The Challenge of Problem-based Learning

David Boud, Grahame Feletti

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781135368692
• Edition: 1
• Topic: Bildung
• Subtopic: Bildung Allgemein

Problem-based learning is a way of constructing and teaching courses using problems as the stimulus and focus for student activity. This edition looks at the topic in the light of changes since the first edition (1991). There are new chapters on the impact of PBL, and inquiry and action learning.

Chapter 1
Changing Problem-based Learning. Introduction to the Second Edition

David Boud and Grahame Feletti

Problem-based learning (PBL) is the most significant innovation in education for the professions for many years. Some argue that it is the most important development since the move of professional training into educational institutions. Why is this so? What are the characteristics of this approach to higher education which make it so attractive and yet so controversial?

Aim of the book

This book examines PBL, explores its significance, how it can be used and its strengths and limitations. It is directed to those who are interested in this form of teaching and learning and who wish to assess how it might address central issues in professional education. The book treats PBL both sympathetically and critically. Almost all its contributors have direct experience of the approach, and are firmly committed to the need to find alternatives to what they believe are indefensible practices in traditional teaching in higher education. However, they are not all wedded to a particular view of PBL. The contributors are very conscious of what can and cannot be achieved and they point to important directions for the further development of this approach.

The principal idea behind problem-based learning is… that the starting point for learning should be a problem, a query or a puzzle that the learner wishes to solve. (Boud, 1985: 13)

PBL is a way of constructing and teaching courses using problems as the stimulus and focus for student activity. While there are different versions of what constitutes PBL, it does not, as is sometimes erroneously assumed, involve the addition of problem-solving activities to otherwise discipline-centred curricula. It is a way of conceiving of the curriculum as being centred upon key problems in professional practice. Problem-based courses start with problems rather than with exposition of disciplinary knowledge. They move students towards the acquisition of knowledge and skills through a staged sequence of problems presented in context, together with associated learning materials and support from teachers.

Although there is no universally agreed set of practices which must be found in problem-based courses to define them as such, the following features are characteristic of PBL as an approach to education:

• using stimulus material to help students discuss an important problem, question or issue;
• presenting the problem as a simulation of professional practice or a ‘real life’ situation;
• appropriately guiding students’ critical thinking and providing limited resources to help them learn from defining and attempting to resolve the given problem;
• having students work cooperatively as a group, exploring information in and out of class, with access to a tutor (not necessarily a subject specialist) who knows the problem well and can facilitate the group’s learning process;
• getting students to identify their own learning needs and appropriate use of available resources;
• reapplying this new knowledge to the original problem and evaluating their learning processes.

The origins of PBL

PBL as it is generally known today evolved from innovative health sciences curricula introduced in North America over 30 years ago. Medical education, with its intensive pattern of basic science lectures followed by an equally exhausting clinical teaching programme, was rapidly becoming an ineffective and inhumane way to prepare students, given the explosion in medical information and new technology, and the rapidly changing demands of future practice.

Medical faculty at McMaster University in Canada introduced the tutorial process, not only as a specific instructional method (Barrows and Tamblyn, 1980) but also as central to their philosophy for structuring an entire curriculum promoting student-centred multidisciplinary education as a basis for lifelong learning in professional practice (Neufeld and Barrows, 1974). Some key features of the McMaster model are evident in an earlier curriculum reform by medical faculty at Case Western Reserve University in the late 1950s, which incorporated a wide range of instructional methods and strategies. Their multidisciplinary laboratory was perhaps the forerunner to the PBL tutorial (Bussigel et al, 1988). The Case Western Reserve model heralded an equally legitimate and perhaps more feasible approach for developing problem-based curricula at larger and more traditional schools. Harvard Medical School’s ‘hybrid’ model is a good example of the latter. It uses problem-based tutorials, lectures, conferences and clinical sessions to integrate teaching and learning around weekly themes (Tosteson et al, 1994).

The appeal of both the McMaster philosophy, which led to a worldwide spread of problem-based learning in many professional fields by 1980, and Harvard’s hybrid model (which has influenced more traditional medical schools since 1990), is twofold. First, they revitalize classroom teaching and learning processes, and enable students to get the most from independent studies. Second, these curricula feature regular small group ‘problem solving’ sessions at which students discuss simulated but true-to-life problems, and a weekly schedule which facilitates integration of learning across disciplines, with very few lectures and more ‘protected time’ for electives or self-directed studies.

