the authors acknowledge that despite the growth of interest in problem-based learning in medical education, there was, at that
time, little evidence to support problem-based learning and some confusion about exactly what problem-based learning was.
In order to identify studies that looked at the effectiveness of problem-based learning Albanese and Mitchell (1993) used
Barrows' (1985) definition of problem-based learning … “the basic outline of the problem-based learning process is:
encountering the problem first, problem solving with clinical reasoning skills and identifying learning needs in an interactive
process, self-study, applying newly gained knowledge to the problem, and summarizing what has been learned” (Barrows,
1985, p. 15).
The authors further defined, for the sake of their meta-analysis, conventional instruction as “instructor-provided learning
objectives and assignments, large-group lectures, structured laboratory experiences, and periodic multiple-choice tests of
achievement” (Albanese & Mitchell, 1993, p. 54).
With regards to knowledge acquisition, for six of the 10 studies that compared basic science examination performance,
traditional, lecture-based instruction produced higher test scores, and in three of these cases statistically significant higher
test scores. With regards to clinical problem-solving skills, in five of the seven studies that compared clinical examination
performance, problem-based instruction produced higher, though in only one case statistically significant higher examination
scores. For this meta-analytic survey, lecture-based instruction led to more general knowledge acquisition, while problembased
learning led to more problem-solving skill.
Additionally, with regards to student satisfaction, seven of seven studies looking at student satisfaction ratings for
problem-based learning showed average or higher than the mid-point scores on each rating scale. However, this result should
be interpreted cautiously as there was no comparison in any of the studies with traditional, lecture-based instruction. Finally,
the authors (Albanese & Mitchell, 1993) noted that in all studies that looked at students' perceptions of their preparation to do
clinical work problem-based students did not view themselves as being disadvantaged having learned through problembased
instruction, nor where problem-based students rated by their supervisors as being disadvantaged in their actual
clinical work. In general, these medical students rated themselves as highly satisfied with their experience, and did not feel
disadvantaged for doing future clinical work.
In general, these studies (Albanese & Mitchell, 1993) reveal a mixed bag with regards to problem-based learning. Problembased
learning improved problem-solving skills over traditional, lecture-based instruction; however, it did not improve and
actually decreases knowledge acquisition. At the same time, students in problem-based classrooms rated the course highly,
and did not feel disadvantaged for having gone through problem-based instruction.
Concurrently, though independently, Vernon and Blake (1993) conducted the second meta-analytic study comparing
problem-based learning with more traditional lecture-based learning across a variety of studies conducted in medical schools
from 1970 through 1992. Vernon and Blake (1993) defined problem-based learning as “a method of learning (or teaching) that
emphasized (1) the study of clinical cases, either real or hypothetical, (2) small discussion groups, (3) collaborative independent
study, (4) hypothetico-deductive reasoning, and (5) a style of faculty direction that concentrated on group processes
rather than imparting information” (pp. 550e551).
Eight published reports assessed, with a total of twenty-eight samples, contained data about students' academic
achievement as measured by standardized tests (Vernon & Blake, 1993). Overall, effect sizes for academic achievement
showed a significant trend in favor of lecture-based instruction. Twelve of the published reports assessed, with a total of
sixteen samples, contained data about students' problem-solving or clinical functioning. In thirteen of the sixteen samples
effect sizes significantly favored students exposed to problem-based learning. Just as Albanese and Mitchell (1993) found,
problem-based learning promotes problem-solving skill whereas traditional, lecture-based instruction promotes knowledge
acquisition.
Five of the published reports assessed contained data about students' evaluation of the curriculum such that effect sizes
could be calculated (Vernon & Blake, 1993). In every case, student attitudes favored problem-based learning over traditional,
lecture-based instruction. Again, as with Albanese and Mitchell (1993), problem-based learning is generally favored by
students.
In general, these studies (Vernon & Blake, 1993) replicate the mixed bag of results with regards to problem-based learning.
Problem-based learning improved problem-solving skills over traditional, lecture-based instruction; however, it did not
improve knowledge acquisition. At the same time, students favored problem-based learning.
Finally, and more recently, Dochy et al. (2003) conducted a meta-analysis on 43 published reports, from 1984 to 2000, with
a specific focus on comparing and contrasting the effects of problem-based vs. lecture-based learning on knowledge
acquisition and skill development and to consider moderator variables. Like Albanese and Mitchell (1993), these authors
(Dochy et al., 2003) noted the ambiguity in the definition of problem-based learning, but also followed Barrows' (1985)
definition.
Of the 43 studies included in the meta-analysis, 33 contained data on knowledge acquisition and 25 contained data on
knowledge application or skill development (Dochy et al., 2003). In general, using both effect size and vote count techniques,
problem-based learning showed a significant effect on knowledge application and skill development. However, traditional,
lecture-based instruction showed a directional, though non-significant, effect on knowledge acquisition.
In general, these more recent studies (Dochy et al., 2003) again replicate the mixed results for problem-based learning. In
all three meta-analytic studies (Albanese & Mitchell, 1993; Dochy et al., 2003; Vernon & Blake, 1993) problem-based learning
improved problem-solving skills over traditional, lecture-based instruction; however, it did not improve knowledge acquisition.
