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Problem-based learning is a collaborative learning style which presents students with pre-made scenarios or ‘problems’ which then encourage group discussion and self-directed learning, whilst being guided by a designated facilitator. PBLs involve a small number of students, usually 8-12 and in each session, students take on different ‘roles’. Although this varies depending on the institution, the main two roles are the ‘chair’ who leads the session, encouraging participation from all members and keeping track of time, and the ‘scribe’ who keeps a record of the group’s discussion so members can refer back to it at a later date.
There are 7 steps to PBL, which, in relation to medicine are outlined below:
Note, another common and similar type of teaching is CBL (case-based learning) which is very similar to PBL and uses comparable processes but focuses slightly more on patients in the context of medicine.
In literature, problem-based learning has proven advantageous in a number of ways for medical education. Due to this evidence-base, medical schools are increasingly integrating PBL into their curriculums. One example is the University of Nicosia Medical School which recently trialled introducing PBL into their first year curriculum alongside more traditional lecture-based teaching. They found that the PBL classes had higher levels of interest and engagement compared to the traditional teaching and were effective as part of student learning from the first year. We will now outline some of the main advantages of PBL in medical education.
Mimics real life scenarios: In medical practice, doctors are often presented with patients who have complex biopsychosocial needs, which require holistic approaches with good communication alongside clinical diagnosis and treatment. PBL mimics these situations which better prepare students for the interactions they will have with patients after university. In contrast, lectures and traditional teaching tend to focus more on ‘textbook’ presentations of diseases rather than the wider complexities of the patient, which may be less generalisable to future practice.
Evidence: There has been a large body of research into the effectiveness of PBL in medical education in the past couple of decades which has proven its effectiveness in medical education. One scoping review (Trullas et al., 2022), which included 124 individual studies assessing the effectiveness of PBL in medical education found that, compared to traditional teaching methods (such as lectures), PBL was more effective at improving communication skills, problem solving skills and self learning skills, while not compromising knowledge retention and academic performance. As non-academic skills such as problem solving and communication are key in medical practice, PBL is particularly advantageous for medical education.
Learning from a range of perspectives: The third step of PBL involves the group discussing their knowledge and experiences which enables students to learn from each other’s experiences and perspectives. As everybody has different backgrounds and particularly as they progress through medical school, different clinical experiences, students have the advantage of drawing upon their peers’ learning as well as their own which can help broaden perspectives and enhance knowledge and understanding.
Although there are many advantages of problem-based learning in medical education, there are some challenges you should be aware of.
It’s not for everyone: Students vary in their preferred learning styles, for example, while some people find learning from other people and through group discussion useful, others prefer solitary study or more direct teaching. While including self-directed study, PBL focuses heavily on group discussion and learning from your peers, which may not be the favoured style of teaching for all students.
Dependability on the group: As explained above, PBL relies upon effective group communication and discussion, which can be impacted by group dynamic and teamwork. Some students may find this aspect challenging if some members are more active than others or if tensions form within a group, which may hinder learning.
Uncertainty: Although PBLs include a facilitator to help guide the students through the process, they are not teachers and are in fact often not clinically trained. This can lead to a level of uncertainty when working through the PBL process, for example uncertainty that you are exploring the right topics or that you have found the right answers. In contrast, some students may prefer receiving a definitive ‘correct’ answer from an expert in a lecture.
Problem-based learning has become increasingly popular in medical education in the last couple of decades. As discussed above, the University of Nicosia Medical School in Cyprus uses PBL as part of their course and have also recently integrated it into their first year curriculum. Below is a list of the universities specific to the UK that specifically use PBL as part of their curriculum, note, this does not include universities with related teaching styles such as CBL.
Problem-based learning is a teaching style which is student led, focuses on peer learning, problem solving skills and working through scenarios relevant to medical practice. There are many advantages to PBL including the applicability to real world scenarios and its effectiveness in essential non-academic skill development such as communication. However, PBL may also not be best suited for each student depending on preferred learning style, and can present its own challenges compared to traditional teaching methods.
It is important to understand what PBL is and consider whether it will be a good fit for your education when researching different universities and their teaching styles. If you think you will thrive from PBL teaching, maybe consider a medical school with a heavy focus on PBL, in contrast, if you are less sure, you may wish to look at a course with a more mixed teaching style.
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