Problem based learning (PBL): A revolution in the area of medical education?

Problem based learning (PBL) is a method of undergraduate medical education which was first introduced in Canada in 1969 and has since been applied in an increasing number of medical schools worldwide. It is defined as learning that results from the process of working towards the understanding or resolution of a problem given to the learners, who are invited to discover on their own the knowledge that is needed to understand and resolve the problem. This is effected through working in small groups consisting of 5-10 students with a tutor who guides the group in its work. During the group meetings the students analyse the problem, set learning objectives, look for knowledge resources and explore critically the work hypotheses they have set, under close guidance by their tutor. Activities outside group work include personal study, searching resources for knowledge, and tutorials related to the problem in laboratories and clinical departments. The ensuing group meetings include reporting of the newly acquired knowledge, its application to the resolution of the problem, assessment of the knowledge and evaluation of the whole learning process. The problems chosen must be relevant to the level of studies and include areas of knowledge from both the basic sciences and clinical medicine, and they should be broad enough to ensure that group work does not end too soon and interesting enough to stimulate participation of all the students. The tutors should be well trained in tutoring and facilitation of group work, should take part without dominating the process and should be well prepared and supplied with the relevant learning material. PBL was initially criticised with regard to the amount of theoretical knowledge that students acquire, but an increasing number of studies shows no difference in comparison to traditional methods of teaching. The advantages of PBL are active and self-directed learning, acquisition of clinical reasoning and problem-solving skills, evidence-based decision making, improvement of critical thinking, motivation for continuous learning, effective teamwork and satisfaction of the students from their studies. The disadvantages are the cost of implementation, the need for educating the academic staff in this new teaching method, the unwillingness of many of them to take part and the poor support they may therefore provide to the students during the learning process.