Problem-based learning and problem-solving: sowing seeds of confusion - abstract

ABSTRACT

A major principle of problem-based learning (PBL) is that knowledge gained in a specific context is more easily incorporated into one's fund of usable information. In PBL curricula, students are self-directed, meet regularly in small tutorial groups to consider a clinical problem at each session. Problems are presented in blocks based on biologic development or organ systems. The issues identified determine the disciplines learned and focus the subsequent discussion. Issue guides help students and tutors cover the disciplines and topics each problem involves. The emphasis is on learning principles and mechanisms of disease that explain clinical phenomena, preventive and management strategies for individuals and communities. Problem-solving follows steps involving specific and discriminating application of knowledge and skills already acquired. In this process, the clinical situation provides the cues needed to define the problem medically and to suggest explanations. The expertise of the observer will dictate the choice, efficiency, utility, discrimination etc. of data-gathering strategies used to make a final diagnosis, assess prognosis and plan management. With expert monitoring of outcomes, changes are readily made. PS is thus a process for experts not novices. PBL curricula claim to teach students the elements of PS quickly, consistently and usefully. PS is thus the outcome of PBL and the lasting skills needed will be mastered if students pursue PS and ignore the wider scope and ramifications of PBL (AU)