What is intriguing about these two models of PBL is their international appeal and influence despite their very specific contexts, particularly the academic confidence and capability of their students. The McMaster approach would seem only generalizable to a limited number of other medical schools - in terms of its relatively small number of students and dedicated faculty, its funding and learning resources, and its commitment to improving the health status of populations and communities in both developing and developed countries. Not content with producing generalist physicians for Canada’s city hospitals and academic medical centres, McMaster made a shift of emphasis in its approach towards community-based learning which has been reflected in a growing trend elsewhere. It linked with a number of sister medical schools to form a Network of Community Oriented Educational Institutions for Health Sciences.

Its mission, and similar ventures funded by the W K Kellogg Foundation (USA), has been to support problem-based curricula which enable health profession students to spend significant periods of time learning from real experiences off-campus, in non-traditional practice environments in community settings (Richards, 1995; Richards et al, 1987; Magzoub et al, forthcoming). Curricula designed for other professions and vocations have adopted similar workplace orientations. In essence, as the context of professional practice changes so will the nature of the curriculum model.

PBL is not static. It is changing from the approach which arose from the unique context of medical education. Nevertheless, those original ideas were sufficiently robust that they have provided the foundations for many others elsewhere. Some of the compelling features of PBL which have generated interest are as follows.

• It takes account of how students learn. It is becoming increasingly apparent that learning takes place most effectively when students are actively involved and learn in the context in which knowledge is to be used.
• The expanding knowledge base of most professions means that it is impossible to include all the knowledge that is required for the beginning practitioner in the pre-service curriculum. It is more important for students to be able to learn quickly, effectively and independently when they need it, than it is for them to have assimilated (at graduation) all the information which their teachers believe is desirable.
• It supports the view of many professionals about what constitutes their field of activity, in contrast to the curriculum they experienced as neophytes in the profession. The problem-based course has high face validity for practitioners.
• It fits well with the political exigencies of higher education institutions: the need to respond to changes in professional practice, to update both content and method in the light of changing learning environments, and to regenerate enthusiasm amongst faculty in the face of a tight economic future.
• Most importantly, despite the apparent different demands that PBL places on an institution compared with the traditional lecture/lab/tutorial structure, it is sufficiently adaptable to fit within the rigidities of large educational institutions.

Changes to the second edition of this book

Since the publication of the first edition, there has been a substantial increase in the adoption of PBL in many different countries and in many additional professional areas. This has been accompanied by innovation extending the boundaries of a problem-based approach. There is a more sophisticated appreciation of the issues that underpin successful adoption. These important developments are discussed in the next section.

However, alongside the positive developments there have also been misapplications and misconceptions of PBL, some of which relate to the particular features of the approach, others which involve the challenges associated with instituting major educational change. Many of the difficulties have arisen because insufficient attention was given to issues raised in the earlier edition of this book. These include:

• confusing PBL as an approach to curriculum design with the teaching of problem-solving;
• adoption of a PBL proposal without sufficient commitment of staff at all levels;
• lack of research and development on the nature and type of problems to be used;
• insufficient investment in the design, preparation and ongoing renewal of learning resources. This is commonly associated with a lack of recognition of the additional resources for the start-up phase of a problem-based curriculum;
• establishing small elements of PBL in a context which rewards students for the kind of behaviour favoured in a traditional lecture-plus-examination environment;
• insufficient concern with staff induction and development, particularly for those staff who were not part of the original team which developed the programme;
• inappropriate assessment methods which do not match the learning outcomes sought in problem-based programmes; and
• evaluation strategies which do not focus on the key learning issues and which are implemented and acted upon far too late.

While there have also been difficulties associated with reduced funding levels for teaching and learning in higher education, it is interesting to observe that there is no simple connection between low resourcing for courses and unsuccessful implementation. Some of the best examples of problem-based practice can be found at modest levels of funding, while access to resources does not guarantee that they will be well used.

The second edition of this book has retained the best features of the first while incorporating a number of changes throughout. It aims to address the misperceptions mentioned above. There are several new chapters and authors. Greg Ryan reports on first year students’ development of knowledge structures, problem solving and self-directed learning skills in an undergraduate curriculum. Imogen Taylor and Hilary Burgess discuss how PBL courses can be designed to meet the needs of non-traditional students. Debra Creedy and Christine Alavi discuss some of the msgor developments and issues for nursing education, which has seen a huge increase in PBL initiatives. Of particular importance in the light of questions about the value and effectiveness of problem-based curricula is Christel Woodward’s chapter, which reviews what research studies have revealed about the impact of PBL courses on a wide range of outcomes.

