The role of problem-based learning in the enhancement of allied health education.

Abstract

PROBLEM-BASED LEARNING (PBL) has gained much attention and implementation in medical and allied health education. It is a student-centered method of teaching, which is considered one of the most significant educational innovations in the past 2 decades. PBL depends on self-directed learning and is initiated by a clinical problem. In contrast to traditional teaching, it provides an environment in which learning is fostered by active inquisition.1 The role of the teacher in PBL is not that of a giver of information. Rather the PBL tutor or facilitator takes on a new role in which he or she, curbing the desire to impart knowledge directly, focuses on the learning process that the student requires.2 The basic premise in PBL is that the students take the major responsibility for their own learning. Conducting case discussions in small groups, raising questions, proposing hypotheses, searching for information, presenting data, setting priorities relevant to the case, and teaching each other become the principal tasks for the students in PBL programs. This process has led to efficient integration of knowledge, has improved interdisciplinary collaboration, and has had positive effects on students and facilitators. This article analyzes current literature on the basis, effectiveness, and working models of PBL in allied health education. It is designed for readers who are unfamiliar with PBL and are interested in using this new approach in their curricula. The goals of this article are to explain the PBL rationale, process, and current outcomes research. Examples of PBL in medical education and its application to allied health education are presented. Historical Background and Perspective During the 1950s and 1960s, predominantly lecture-based courses taught in medical schools were criticized for their lack of relevance to future practice of physicians. Concerns were expressed about the limited use of teamwork, the poor development of inquiry skills, and the gap between theory and practice.3 In the traditional, lecture-based environment, students showed little interest in their own professional development, which is essential in a time of rapid technologic and information growth.4 The dissatisfaction with traditional education was also stressed by the World Health Organization (WHO), which stated that: The explosion of scientific information makes traditional curricula increasingly irrelevant, because they are based on what is known today, to the exclusion of how to learn what will be known tomorrow.5 This position was enhanced in the more recent WHO Technical Report Series,6 which recommend that health professionals' ability to perform well in health care settings can be improved by using PBL or other student-centered approaches. Studies7,8 also reported that senior medical and nursing students often were frustrated with their inability to recall or apply the knowledge they had learned in previous years. What was missing was enough emphasis on the problem-solving skills required for the synthesis of information. To address these concerns, a move toward PBL began at medical schools at Case Western University in the United States during the 1950s and at McMaster University in Canada in 1965.9-11 This approach was based on the premise that physicians needed to learn more about the human side of medicine rather than just the technical side. The PBL approach was so successful that Harvard Medical School adopted a similar program in the 1980s.12 It was not until many years later, however, that PBL made its introduction into allied health education. In the 1980s, the responsibilities of physical therapists and occupational therapists grew. Educators of these students in the United States and Canada were faced with the challenge of shifting the educational focus from technical skills training to educating professionals. These health care providers required clinical reasoning skills and the ability to review critically and integrate research findings. …