What’s the rationale for PBL?
PBL was first implemented in medical education at McMaster University in Hamilton, Ontario. Based on the McMaster model of PBL Dr. Howard Barrows became an important proponent of this pedagogy and contributed to scholarship in medical education (Barrows & Tamblyn, 1980, Barrows, 1985). Barrow’s, a physician and medical educator, had long been frustrated that medical students who had done well in their non-clinical courses had difficulty applying what they had learned once they arrived in the clinic. Barrows attributed this in part to the lack of integration of subjects and a detachment from the realness found in patient’s cases. Barrows believed that students should learn about medicine by learning through life-like patient cases and by practicing the activities clinicians do in their work. Assessing and managing a patient would include: gathering patient information (history, examinations), hypothesizing explanations for signs and symptoms, gathering additional information (reading further, lab tests, imaging studies) to support or refute hypotheses, making new hypotheses, reflecting on the results of clinical action and updating one’s knowledge and skills when necessary. The process for learning, Barrows suggested, should resemble some of these processes. In an age where new biomedical and clinical advances are made at a rapid pace, being able to identify one’s knowledge gaps and fill them is of ever increasing importance.
Since its inception in the 1970s, PBL, in various forms, has been taken up by many primary schools, secondary schools, higher education institutions and, of course, professional schools including medicine, nursing, midwifery, and dentistry, business and engineering across the globe. For links to other institutions using PBL please see the resources page.
Coincident with the development of PBL, educationalists, cognitive scientists, psychologists, and social scientists, amongst others, have theorized and gathered empirical evidence to define practices that support the learning process (Bransford, 1999). Together many of these practices can be found within the framework of the PBL methodology. Though not exhaustive, there is strong empirical and theoretical backing to support learning processes that are constructive, contextualized, self-directed and cooperative (Reviewed in Dolmans, 2005, Norman & Schmidt, 1992).
What do these theories mean?
Constructive learning is based on the theory of constructivism and is one of the major learning theories that dominate the field of education. It is based on the notion that learners construct meaning through experience and importantly through the lenses of their past experience. Put simply, a learner’s prior knowledge should be actively drawn upon, examined and linked to new learning. In PBL, the case is built to fit well with the level of prior knowledge and discussions are meant to link prior knowledge to information in the case and to the learning that is done by students.
Contextualized learning emerges as an important practice because learners across a range of subjects and ages have been shown to learn more effectively when they learn through life-like situations (Bransford, 1999, Dolmans, 2005). In other words, people learn by doing and by seeing the real things that are a part of their chosen profession, hobby, etc. Dental students learn the most about dentistry by working with real patients and performing the skills of a dentist. Of course to make decisions about what type of treatment is necessary or what the signs and symptoms of a patient signify, one needs the background knowledge to inform those conclusions. In PBL, that background knowledge is built through the discussions and readings that take place around the cases. The cases present information about patients that one might see in a real patient. This is in contrast to learning subject matter that is organized and taught by discipline (e.g. physiology, anatomy, pathology, genetics, histology, etc.). Many students, and indeed many faculty members, have learned subject matter through subjects and will be accustomed to learning in this fashion. It can therefore take some time to adjust to learning about subject matter in an integrated way.
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The premise of self-directed learning revolves around the notion that successful learners and, in fact, experts, plan, monitor and reflect on their own learning (Dolmans, 2005). Such learners ‘think about their thinking’ and work on maintaining their motivation toward learning. Motivation is key in the learning process because it relates strongly to the effort the learner puts into the learning task. When learners are more self-directed they must play a larger role in deciding what they need to learn and reflecting on whether or not they’ve learned it. |
To take more responsibility for learning however, one needs to develop the tools to feel capable and confident to learn on one’s own. In practice this means developing the skills to define gaps in one’s knowledge, find relevant resources to fill gaps, and reflect on how one is doing. A PBL approach deliberately introduces activities that support development of these skills with the aim of integrating them firmly into the student’s approach to learning. It may come as no surprise that skills like self-assessment (assessing where you are) and information literacy (being able to find and chose among appropriate resources) are important skills for competent health care professionals and are spelled out as such by professional bodies that govern the practice of dentists, physicians, surgeons, nurses and midwives to name a few.
PBL is conducted in small working groups and represents one type of cooperative learning. Though cooperative learning can be accomplished in various forms, all cooperative learning approaches are hinged on students being active and interactive participants. In this sense, the strength of cooperative learning can be linked to ‘construction’ of knowledge as the group provides an environment where exposure and elaboration of prior knowledge is more likely to occur. Cooperative learning also requires that student groups have common goals, individual responsibility and accountability, appropriate interpersonal skills and a process for regularly reflecting on how their group is doing. Groups that fulfill the tenets of cooperative learning have been shown to have higher achievement and satisfaction with the learning process (Johnson & Johnson, 1994). The interpersonal and communication skills that can be developed through working in diverse groups can also serve you in the future and, as you might anticipate, are necessary professional skills.
As you read about the process for doing PBL, try to think about how and where these learning theories emerge.
If you’d like to do more background reading about PBL and general educational principles, please consult the Resources.
