To what extent can PBL principles be applied in blended learning: Lessons learned from health master programs

Figures & data

Figure 1. PBL study skills. Diagram of components (Van Til & Van der Heijden, 2009, p. 7).

Table

Practice points

Face-to-face and synchronous online tutorial group sessions are comparable. A face-to-face lecture is not automatically appropriate for online purposes. Organize (face-to-face) meetings to allow “online” students to get to know one another. Agreement on rules for online sessions: a condition for success. Visibility and regular feedback in online sessions are important.

Table 1. Overview of details of the programs, the involvement of participants and the communication tools.

Master program	Start of program	End of program	Duration program	Blended learning	Participant involvement	Country involvement	Synchronous and asynchronous	Tools
Health Services Innovation (HSI)	2008	2010	Two years	Entire program	Part-time students Faculty	Europe Netherlands	Synchronous Asynchronous	Surfgroepen^a Skype^b Intranet Blackboard
Global Health (GH)	2010	Still running	One year	Part of the program	Fulltime students Faculty	International International	Synchronous Asynchronous	Elluminate^a Skype Intranet Blackboard FirstClass
Health Professions Education (MHPE)	2011	Still running	Eight weeks	Part of the program	Health care professionals Faculty	International Netherlands	Synchronous Asynchronous	Elluminate^a Skype Intranet Blackboard

^a Surfgroepen and Elluminate (currently: Blackboard Collaborate) are web conferencing tools.

^b Skype is used for visual contact between students and between students and teachers. Students can ask their fellow students or teachers questions when they are available.

Table 2. Overview of the HSI modules: situation in September 2009 (part-time timetable).

Year 1	Year 2
1. Quality and professionalism (A)^a	4. Innovation management in health care
2. Logistics and operations management (A)	5. Implementation and evaluation of health care innovations
3. Normative and social aspects of technology, innovation, care and management in health care (A)	6. Financial management of health care organizations

^a The A modules will be followed in 2009–2010.

Illustration 1. Discussion in a synchronous online PBL group session (the web conferencing tool is called Surfgroepen).

Table 3. Results for three modules of the HSI program.

Module	F2f^a or online	Main online activity	Participants (n)	Data collection participants	Data collection instruments	Main results
Quality and professionalism	F2f: 1 PBL session^b 1 lecture Presentation End-of-module test Online: 4 PBL 10 lectures^c Presentation	Synchronous online PBL^b and lectures^c (made by professionals)	F2f, full-time students (n = 14): BL^a, part-time students (n = 8)	Students	Baseline questionnaire^d Questionnaire at the end^d Tutor interventions^e Process influences^e Focus group interview Test result	BL students were older, had experience in health care and had a different motivation than f2f students. The motivation of BL students was related to their work. Students were satisfied with the online tools and technical support. Non-verbal expressions were not always visible online. Spontaneous remarks were practically impossible online, which resulted in turn taking and discussions in how to communicate. Good quality sound is the most important aspect for online sessions. The online student roles in PBL were comparable to those in the face-to-face setting. Students said f2f discussions did not differ from online discussions. The informal face-to-face meeting at the beginning of the program was seen as a good start for collaboration.
			Tutor (n = 1)	Tutor	Baseline interview Interview at the end Video recordings	The tutor was experienced in PBL, but not in online PBL. The tutor said BL students were more active and motivated. The tutor felt he had to stimulate the students in the f2f groups more. The tutor had a double task: tutoring and managing technical equipment. This was not considered problematic.
Logistics and operations management	F2f: Three sessions Two lectures End-of-module test	Synchronous online sessions and lectures (made by professionals)	BL, part-time students (n = 6)	Students	Baseline questionnaire^d Focus group interview Test result	Students were satisfied with the f2f and online sessions. Video lectures: students liked the freedom of being able to watch the lecture where and when they liked. In spite of the distance, collaboration was possible.
	Online: 7 sessions Seven lectures		Tutor (n = 1)	Tutor	Interview at the end	The tutor had some experience in education. There was not much difference between the f2f and the online group sessions. It was difficult to notice when BL students did not understand something due to inability to pick up signs from body language.
Statistics module “Multilevel analysis of longitudinal data and factor analysis”	F2f: 1 f2f session 1 lecture End-of-module test Online: four sessions via discussion board six lectures	Asynchronous online sessions via discussion board and lectures (made by professionals)	F2f, full-time students (n = 11): BL, part-time students (n = 12)	Students	Baseline questionnaire^d Questionnaire at the end^d Process influences^e Use of discussion board Test results	There was no evidence of students having difficulty using the technology. The only item scored lower by BL students was satisfaction with the timing of tutor feedback. The freedom provided by the BL variant was appreciated. BL students mentioned that the asynchronous format was suitable for other course. The lectures recorded by professionals were considered to be of good quality. No meaningful difference in test results between the two groups.
			Module coordinator (n = 1)	Module coordinator	Interview	Frequent contact between the module coordinator and blended learning coordinator was considered important.
			Tutor (n = 1)	Tutor	Interview	The tutor had no prior experience of e-learning technologies. The tutor initially disliked the idea of “talking into the machine” without direct interaction. Feedback from the tutor was relevant, clear, and sufficient for both groups.

