Problem-based Learning

A Research Perspective on Learning Interactions

Dorothy H. Evensen, Cindy E. Hmelo, Cindy E. Hmelo-Silver

• Editore: Routledge
• Anno: 2000
• ISBN:
  9781135684549
• Edizione: 1
• Argomento: Education
• Categoria: Education General

This volume collects recent studies conducted within the area of medical education that investigate two of the critical components of problem-based curricula--the group meeting and self-directed learning--and demonstrates that understanding these complex phenomena is critical to the operation of this innovative curriculum. It is the editors' contention that it is these components of problem-based learning that connect the initiating "problem" with the process of effective "learning." Revealing how this occurs is the task taken on by researchers contributing to this volume. The studies include use of self-reports, interviews, observations, verbal protocols, and micro-analysis to find ways into the psychological processes and sociological contexts that constitute the world of problem-based learning.

Chapter 1

INTRODUCTION

Problem-Based Learning: Gaining Insights on Learning Interactions Through Multiple Methods of Inquiry

Cindy E. Hmelo

Rutgers University

Dorothy H. Evensen

The Pennsylvania State University

The workplace of the 21st century requires professionals who not only have an extensive store of knowledge, but who also know how to keep that knowledge up-to-date, apply it to solve problems, and function as part of a team. This revised view of the workplace compels educators to rethink and reinvent the ways in which professionals are prepared. Schooling, in particular, must extend beyond the traditional preparatory goal of establishing a knowledge base. Concomitantly, it must actively engage preservice doctors, lawyers, teachers, and businesspersons in opportunities for knowledge seeking, for problem solving, and for the collaborating necessary for effective practice. To realize such experiences, educators have looked to constructivist pedagogical designs that are based on the assumption that learning is a product of both cognitive and social interactions in problem-centered environments (Greeno, Collins, & Resnick, 1996; Savery & Duffy, 1994). Problem-based learning (PBL) is an example of such a design.

PBL can be used to refer to many contextualized approaches to instruction (Bruer, 1993; Williams, 1993). What all of these methods have in common is that they anchor much of the learning and instruction in concrete problems. There are five objectives that PBL is most likely to address for medical students (Barrows, 1986): construction of clinically useful knowledge, development of clinical reasoning strategies, development of effective self-directed learning strategies, increased motivation for learning, and becoming effective collaborators. Barrows (1986) has identified two factors that affect the probability that any of these objectives might be achieved: the nature of the case: whether it is a complete case, a vignette, or a full problem simulation; and the locus of control of learning: whether it is teacher-centered, student-centered, or mixed.

What has become known as a classic version of PBL is described by Barrows (1985, 1988). This model has two key features: a rich problem is used that affords free inquiry by students, and learning is student-centered.

In this approach, a group of five to seven medical students and a facilitator meet to discuss a problem (Barrows, 1986). The facilitator provides the students with a small amount of information about a patient’s case, and then the group’s task is to evaluate and define different aspects of the problem and to gain insight into the underlying causes of the disease process. This is accomplished by extracting key information from the case, generating and evaluating hypotheses, and formulating learning issues. Learning issues are topics that the group deems relevant and in need of further explication. The group members divide up the learning issues among themselves and research them. They then share their information and use it to explain the patient’s disease process. At the completion of the cycle, the students reflect on what they learned from the problem. The facilitator’s role is to help the students’ learning processes by modeling hypothesis-driven reasoning for the students and by encouraging them to be reflective.

At the heart of PBL is the tutorial group. The PBL tutorial consists of several phases: introductions and climate setting, starting a problem, problem follow-up, and post-problem reflection (Barrows, 1988). Before beginning to grapple with a problem as a group, students must get to know each other, establish ground rules, and establish a comfortable climate for collaborative learning. Meeting in a small group for the first time, students introduce themselves, stressing their academic backgrounds to allow facilitators and each other to understand what expertise might potentially be distributed in the group. The other important function of this preproblem-solving phase is to establish a nonjudgmental climate in which students recognize and articulate what they know and what they do not know (Barrows, 1988).

The actual problem-based episode begins by presenting a group of students with minimal information about a patient’s case. The students then query the case materials to determine what information is available and what they still need to know and to learn to solve the problem. During this phase students typically take on particular roles.

One student takes on the role of scribe. The scribe records the groups’ problem solving on whiteboards or on easel paper where they list the facts known about the problem, students’ ideas or hypotheses, additional questions about the case, and the learning issues generated throughout ensuing discussion. This written record (which usually remains visible during the entire discussion around the case) helps the students keep track of their problem solving and provides a focus for negotiation and reflection. At several points in the case, students reiterate this process: pausing to reflect on the data collected so far, generating additional questions about that data, and hypothesizing about the problem and about possible solutions. In addition, the facilitator models metacognitive questions to encourage reflective thinking by asking students to explain why they consider a particular solution to be good, or why they need a particular piece of information about the problem.

