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Efficacy of Problem-Based Learning (PBL) Versus a"Literature Review" Chapter

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¶ … Efficacy of Problem-Based Learning (PBL) versus a Traditional Teaching Model in Respiratory Therapy Education

For more than 50 years, scholars have been debating whether Problem-Based Learning (PBL) is more effective than a traditional educational model (Colliver, 2000). So far, this question remains unresolved. Problem-based learning started in medical settings but since its inception it has been adopted by other disciplines as well ((Barrows, 1996). Thus, it seems appropriate to examine the literature on problem-based learning (PBL) as it applies to three populations engaged in various forms of medical education: Medical students, nurses, and respiratory therapists. My intent is to begin with a working definition of the term "problem-based learning" followed by a description of the literature on the education of doctors, nurses, and respiratory therapists. This literature review closes with a summation of the results.

Statement of Purpose

The central purpose of this report is to produce a literature review that offers a comparative analysis on the efficacy of Problem-Based Learning (PBL) as compared to traditional methods of teaching. This literature review focuses on research that directly affects the training of doctors, nurses and respiratory therapists.

Problem Statement

Problem-Based Learning has been endorsed and adopted by many institutions (Hoffman, 2006). Even so, its reputation remains questionable to others. PBL has received mixed reviews on its actual efficacy since its inception (Colliver, 2000). This literature examines the genuine efficacy (or not) of this training model as it applies to the training of doctors, nurses and respiratory therapists.

A secondary dilemma clouds this discussion. PBL has been adapted at numerous institutions; these adaptations are inevitable. But these adaptations blur what PBL actually means. Therefore, a clear definition of what constitutes PBL remains unresolved. In turn, this lack of clarity makes research difficult and definitive answers elusive (Hmelo-Smith, 2006).


Problem-based learning will prove to be more effective than traditional teaching methods.


If problem-based learning appears to enhance the training of medical personnel, then one can extrapolate that more patients will experience better care and more positive outcomes in their treatments.

Literature Review

First, what is problem-based learning (PBL)? The question remains murky, in part, because people adapt the model to suit their own environments and internal culture. However, a general description would be useful for this literature review (Hmelo-Smith, 2004).

Throughout this paper PBL will be defined this way: Problem-based learning takes shape when students pursue questions that have more than one answer. In this instance, students typically have to choose actions that are best suited to their patients' health. PBl favors authentic activities. The word authentic takes on special meaning here: "Authentic" implies that the tools and insights students acquire parallel the actions they will need to use when they work with patients. Students typically work in small groups as well. Since the students are largely responsible for their education, the teachers' role also changes. S/he becomes a guide rather than an all-knowing teacher, Altogether students are primarily responsible for their own education (Carrows & Tambly, 1980)

The PBL model has grown exponentially since it began -- roughly 50 years ago (Barrows and Tambly, 1980). Most of PBL training has taken shape in various types of medical training. (Camp, 1996).

Medical Students

Problem-based learning was predicated on the notion that change was needed specifically in medical education. (Barrows & Tambly, 1980) -- (who were both medical professors in Canada) -- were responsible for creating a new teaching paradigm in medical schools. Their educational model was called the McMaster system.

Most traditional medical students' educations were reliant on facts. Students were principally made to absorb facts and memorize volumes of information. Barrows and Tambly took issue with this teaching paradigm. They noted that this type of education mandated memorization rather than problem solving. They wanted their students to grapple with much more complex conundrums. They wanted to eliminate the passivity that was implicit in their educations.

Since both of these professors were also doctors, they were especially familiar with the real skills and intelligences required of a doctor. They grew to dislike the students' reliance on fact-based knowledge alone. Both professors insisted that training must be based on knowledge that matched the work they would do when they completed their education. They also believed in the centrality of the student vs. The teacher. Both Barrows and Tambly created a system -- the McMaster System (at McMaster University). This educational paradigm matched their philosophical viewpoints.

The book they wrote together is entitled an Approach to Medical Education (1980). It is largely a protracted description of a philosophical point-of-view on how to best train doctors for a life in medicine. It offers a detailed description of the essential components their model required. The book is punctuated by careful descriptions of what comprises a problem-solving paradigm, but the book primarily offers an enthusiastic endorsement of their own educational philosophy. It is a prejudiced book; it celebrates their educational methods and philosophy.

Even though both professors remained enthusiastic over the McMaster system, Barrows and Tambly were also aware of the shortcomings inherent in their new model. They knew that more resources were needed and that the evaluation of students' knowledge and skills was critical. More and different learning resources were needed as well. Since the students determined what they would learn, each teacher had to evaluate the students' work in such a way that it corresponded with each student's personal educational goals.

Both professors also learned that some students became unsure and anxious -- about what they needed to know and to what degree they needed to know it.

Cindy Hmelo-Silver's research (2004) offers a more balanced analysis of the assets and shortcomings of problem-based learning. Initially Hmelo-Smith appears to be a strong advocate for PBL because PBL appears to help students learn the factual content alongside deeper thinking (p.235). Hmelo-Smith also believed that recipients of this form of education would be capable of construct their own ways of thinking and judging. She also offers an in-depth description of the PBL model and shares an intricate description of the methods used to optimize PBL learning experiences.

Despite her opening comments, she remains skeptical as well. She contends that not much empirical evidence fully supports PBL's effectiveness. She argues that the research emerges from one sector: medical schools. Furthermore, as PBL proliferates, it becomes unclear what the paradigm consists of exactly. The results that have accumulated seem to have generated mixed reviews. At its best, students appear to "fall short" of traditionally trained students. Her final criticism suggests that the validity of the research is questionable, in part because the research is based solely students on higher education.

By contrast, Hank Schmidt (2004), a Professor of Psychology at Maastricth University in the Netherlands, applauds the PBL model. He notes that PBL has become the instructional choice of many medical schools worldwide. Schmidt notes that PBL is now used in one-third of the medical schools in the world. Schmidt contends that the PBL model that is proliferating because it helps learners become engrossed in the material. As a result of becoming immersed in the material, the students spend their time pursuing what they feel is important to learn.

His synopsis on how students are taught, as well as his international perspective on data generated in the late 1990's, is especially helpful in determining the efficacy of PBL. In closing, Schmidt offers a summation of outcomes that are sometimes contradictory. One example if the efficacy of PBL took place at his own university. He noted that during students' final year at his university, they operated at a much higher level of professional skills than traditionally taught students at an unnamed Dutch school..

Schmidt also notes that some people believe that PBL students are likely to become life-long learners. He sees it as an inevitable outcome since doctors need to update their knowledge. He also notes that in Finland graduates -- from innovative programs -- are more likely to chose careers in primary care. Even so, it appears that PBL does not guarantee that doctors leave with more diagnostic competence than their traditionally taught counterparts. As of 1998, Schmidt's research suggests the outcomes surrounding PBL's value, are still mixed.

Richard Epstein (2004) writes that medical education is increasingly moving from a didactic model of education with all-knowing doctors. Instead, the field appears to be moving toward contextual, or problem-based learning (PBL). This "paradigm shift" is verified by studies that show PBL enhances students' reasoning and communication. These studies also suggest that there does not appear to be any detectable loss of understanding in their educations.

Are there other reasons why PBL has been so widely accepted? Its ascendance parallels the influx of information that is easy to access and offers enormous information.. As a result, medical personnel can extract key information immediately. Since PBL training requires that students actively seek information and construct their own knowledge base, they are especially prepared to seek out answers independently. Their proactive education, in tandem with the remarkable depth of information… [END OF PREVIEW]

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