A number of previous authors have completely revised their chapters as their courses have evolved or their thinking about PBL developed: Don Woods and Geoff Norman at McMaster, Shona Little, Janet Hafler, Natalie Bolzan and Karen Heycox, Keith Winsor, John Usher and his colleagues, Alan Gilbert and Stephen Foster, and faculty from Alverno College. In most other chapters there has been an updating of material and incorporation of new references. Many of the original chapters that have been retained express views that are as current now as when they were written.

The new challenges of PBL

As we have seen, the notion of PBL is not new, nor is it unique to the health sciences despite their major contribution to its origins and literature. PBL in its very many manifestations does, however, attempt to link a sophisticated analysis of professional practice to a humanistic technology of education, to develop highly competent practitioners who will continue to learn effectively throughout their lives. This last statement seems just as valid six years after publishing our first edition, but a number of new developments and challenges have emerged.

First, the definition of PBL is now international property rather than the publicized impressions of any one profession or institution. Up to the mid-1980s the PBL literature was more descriptive of process than analytical of either process or outcome. Research mostly related to student perceptions and to some extent student performance within certain aspects of courses. There were very few impact studies on graduates, the faculty, the institution or the profession. With most evidence coming from only a handful of medical schools, and with few examples of coherent PBL curricula for any other profession, curriculum designers had little choice in finding an appropriate model. And so the mid-70s to -80s saw schools struggling to develop and implement a curriculum appropriate for their particular context. Perhaps this concentrated effort - to make ‘it’ work - diverted attention from concurrent evaluation research, in particular, from whether effort might be better directed towards critically analysing their paradigm of problem solving and whether their curriculum model served their intended goals.

In common with other educational innovations (eg, computer-based learning and distance education) international acceptance of PBL has distinct benefits for educators in the professions who, in turn, have taken advantage of new information networks. Critical analysis of PBL and problem-solving approaches has been greatly facilitated by access to the Internet, e-mail communication via PBLIST, PBL-dedicated journals such as PROBE (Australian Problem-based Learning Network), and a growing number of conferences and books devoted to PBL theory and practice - all helping to balance the earlier evangelism and intuition with broader based experience and healthy scepticism.

Second, the more recent PBL literature has embraced broader perspectives. These include contemporary learning theories and reflections on curriculum experiences from different disciplines and professions (Wilkerson and Gisjelaers, 1996); more quantitative research studies from these disciplines enhancing our understanding of the dynamics of problem-based curricula (Bouhuijs et al, 1993); integrated studies on the psychological basis for PBL as a teaching and learning phenomenon (Norman and Schmidt, 1992; Schmidt and Moust, in press); and the outcomes and challenges remaining for evaluating its impact on professional practice and standards (Berkson, 1993).

Paradoxically, as the number of vocations, disciplines and professions contributing to the PBL literature increases, the nature of PBL has become both more explicit and controversial (Feletti, 1993). Health sciences like medicine, occupational therapy, physiotherapy, orthoptics, nutrition and dietetics have developed curricula and heuristic models that emphasize relatively well-defined problems -ones that could be resolved. Other applications in areas such as agriculture, architecture, community nursing and social work are more field or community based. Their ‘problems’ are less well defined, and ‘solutions’ are less predictable in terms of specific factors, strategies and outcomes. Some disciplines have even adopted a version of PBL while rejecting the term ‘problem’ (eg, enquiry and action learning or issues-based learning in social work, and situation improvement in agriculture). Their curricula may incorporate systems thinking, social theory, and models of critical thinking that make different assumptions about the nature of problem solving and the roles of student and teacher (Checkland, 1981; Paul and Heaslip, 1995). They can be regarded as havin...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Table of Contents
• Contributors
• 1. Changing Problem-based Learning. Introduction to the Second Edition
• Part I What is Problem-based Learning?
• Part II Getting Started
• Part III Design and Implementation
• IV Examples From Different Professions
• V Student Assessment and Programme Evaluation
• VI Beyond Problem-based Learning
• Index