As the students work on the problem, they identify concepts they do not sufficiently understand and so need to learn more about to solve the problem (the “learning issues”). Early in the PBL process, the facilitator may question students to help them realize what they don’t understand. For example, he or she may ask puzzled students whether or not a particular issue should be added to the growing list of learning issues posted on the board. As students become more experienced with the PBL method and take on more of the responsibility for identifying learning issues, the facilitator is able to fade this type of support, or scaffolding. After the group has developed its initial understanding of the problem, the students divide up and independently research the learning issues they have identified. The learning issues define the group’s learning goals and help group members work toward a set of shared objectives. These objectives can also help the facilitator to monitor the group’s progress and to remind members when they are getting off course, or alternately, to ask if they need to revise their goals (Barrows, 1988).

In the problem follow-up phase, the students reconvene to share what they have learned, to reconsider their hypotheses, or to generate new hypotheses in light of their new learning. These further analyses, and accompanying ideas about solutions, allow students to apply their newly acquired knowledge to the problem. Students share what they have learned with the group as they coconstruct the problem through the lens of their newly accessed information. At this point, it is important for the students to evaluate their own information and that of the others in their group. In the traditional classroom, information is often accepted at face value. In the PBL tutorial, the students discuss how they acquired their information and critique their resources. This process is an important means of helping the students become self-directed learners.

The emphasis in PBL is not necessarily on having students solve the problem; rather, it is on having them understand the cause of the problem. During postproblem reflection, students deliberately reflect on the problem to abstract the lessons learned. They consider the connections between the current problem and previous problems, considering how this problem is similar to and different from other problems. This reflection allows them to make generalizations and to understand when this knowledge can be applied (Salomon & Perkins, 1989). Finally, as the students evaluate their own performance and that of their peers, they reflect on the effectiveness of their self-directed learning and their collaborative problem solving.

Both cognitive constructivist and sociocultural theories provide insights into the learning mechanisms of PBL (Greeno et al., 1996). In terms of individual learning, PBL situates learning within the context of medical practice. Problems give rise to epistemic curiosity (Schmidt, 1993) that will, in turn, trigger the cognitive processes of accessing prior knowledge, establishing a problem space, searching for new information, and reconstructing information into knowledge that both fits into and shapes new mental models. At the same time, proceeding through the PBL process requires the learner’s metacognitive awareness of the efficacy of the process. In this regard, PBL is inherently self-regulated. Yet, PBL does not exist in a vacuum. Rather, it is a social system within a larger cultural context. The knowledge that the learner seeks is embedded in and derives from social sources—in this case, the world of medical practice. From this perspective, the learner is seen as both transforming and as transformed as the processes of practice and their underlying symbol systems are internalized through dialectical activity (John-Steiner & Mahn, 1996). In this sense, learning is not an accumulation of information, but a transformation of the individual who is moving toward full membership in the professional community. This identity-making is marked by observing the facility with which cultural tools, or the ways of thinking and using language, are invoked. The sociocultural context of PBL is the group meeting that simulates the social process of medical problem solving in a scaffolded way.

Although theoretical grounding provides an important starting point for educational initiatives, what is also required is an ongoing research agenda. Indeed, PBL has received a large amount of research attention since the late 1980s; however, although much research has focused on knowledge acquisition and problem-solving advantages of PBL, few studies have targeted self-directed learning or group interactions, which are equally important components of the curriculum. By narrowing the scope of inquiries to cognitive variables, studies have often bypassed or bracketed the social and pragmatic aspects of these key components. Assumptions are made that enhanced understanding develops in conjunction with self-regulation and with group participation, but theories remain vague about how these interactions are practiced or which aspects of the interactions differentially affect learning.

What we hope to do in this volume is to present empirical work that scrutinizes these two crucial components of PBL, revealing the complexity of each. The learning advantage of PBL is theorized as being embedded in the interactional dynamics between group processes and individual study; however, the mere presence of these entities cannot guarantee departure from traditional practices. It has been argued that surface differences do not necessarily mean substantive differences, and that what may appear to be transformational learning practices might actually reflect conventional transmission teaching models (Pea, 1993). This possibility adds impetus to the argument that PBL might just be old wine in new casks, an idea anathema to PBL proponents. Decades of research on cooperative learning continues to result in ambiguous findings pointing to both advantages and disadvantages of working in groups (see McCaslin & Good, 1996). But what’s more important is that the educational research community is just beginning to ask how self-regulatory functions interact with group dynamics to enhance goal setting, planning, execution, and evaluation of learning issues in social relations (Schunk & Zimmerman, 1997). Hence, what we attempt to do in this volume is to get closer to PBL-in-practice.

