Educational Approach and Quality: Does PBL support quality learning outcomes

1
Educational Approach and QualityDoes PBL
support quality learning outcomes?

• Tracey Winning
• School of Dentistry
• The University of Adelaide

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Educational Approach and Quality

• Objectives
• To share knowledge and experience of learning and
  teaching in PBL
• ? review published outcomes of PBL

3
Why PBL? Quality Student Experience

• Student-centred focus 1, 2
• Improve integration of basic science and clinical
  education 1, 2
• Develop skills, understandings, qualities and
  dispositions appropriate to employment3
• life-long learning, critical thinking and
  decision making, independent working, teamwork,
  flexibility, oral communication, time management,
  planning and organisational ability
• Evidence-based decision making approach for
  patient management 4

1. Institute of Medicine, 1995 2. General Dental
Council, 2002 3. The Pedagogy for Employability
Group, HEA, 2006 4. Institute of Medicine 2003
4
Why PBL?Learning Theories Social
constructivism

• Meaningful learning is most likely with 5, 6, 7
• authentic, real activities,
• modelling and coaching, ie, how to think and act
  as a practitioner,
• interactions inquiry and exploratory talk, 8
• collaboration students and staff,
• reflection content and strategies,
• working independently staff step back.
• Co-construction of new knowledge for
  real-world contexts, linked to prior knowledge.
  
• These elements inform the design of
  problem-based learning (PBL) with the aim to
  support meaningful student learning. 9

5. Brown et al. 1989 6. Savery Duffy, 1995
7. Brophy, 2002 8. Wells, 2002 9. Dolmans et
al., 2005
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What is PBL? 10, 11

• Principles
• Problem organiser for learning
• Learner-centred
• Educational approach (not a method)

• Characteristics
• Problem authentic professionally relevant
  situation
• Encountered first
• Student responds as practitioner
• Students involved in deciding what, how to learn
• Construct own knowledge understanding
• Guidance/scaffolding provided by teacher as a
  facilitator of learning
• Multiple learning and teaching methods
• Organised around problem small groups,
  collaborative independent research, peer
  learning and teaching, reflection and
  self-management

10. Barrows 2000 11. Charlin et al., 1998
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What is PBL?

• Educational Outcomes 10
• Systematic approach to patient and analysis of
  their situation
• Contextualised and integrated knowledge, skills,
  behaviours
• Self-directed (independent) learning skills,
  lifelong
• Team skills
• Motivating, enjoyable learning experience

10. Barrows 2000
7
PBL Package Purpose

• Package must provide opportunity for
• students to 12
• Think and act as practitioner
• develop new, professional knowledge, skills and
  behaviours
• apply new, professional knowledge, skills and
  behaviours
• Develop learning skills
• collaborative, independent study
• discussion and critique of learning
• ? Is there support that PBL can achieve these
• educational outcomes?

• 12. Adapted from PROBLARC 2000

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Outcomes Systematic approach to analysis of
patient situation

• Developing systematic enquiry skills
• Graduates self-rated as better at problem-solving
  skills 13
• Improvement in clinical reasoning strategy more
  accurate hypotheses and coherent explanations
  with basic science knowledge 14
• Improved diagnostic ability with PBL using
  clinical contexts 15

13. Schmidt et al., 2006 14. Hmelo, 1998 15.
Schmidt et al., 1996
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Outcomes Contextualised and integrated
knowledge, skills, behaviours

• Basic and clinical science knowledge
• Critical thinking, logical argument (eg explain,
  test, justify their assumptions, knowledge,
  reasoning)
• Communication/interpersonal skills
• Preparation for practice and clinical skills

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Outcomes knowledge, skills, behaviours 1

• Basic and clinical science knowledge
• Several reviews have reported equivocal outcomes
  re basic science knowledge development 16, 17, 18
• Better skills in applying knowledge 18
• Significantly better performance on Medical Board
  exams (I II) 19
• Critical thinking
• Higher critical thinking disposition which was
  maintained (to a lesser degree over
• subsequent 2 y) 20

