Title: Problem-Based Learning (PBL) in Nursing Education
Author Name: Reana King
Selected Case (Published Article): https://rdcu.be/dh46C
1. Introduction
Problem-based learning (PBL) is a highly effective approach to healthcare education. It places nursing students in realistic scenarios during their clinicals, by putting them in situations with a difficult patient problem and a chance to develop their critical thinking skills. Nursing education makes students look at healthcare problems they will face in the real world, by giving them patients that will mirror the type of problems they will face but in a supervised setting. The patients they care for can have a range of issues, including complex medical conditions, ethical dilemmas one might face in the hospital, or communication problems with patients and their families. When used, PBL is the missing link between theory and practice for nursing students.
Nursing students using PBL will collaborate in small groups, somewhat like a normal healthcare team. They will conduct research, gather information, and then apply it to analyze the patient’s problems/complications. Through this process, students will learn to think critically, make evidence-based decisions, and develop a deeper understanding of a patient’s needs as a whole. Using a collaborative PBL approach with nursing students will increase their communication and teamwork skills. As they work as a team, students will become effective communicators, respect the different perspectives of others, and see the importance of collaborating with other nurses to deliver holistic patient care. Lastly, PBL teaches responsibility and accountability by preparing them for the realities of what they see in the healthcare setting. When nursing students graduate, they will be required to make quick and accurate decisions that are crucial when dealing with someone’s life. So, this approach gets future nurses ready to become adaptable problem-solvers who are ready to handle the dynamic and challenging nature of being a nurse in the healthcare setting.
2. Overview of the Case
One in every ten patients is harmed while receiving hospital care and annually 400,000 premature deaths occur due to preventable adverse events (WHO, 2019). This data shows that a lack of patient safety knowledge is a leading issue for nursing students which leads to unsafe practices. Most colleges/universities are looking for teaching methods to “increase nursing students’ clinical decision-making capabilities and their self-centered learning to ensure safe and quality nursing care” (2021). So, this study “aimed to determine the effect of patient safety education through PBL on nursing students’ knowledge, attitude, and perceptions toward patient safety” (2021).
This randomized, controlled study was conducted at the Urmia School of Nursing and Midwifery from September 2019 to January 2020. A total of 78 fourth-year nursing students (considering the 10% dropout rate) participated in this study. The inclusion criteria consisted of the following: willingness to participate in the study, being a 4th year nursing student, and no involvement in the educational program. The exclusion criteria consisted of the following: unwillingness to stay in the research and having 2 or more absences from the educational sessions.
3. Solutions Implemented
Problem-based learning is now practiced in educational settings, ever since the publication of the Flexner Report demonstrated that learning models had not changed in 70 years. (Reiser & Dempsey, 2018.) The primary purpose of problem-based learning was to connect scientific materials with clinical content. Traditionally, medical education relied on teaching methods where students absorbed information through lectures and memorization. However, educational strategies continued to develop and encourage the classroom to become more innovative with an emphasis on students having critical thinking, clinical reasoning, and practical application of the knowledge they are learning.
To implement PBL in each session, the first researcher presented a written scenario to the students about knowledge, attitude, and perception of patient safety in the intervention group. Students had a week to review the scenario and then the PBL method was used to investigate each scenario within the intervention group. The following steps were taken using the PBL method:
The participants were randomly assigned to either the intervention group or the control group. In the intervention group, the lesson was presented to the students using the PBL method during eight 45–60-minute sessions. In each control group, nursing students received eight education sessions, that were presented through lectures and discussions of the same information. The study interventions lasted for 4 months. Data was gathered 1 month after the intervention using demographic information and knowledge, attitudes, and perception questionnaires.
4. Outcomes
When it comes to students’ knowledge about patient safety, the control group did not see growth whereas the intervention group increased significantly. The results revealed that attitudes toward patient safety increased significantly after the PBL intervention, as well. The findings also showed that the perception of patient safety increased significantly in nursing students after PBL education.
5. Implication
Although they achieved their performance expectations, the study did come across some limitations. “One of our study’s limitations was the participants’ mental and emotional state while completing the questionnaires and answering the questions by which the study results could be influenced.” This is out of the control of the researcher, but it is something that must be taken into account when considering research on attitude and perception. Another limitation I noticed was that all participants came from the same school, getting students from different schools would have reduced bias in the data.
When looking at other research studies, you will see the that PBL is a better approach to medical education compared to what has been done in the past. Like Liu et al. (2019) which concluded that problem-based learning is superior to conventional teaching methods in areas such as interest in learning, teamwork spirit, problem-solving ability, analysis, knowledge attainment and application, and communicational skills. Khatiban et al. (2019) conducted a study to compare the effect of two methods of lecture-based and problem-based learning in ethics education among nursing students. They recommended problem-based learning to be used in other nursing areas since it is an effective tool for developing moral reasoning.
Based on this study’s findings, PBL significantly impacted students’ knowledge, attitude, and perception toward patient safety in a positive way compared to conventional methods used in many nursing programs.
References
Health Ed Solutions. (2012, March 23). Introduction to Cognitive Load Theory [Video]. YouTube. https://www.youtube.com/watch?time_continue=5&v=9ZcjWzXTHng&feature=emb_logo
Jamshidi, H., Hemmati Maslakpak, M. & Parizad, N. Does problem-based learning education improve knowledge, attitude, and perception toward patient safety among nursing students? A randomized controlled trial. BMC Nurs 20, 70 (2021). https://doi.org/10.1186/s12912-021-00588-1
Khatiban M, Falahan SN, Amini R, Farahanchi A, Soltanian A. Lecture-based versus problem-based learning in ethics education among nursing students. Nurs Ethics. 2019;26(6):1753–64. https://doi.org/10.1177/0969733018767246.
Liu L, Du X, Zhang Z, Zhou J. Effect of problem-based learning in pharmacology education: a meta-analysis. Stud Educ Eval. 2019;60:43–58. https://doi.org/10.1016/j.stueduc.2018.11.004.
Problem-based Learning: Developing a Driving Question. (n.d.). Stemedhub.Org. Retrieved December 4, 2021, from https://stemedhub.org/resources/798/download/PBLDriving_Question.pdf
Reiser, R. A., & Dempsey, J. V. (2018). Trends and issues in Instructional Design and Technology. Pearson.
World Health Organization. (n.d.). Patient safety. World Health Organization. https://www.who.int/news-room/facts-in-pictures/detail/patient-safety#:~:text=While%20in%20hospital%2C%201%20in%20every%2010%20patients%20is%20harmed&text=In%20a%20study%20on%20frequency,and%2030%25%20led%20to%20death.