Constructivist, Problem-Based Learning Does Work: A Meta-Analysis of Curricular Comparisons Involving a Single Medical School

TLDR

Effects of problem-based learning in curricular comparison studies have been inconsistent across medical schools. We aimed to summarize the effects of a single well-established problem-based curriculum rather than aggregate conflicting findings from different curricula. Effect sizes were computed for 270 comparisons. Students and graduates of the curriculum performed better in interpersonal and practical medical skills, rated the curriculum higher, dropped out less and graduated faster, and showed modest gains in medical knowledge and diagnostic reasoning, contradicting recent literature and demonstrating that constructivist curricula can positively affect learning even when direct instruction is de-emphasized.

Abstract

Abstract Effects of problem-based learning as reported in curricular comparison studies have been shown to be inconsistent over different medical schools. Therefore, we decided to summarize effects of a single well-established problem-based curriculum rather than to add up sometimes-conflicting findings from different problem-based curricula. Effect sizes were computed for 270 comparisons. The results suggest that students and graduates from the particular curriculum perform much better in the area of interpersonal skills, and with regard to practical medical skills. In addition, they consistently rate the quality of the curriculum as higher. Moreover, fewer students drop out, and those surviving need less time to graduate. Differences with respect to medical knowledge and diagnostic reasoning were on average positive but small. These outcomes are at variance with expectations voiced in recent contributions to the literature. They demonstrate that constructivist curricula can have positive effects on learning even if they deemphasize direct instruction.