tutorials.
The tutorials served as a middle step between the lectures and the laboratories, accommodating discussions amongst the students. This encouraged the theory of constructivism, building knowledge through collaboration and experiences. With the guidance of the tutor or instructor, the students were able to discuss the cases presented by using the general concepts from the lectures with clinical anatomy experienced in the laboratories. A more detailed account of the roles and responsibilities of a tutor can be found here.
4. Outcomes
“Because the PBL literature offers little assessment guidance, grading these projects can present challenges.” (Nilson, 2010). During this case study, the tutors met individually with the students four or five times during the course. This gave the students the opportunity to receive feedback on his/her progress. In addition, the students were able to share the impression that the class had on them individually and the chance to compete a self-evaluation defining their goals and determine if there is room for improvement.
For midterm, the students have a take-home exam that tests their ability to solve clinical problems using anatomy. A final exam is given at the end of the course and can only be graded as marginal pass or appreciation pass.
In comparing this study to the three categories of authentic assessment, the enroute category is encompassed in the weekly meetings between the tutor and the student. These meetings are held four to five times a week assists and allows the tutor to provide meaningful feedback while monitoring the students’ progress. The culminating category is evident when the students engage in discussion and collaboration, sharing direct responses to the problem at hand. The individual category is accommodated through the administering of a take-home exam and a self-evaluation form.
An evaluation of the students’ learning in a traditional classroom versus in a problem-based learning environment had not been documented at the time of this study. This study does not present significant evidence that PBL has a significant effect on knowledge or material learned. “However, there are now increasing number of experimental studies in other disciplines that provide evidence of the superior performance of students learning in PBL conditions as opposed to lecture conditions” (Yew, Goh, 2016).
5. Implications
The case study is organized around the challenge of solving the clinical problems in the nine clinical cases presented at the start of the course. The solutions to the challenge are not predetermined. This challenge becomes the “driving question” and creates an emotional connection for the student, encouraging motivation and responsibility. The problem is presented first which is different from traditional learning in the classroom.
The process for reaching a solution was designed by the students. They developed hypotheses based on the general concepts that they received through the one-hour lecture and prior knowledge from professional education.
The tutorials forced problem-solving and critical thinking as students worked together toward a solution. With guidance from the tutors, scaffolding became an integral part of the discussions. The collaboration among students included different levels of communication influenced by geographic and cultural differences. After the tutorial sessions, the students were able to use the different perspectives gained through collaboration and use other resources towards a solution to the challenge.
The instructor assumed the role of facilitator and stepped away from the traditional instructor toles and responsibilities. “It can be difficult at first for the teacher to “relinquish control” and become a facilitator, encouraging the students to ask the right questions rather than handing them solutions.” (David, 2020). The instructors taught, mentored, and guided the students to locate information by asking questions and developing hypotheses. Acquired knowledge was able to be transferred to new situations.
The real test of a problem-based learning environment is the assessment of the process and product. The three categories of PBL authentic assessment practices in relation to this case study are important to the implications.
REFERENCES
Barrows, H.S. and Tamblyn, R.M. (1980). Problem-based learning: an approach to medical education. New York, NY: Springer Publishing.
David L, “Problem-Based Learning (PBL),” in Learning Theories, March 3, 2020, https://www.learning-theories.com/problem-based-learning-pbl.html.
Goodman, Brandon, Stivers, Ph. D., J (2010). Project-Based Learning A dynamic approach to teaching in which students explore real-world problems and challenges, simultaneously developing 21st Century skills while working in small collaborative groups. Educational Psychology, p. 6.
Maudsley, Gillian (1999). Roles and responsibilities of the problem-based learning tutor in the undergraduate medical curriculum. The BMJ, pp. 657-651.
Nyemb, Philippe Manyacka MA (2017). Studying anatomy through a problem-based learning approach. MOJ Anatomy and Physiology, Vol.4 (5), p. 378.
Nayak, Satheesha, Nayak, Ramnarayan, K., Somayaji, Naren, Bairy, Laxminarayana (2006). Teaching anatomy in a problem-based learning (PBL) curriculum. Neuroanatomy 5, p.1.
Nilson, Linda B. (2010). Teaching at Its Best: A Research-Based Resource for College Instructors. San Francisco, CA: Jossey-Bass.
Yew, Elaine H.J., Goh, Karen (2016). Problem-Based Learning: An Overview of its Process and Impact on Learning. Health Professions Education, Vol. 2 (2), p. 78.