^a F2f = face-to-face; BL = blended learning.

^b PBL = problem-based learning using seven-step approach.

^c One lecture lasted proximately two hours.

^d The questionnaires were developed by the researchers and contained questions about demographic characteristics, baseline experience with PBL, e-learning, level of English, discussion skills, and module content.

^e Tutor interventions were measured using the Tutor Intervention Profile (TIP) (De Grave et al. 1999); process influences were measured using an instrument developed by Dolmans et al. (1998).

Table 4. Overview of the structure of the GH program (one-year program).

Fall term (SEP.–DEC.)		Winter term (JAN.–APR.)	Summer term (MAY–AUG.)
Module A	Module B	Elective program
Methodology and statistics course I		Methodology and statistics course II	THESIS
Foundation course I		Foundation course II

Table 5. Results of statements about language proficiency and collaboration in Foundation course I (2010–2011) (n = 43).

Statements	Fully disagree (%)	Disagree (%)	Neutral (%)	Agree (%)	Fully agree (%)
The level of English of my fellow students was good.	0	2	9	42	47
Language did not interfere with collaboration.	0	7	9	44	40
Time differences did not interfere with collaboration.	0	16	16	51	16
There were problems in collaboration due to differences in cultural background.	21	44	14	14	7
There were difficulties due to the involvement of different universities.	12	33	12	30	14
Students of both universities were treated in the same way.	9	19	23	37	12

Table 6. Results of statements regarding the online synchronous lectures in Foundation course I (study year 2010–2011) (n = 42).

Statements	Fully disagree (%)	Disagree (%)	Neutral (%)	Agree (%)	Fully agree (%)
I learned as much from a lecture at a distance (via Elluminate^a) as from a regular face-to-face lecture.	12	24	17	38	10
I could ask fewer questions in a lecture at a distance (via Elluminate) compared to a face-to-face lecture.	2	31	17	43	7
The lectures contributed to achieve the objectives of the foundation.	17	19	21	41	2
The delivered content of the Elluminate lectures was effective enough.	5	21	31	43	0
The Elluminate lectures were technically (image and sound) effective enough.	5	24	19	53	0
Accessing the Elluminate lectures from your home/work location was satisfactory.	5	10	19	57	10
Using the Elluminate lecture was satisfactory.	10	10	17	60	5
Any additional rich media components were of added value.	0	10	50	38	2
The lecturers performed satisfactory.	2	10	19	64	5
The Elluminate lectures had a positive effect on my personal expertise.	2	21	24	48	5
An Elluminate lecture is an indispensable tool for this course (foundation).	5	12	21	50	12

^a Elluminate is now called “Blackboard Collaborate”.

Van Til T, Van der Heijden F. 2009. PBL study skills. An overview. Maastricht, Datawyse: Universitaire Pers Maastricht.

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