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Aim: The intention of this brief literature review is to identify what aspects of the traditional problem-based learning framework can be applied in a case-based online learning session.

 

Methods: A Google search was conducted as a screening tool for relevant documents using the search terms “problem-based learning” AND “dental education”. This search was repeated in Ovid Medline and SCOPUS. Journal articles, University guides and book chapters found using these search engines were screened manually for relevance and publication quality through a subjective assessment of topic, agenda/funding, publication date, scientific methods, expression and the inclusion of further useful references. Information from these resources was applied to the learning outcomes for teaching session three and then synthesized into the following review.

 

Results: There is little quality contemporary evidence available on the use of problem-based learning(PBL) in dental education, and less still that evaluates an Australian context specifically. This reflects the fact that whilst medical education has embraced this concept decades ago, PBL has only started to feature significantly in dental curricula for approximately 10 years.(1)

 

Since dental trauma varies widely in its presentation and may be encountered only sporadically, this is a learning area in which process is favoured above memorization. It is hypothesized that such content is particularly suited to a PBL platform.(2) The remote delivery, time constraints, lack of teaching staff and on-site expertise associated with the teaching program developed introduces very specific challenges to the use of “authentic PBL” as it was prescribed by Howard Barrows and Robyn Tamblyn.(3, 4)

 

It is clear that broad differences exist in the definition of PBL and the framework for its delivery.(1, 3, 5) Whilst purists may not consider session three of this course to fit within these confines, such hybridization is now a widely acknowledged trend.(1) The fact that McMaster (the ‘homeland’ of PBL (3)) now adopts a more flexible format with properties of hybridization reveals a promising prospect of collegial lenience for well-intentioned educators.(1) It is clear that idealism has had to accommodate the financial and organizational challenges of modern health education and that this very general trend has tangible structural ramifications for individual PBL sessions.(1)

 

Based on characteristics described in literature relevant to the teaching of PBL in a health context, (1, 3, 4, 6-8) session three of this course conforms to and deviates from traditional PBL features in the following ways:

 

Conformity to traditional PBL features

  • Starts with a problem
  • Encourages students to summarise/interpret the situation
  • Encourages formation of problem list
  • Asks students to form cause and effect hypotheses
  • Prompts students to identify further information needed to test hypotheses
  • Allows students to create their own learning plan to acquire knowledge relevant to the problem
  • Encourages students to react to changes in the situation and newly presented information
  • Provides a chance for self reflection and learning strategy evaluation(1)
  • Facilitator/problem presentation provides reinforcements, destabilizations, hints and scaffolding.
  • Activation of prior knowledge
  • Encoding of specificity
  • Capacity for elaboration of knowledge
  • Encourages investigation of why, how and when (not just content knowledge)
  • Does not arrive at a specific ultimate solution
  • Facilitator intervenes as little as possible, serving primarily to assist as a prompt for progression through the PBL process

 

Divergences from PBL traditions

  • Online delivery without direct teacher input
  • Simulated facilitator
  • Provision of benchmarks for learning in key areas
  • Computer assistance to organize processes and knowledge gained

 

Conclusion:

The development of problem-based learning was borne from an aspiration to move towards a more ‘student-centered’ education approach.(3) Creation of guidelines for its application provide a useful reference, however dogmatic adherence to appointed ‘rules’ threatens to replace one ‘one size fits all’ approach with another.(1) A more flexible interpretation of this educational strategy may be necessary to accommodate modern limitations in teaching and learning resources and use technology to its full advantage.(1, 6) Although it is the author’s opinion that an approach such as that used for session three of this course upholds the ethos of PBL, there is currently insufficient evidence to state what (if any) efficacy reductions can be expected from this hybridization.

 

References:

1.       Winning T, Townsend G. Problem-based learning in dental education: what’s the evidence for and against…and is it worth the effort? ADJ. 2007;52(1):2-9.

 

2.       Marcangelo C, Gibbon C, Cage M. Problem Based Learning Evaluation Toolkit. The Higher Education Academy Health Sciences and Practice; 2009 [cited 2012 29th March]. Available from: www.pbldirectory.com/downloads/pbl-toolkit.pdf.

 

3.       Barrows H, Tamblyn R. Problem-Based Learning: An Approach to Medical Education. New York: Springer Publishing Company, Inc; 1980.

 

4.       Barrows H. The essentials of problem-based learning. J Dent Educ. 1998;62:630-3.

 

5.       Maudsley G. Do we all mean the same thing by “problem-based learning”? A review of the concepts and a formulation of the ground rules. Acad Med. 1999;74:178-85.

 

6.       Fincham AG, Shuler CF. The changing face of dental education: the impact of PBL. J Dent Educ. 2001 May;65(5):406-21.

 

7.       Balacheff N, Ludvigsen S, Jong T, Lazonder A, Barnes S. Technology-Enhanced Learning: Principles and Products. Amsterdam: Springer; 2009 [cited 2012 30th March]. Available from: http://books.google.com.au/books/about/Technology_Enhanced_Learning.html?id=ftmLICXFCPkC&redir_esc=y.

 

8.       Reznich CB, Werner E. Facilitators’ influence on student PBL small group session online information resource use: a survey. BMC Med Edu. 2004 Jun 15;4:9-13.