Misfit for a purpose? 1

May 23, 2003

Alison Utley looks at controversial findings that raise doubts over the success of problem-based learning

Problem-based learning is hugely popular in many fields - medicine, nursing, dentistry, social work, management, engineering and architecture - and its supporters make sometimes extravagant claims for its success. But despite its widespread use in higher education, the method remains controversial, and a study to be published next month is likely to add fuel to the fire.

The study compares two groups of nursing students (67 in total) from six London hospitals - one group taught traditionally and the other using problem-based learning.

Project leader Mark Newman has correlated a variety of indicators, including attendance, dropout rates and academic results across the groups to find out what type of problem-based learning works for which types of students.

Newman, based at Middlesex University, found that the student dropout rate in the PBL group was significantly higher at 41 per cent than than that of the traditionally taught group, where only 6 per cent quit. Across all the indicators, students in the PBL group appeared less satisfied than the traditionally taught cohort. “These results do not mean that PBL doesn’t work. But it is not always the right approach and the teaching needs to be very skilled in order for it to work effectively,” Newman says.

One area of contention is that there is no general agreement about what PBL is or how to measure its success. The Middlesex project, part of the Economic and Social Research Council’s teaching and learning research programme, is intended to fill the gaps.

For the purposes of the study, the PBL students were taught in small groups fousing on scenarios designed to mirror real-life clinical problems and integrating different elements of the curriculum. The teachers acted more as facilitators and the onus was on the students to uncover what was going on.

The traditionally taught group learnt about different areas of the curriculum as discrete modules taught by specialists in each field.

Charles Engel of the Centre for Research into Higher Education in London says there is a need for more research. “There is a danger that PBL is adopted as a fashion without real understanding of its educational basis. This may lead to it failing to live up to its promise and thus becoming discredited.”

A supporter of the approach is John Harries, dean of science at Aberystwyth University. He says he began using PBL some 15 years ago as a way of trying to engage students in crop science. He provided the group with small field plots and let them get on with growing different varieties of crops. “The success really has been remarkable,” he says. “The students have enjoyed the work and the standards achieved in coursework have gone through the roof.”

PBL is also endorsed by a variety of national and international organisations, including the Association of American Medical Colleges, the World Federation of Medical Education, the World Health Organisation, the World Bank and the English National Board for Nursing, Midwifery and Health Visiting.

Yet Newman’s exit interviews with nursing students who dropped out reveal that for eight of the 12 students who left the PBL group, dissatisfaction with PBL was given as the major reason. For three of these students there were no other clear reasons.

“These students felt that there had been no ‘teaching’ in the PBL programme, that they were still not clear what they were supposed to be doing or that the tutors lacked the necessary expertise,” Newman says.

They couched their criticisms in moral terms and sought to apportion blame for their “failure” to complete the programme - often on themselves. However, the three students whose only ostensible reason for quitting was their dissatisfaction with PBL placed moral responsibility solely with the programme and the teachers. “One interpretation of the data is that, in this particular context, a substantial proportion of students will not ‘enjoy’ the PBL experience and a still significant proportion will not get through to the other side but will simply drop out,” Newman says.

“Despite the volume of literature on PBL, there is a lack of robust evidence that demonstrates the superiority of the approach over any other method of teaching and learning,” he says. “At the very least, the claim that students like PBL will be opened up to scrutiny.”

Details: http:///www.hebes.mdx.ac.uk/teaching/ Research/PEPBL/index.htm

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