16. Albanese Mitchell, 1993 17. Vernon
Blake, 1993 18. Dochy et al., 2003 19. Hoffman
et al., 2006 20. Tiwari, et al., 2006
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Outcomes knowledge, skills, behaviours 2

• Communication /interpersonal skills
• High levels of communication skills in PBL
  graduates (self 13 and clinical
  directors/co-workers 21, 22)
• Preparation for practice
• Graduates felt better prepared than their peers
  from conventional curricula 23
• Graduates self-rated as better at professional
  skills (eg physical examination) 13 and were
  rated above average by clinical directors 22
• Better clinical periodontics performance in OSCE
  (NS difference for examination of patient) 24

13. Schmidt et al., 2006 21. Rolfe and Pearson,
1994 22. Dean et al., 2003 23. Mennin et al.,
1996 24. Rich et al., 2005
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Outcomes Self-directed learning

• Identifying own learning needs and resources
• Information literacy skills (eg identify, locate,
  evaluate and use information)
• Identifying and utilising appropriate learning
  processes (eg self-testing, concept maps,
  diagrams, teaching others, applying knowledge to
  novel situations)
• Developing time management and organisational
  skills
• Monitoring and evaluating learning processes and
  outcomes

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Outcomes Self-directed learning 1

• Identifying needs and resources
• gt 60 (average) learning issues match
  faculty-identified learning issues identify
  other relevant learning issues 25, 26
• plan and undertake research in own time, using
  self-identified resources 27
• Information literacy skills
• Graduates self-rated as better at self-directed
  learning 13, 22 and using information resources
  13

13. Schmidt et al., 2006 22. Dean et al., 2003
25. Dolmans et al., 1993 26. Sigrell et al.,
2004 27. Blumberg 2000
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Outcomes Self-directed learning 2

• Learning processes/approaches
• PBL associated with learning for meaning (deep)
  28, 29, 30, 31
• Developing time management and organisational
  skills
• Graduates self-rated as better at planning,
  efficiency and time management 13, 22 and rated
  highly by clinical directors 22
• Monitoring and evaluating learning processes and
  outcomes
• Updating of current knowledge for practice 32

13. Schmidt et al., 2006 22. Dean et al., 2003
28. Coles, 1985 29. Newble and Clarke, 1986 30.
Vu et al., 1998 31. Richardson et al., 2007, in
press 32. Shin et al., 1993
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Outcomes Team Skills

• Group function
• Group dynamics
• Working relationships (eg respect, trust,
  valuing, etc)
• Communication (eg negotiation, discussion, giving
  and receiving feedback)
• Conflict management, (eg trouble-shooting
  dysfunctional groups domination,
  non-participation, exclusion, short-cutting,
  sponging)
• Group process
• Roles responsibilities (eg leader, scribe,
  researcher, recorder/ administrator)
• Monitoring and evaluating group functioning
• Organising

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Outcomes Team Skills

• Group dynamics
• Graduates self-rated as better collaboration
  skills 13, 22
• Group process
• Graduates self-rated as better at skills required
  for running meetings 13

13. Schmidt et al., 2006 22. Dean et al., 2003
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Outcomes Student satisfaction

• improved enjoyment, student interaction, and
  flexibility in their programs 16, 30, 33, 34
• overall satisfaction strong for PBL experience 35
  and better cf with conventional curricula (CEQ) 31

16. Albanese Mitchell, 1993 30. Tiwari et al.,
2006 31. Richardson et al., 2007, in press 33.
Rohlin et al., 1998 34. Townsend et al., 1997
35. Lyon and Hendry, 2002.
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Conclusion

• Evaluation of PBL indicates achieving some of
  educational outcomes these link to quality
  higher education learning outcomes
• Issues in interpreting results due to variable
  implementations of PBL and limited use of
  theoretical basis need clear definition of
  programme processes to assist in
• interpretation 10, 11
• Research needed to identify key elements of
  context that are required to achieve PBL outcomes
  9

9. Dolmans et al., 2005 10. Barrows 2000 11.
Charlin et al., 1998
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References 1

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• Barrows H. 2000 Problem-based Learning Applied
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References 2

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References 3

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