At the same time, students liked problem-based learning approaches.
the authors acknowledge that despite the growth of interest in problem-based learning in medical education, there was, at thattime, little evidence to support problem-based learning and some confusion about exactly what problem-based learning was.In order to identify studies that looked at the effectiveness of problem-based learning Albanese and Mitchell (1993) usedBarrows' (1985) definition of problem-based learning … “the basic outline of the problem-based learning process is:encountering the problem first, problem solving with clinical reasoning skills and identifying learning needs in an interactiveprocess, self-study, applying newly gained knowledge to the problem, and summarizing what has been learned” (Barrows,1985, p. 15).The authors further defined, for the sake of their meta-analysis, conventional instruction as “instructor-provided learningobjectives and assignments, large-group lectures, structured laboratory experiences, and periodic multiple-choice tests ofachievement” (Albanese & Mitchell, 1993, p. 54).With regards to knowledge acquisition, for six of the 10 studies that compared basic science examination performance,traditional, lecture-based instruction produced higher test scores, and in three of these cases statistically significant highertest scores. With regards to clinical problem-solving skills, in five of the seven studies that compared clinical examinationperformance, problem-based instruction produced higher, though in only one case statistically significant higher examinationscores. For this meta-analytic survey, lecture-based instruction led to more general knowledge acquisition, while problembasedlearning led to more problem-solving skill.Additionally, with regards to student satisfaction, seven of seven studies looking at student satisfaction ratings forproblem-based learning showed average or higher than the mid-point scores on each rating scale. However, this result shouldbe interpreted cautiously as there was no comparison in any of the studies with traditional, lecture-based instruction. Finally,the authors (Albanese & Mitchell, 1993) noted that in all studies that looked at students' perceptions of their preparation to doclinical work problem-based students did not view themselves as being disadvantaged having learned through problembasedinstruction, nor where problem-based students rated by their supervisors as being disadvantaged in their actualclinical work. In general, these medical students rated themselves as highly satisfied with their experience, and did not feeldisadvantaged for doing future clinical work.In general, these studies (Albanese & Mitchell, 1993) reveal a mixed bag with regards to problem-based learning. Problembasedlearning improved problem-solving skills over traditional, lecture-based instruction; however, it did not improve andactually decreases knowledge acquisition. At the same time, students in problem-based classrooms rated the course highly,and did not feel disadvantaged for having gone through problem-based instruction.Concurrently, though independently, Vernon and Blake (1993) conducted the second meta-analytic study comparingproblem-based learning with more traditional lecture-based learning across a variety of studies conducted in medical schoolsfrom 1970 through 1992. Vernon and Blake (1993) defined problem-based learning as “a method of learning (or teaching) thatemphasized (1) the study of clinical cases, either real or hypothetical, (2) small discussion groups, (3) collaborative independentstudy, (4) hypothetico-deductive reasoning, and (5) a style of faculty direction that concentrated on group processesrather than imparting information” (pp. 550e551).Eight published reports assessed, with a total of twenty-eight samples, contained data about students' academicachievement as measured by standardized tests (Vernon & Blake, 1993). Overall, effect sizes for academic achievementshowed a significant trend in favor of lecture-based instruction. Twelve of the published reports assessed, with a total ofsixteen samples, contained data about students' problem-solving or clinical functioning. In thirteen of the sixteen sampleseffect sizes significantly favored students exposed to problem-based learning. Just as Albanese and Mitchell (1993) found,problem-based learning promotes problem-solving skill whereas traditional, lecture-based instruction promotes knowledgeacquisition.Five of the published reports assessed contained data about students' evaluation of the curriculum such that effect sizescould be calculated (Vernon & Blake, 1993). In every case, student attitudes favored problem-based learning over traditional,lecture-based instruction. Again, as with Albanese and Mitchell (1993), problem-based learning is generally favored bystudents.In general, these studies (Vernon & Blake, 1993) replicate the mixed bag of results with regards to problem-based learning.Problem-based learning improved problem-solving skills over traditional, lecture-based instruction; however, it did notimprove knowledge acquisition. At the same time, students favored problem-based learning.Finally, and more recently, Dochy et al. (2003) conducted a meta-analysis on 43 published reports, from 1984 to 2000, witha specific focus on comparing and contrasting the effects of problem-based vs. lecture-based learning on knowledgeacquisition and skill development and to consider moderator variables. Like Albanese and Mitchell (1993), these authors(Dochy et al., 2003) noted the ambiguity in the definition of problem-based learning, but also followed Barrows' (1985)definition.Of the 43 studies included in the meta-analysis, 33 contained data on knowledge acquisition and 25 contained data onknowledge application or skill development (Dochy et al., 2003). In general, using both effect size and vote count techniques,problem-based learning showed a significant effect on knowledge application and skill development. However, traditional,lecture-based instruction showed a directional, though non-significant, effect on knowledge acquisition.In general, these more recent studies (Dochy et al., 2003) again replicate the mixed results for problem-based learning. Inall three meta-analytic studies (Albanese & Mitchell, 1993; Dochy et al., 2003; Vernon & Blake, 1993) problem-based learningimproved problem-solving skills over traditional, lecture-based instruction; however, it did not improve knowledge acquisition.At the same time, students liked problem-based learning approaches.
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