Student perceptions of the benefits of problem-based learning

Dear Sir

The educational outcome of problem-based learning (PBL) has been intensely scrutinized and debated (Colliver 2000) and, in spite of the unfavourable outcome documented, many medical schools still promote and practise PBL aimed at nurturing the ‘soft-skills’ deemed to be important outcomes in contemporary medical education. PBL is a resource-intensive learning process. Consequently, many medical schools implement PBL only in part (hybrid curriculum), and usually in the early years of the medical curriculum as in the case of our medical school. PBL was implemented in 1999 in our medical school for year 1 and year 2 students as an additional pathway to learning. PBL constitutes about 20% of our total curricular time in the first two years. We surveyed our students to determine the perceived benefits of PBL, and whether the benefits persist after their initial two years of PBL experience. Our working hypothesis is that, although students might perceive PBL positively at the beginning, a lack of engagement in the PBL process in later years would result in a significant decline in the perceived benefits. A 17-item cross-sectional, questionnaire-based feedback survey was conducted among year 3 (n = 232), 4 (n = 211), and 5 (n = 202) students who had undergone PBL in years 1 and 2. Response rates were high (77–90%). There were more year 3 students (average 63%, range 57–68%) who perceived the benefits of PBL than year 4 or 5 students. Despite the progressive decline seen among the different groups of students, more than 40% of year 5 students still perceived the positive benefits of PBL three years after their experience of PBL as helpful in preparation for clinical postings; linking signs and symptoms of patients with basic science knowledge; generation of differential diagnosis; learning effectively from, and with, fellow students; having initiative and responsibility for their own learning; and in skills as self-directed learners. An average of 68% (range 58–78%) of students from all three years perceived (without significant decline) PBL as helpful in collaboration with colleagues; working in small groups; taking responsibility for contribution to the group; and accountability to other group members. These benefits are consistent with the findings of Sanson-Fisher & Lynagh (2005) in pre-registration house officers.