The research reported here derives from constructivist traditions that employ a variety of methods to focus on learning processes and seek to discover ways of documenting change and transformation within learning contexts. Constructivism is represented by a range of perspectives that situate the individual learner, epistemological beliefs, and the sociocultural context of learning in different relations to each other (see Prawat, 1996). The contributing authors of this volume assume different constructivist perspectives ranging from information processing to social reconstructivist. As a result, each sheds light on different aspects of learning interactions. Likewise, different perspectives employ different methods of inquiry. The studies that follow use self-reports, interviews, observations, and microanalyses to find ways into the psychological processes and sociological contexts that constitute the world of PBL in medical education.

To a large extent, these studies are derived from empirical work conducted within a variety of disciplines. For example, many of the authors from Part I credit the work of researchers who studied cooperative learning in K–12 settings (D. W. Johnson & Johnson, 1987; Slavin, 1983), whereas many in Part II refer to work in self-directed learning emanating from adult education (e.g., Candy, 1991). But at the same time, these studies are situated within the literature of PBL, especially the body of work representing the field of medical education. That work tends to focus on the effects of PBL, particularly how engagement with PBL curricula affects both the methods of knowledge construction and performance that requires the application of knowledge.

PBL AND KNOWLEDGE CONSTRUCTION

Research in psychology predicts several advantages for students in PBL curricula compared with those in traditional medical education contexts (Norman & Schmidt, 1992). PBL students may be more highly motivated, better at problem solving and self-directed learning, better able to learn and recall information, and better able to integrate basic science into the solutions of clinical problems. PBL students may also be better at collaboration.

PBL provides an appropriate situation for learning basic science because all of the content is learned in the context of a clinical problem, which should enhance recall of this information when it is needed (Adams et al., 1988; Needham & Begg, 1991; Perfetto, Bransford, & Franks, 1983). Norman and Schmidt (1992) reported several direct tests of the effect of PBL on recall. These studies indicate that PBL students’ initial learning is not as good as students in a conventional curriculum but their long-term retention is superior.

In addition to facts, medical students need to learn the principles and concepts of the basic biomedical sciences. These concepts are typically taught in the first 2 years of medical school with the assumption that students will be able to transfer them into their clinical practice. However, students need to learn more than science; they need to learn how science can be used as a tool that can be applied in subsequent clinical practice. Barrows and Feltovich (1987) argued that because clinical reasoning processes and scientific knowledge are inextricably linked, educational strategies should be used that teach embedded knowledge construction in the clinical reasoning context.

Thus it is hypothesized that if students in a PBL curriculum learn basic science concepts in the context of a clinical problem, they should be better able to integrate concepts into the solution of other clinical problems. Patel, Groen, and Norman (1991, 1993) asked students from conventional and from PBL curricula to solve a clinical problem and to then integrate passages of relevant basic science information into their pathophysiological explanations of the problem. The PBL students incorporated many more causal explanations than did the students from the conventional curriculum. In a similar pathophysiological explanation task, Hmelo (1998) demonstrated that, when compared with students in a traditional curriculum, PBL students were more likely to use basic science as a tool for problem solving.

Much evaluation of PBL has examined traditional academic outcome measures such as examination scores. Schmidt, Dauphinee, and Patel (1987) reviewed 15 studies of PBL on several outcome measures. They found that the PBL students tended to score slightly lower on traditional measures of academic achievement such as the National Board of Medical Examiners (NBME) Part I (see also Albanese & Mitchell, 1993; Goodman et al., 1991; Mennin, Friedman, Skipper, Kalishman, & Snyder, 1993; Vernon & Blake, 1993). They found that PBL students performed slightly better at tasks related to clinical problem solving such as the NBME III, the portion of the licensing examination that deals with clinical practice. This research suggests that problem-based curricula encourage a more intentional style of learning, with the students attempting to integrate their prior knowledge with what they are learning, to understand the meaning, and to look for explanations underlying concepts rather than facts to be mastered (Schmidt et al., 1987).

Some recent research has focused on PBL outcomes from a cognitive perspective; these have focused largely on measures of problem solving. Patel and colleagues’ research suggests that students in a PBL curriculum do not outperform students in a conventional curriculum, and, in fact, they may do worse on a task requiring diagnostic explanation. Patel, Groen, and Norman (1991, 1993) compared beginning, intermediate, and senior level medical students at two Canadian medical schools, one using a conventional medical curriculum and the second using a PBL curriculum. The students were asked to provide diagnost...

Indice dei contenuti

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Contents
• Foreword
• Preface
• 1 Introduction: Problem-Based Learning: Gaining Insights on Learning Interactions Through Multiple Methods of Inquiry
• Part 1 The Group Meeting
• Part 2 Self-Directed Learning
• Author Index
• Subject Index
• Contributors