Problem-based learning, work demands and psychological distress in pre-registration house officers: a preliminary...

There has been little work examining the longer term occupational and psychological outcomes of problem-based learn-ing (PBL). The authors aimed to investigate the relationship between psychological distress, occupational factors and experience of PBL in the first cohort of UK pre-registration house officers to be trained exclusively using problem-based methods. Questionnaires were sent to al pre-registration house officers working in the three teaching hospitals in the Manchester area. Measures included demographic items, hours of actual work and the GHQ-12 as a measure of psychological distress, as well as validated Likert scales of job satisfaction, perceived work demands, support from superior,and experience and attitudes towards PBL. The response rate was 87% (66/76). Almost one-third of respondents (20/66) worked more than 72 hours a week. The occupational and psychological measures were significantly interrelated. The multiple regression analysis revealed that work demands and job satisfaction together accounted for over 45% of the variance in psychological distress. The other demographic, occupational and PBL-related factors did not make an independent contribution to distress. Scores were similar for respondents with high and low levels of exposure to PBL, and similar to scores obtained from a previous cohort of house officers graduating from a traditional course. These findings should be interpreted cautiously because of the small size of the current study and the setting. It is possible that as staff and students grow accustomed to new styles of teaching, and work intensity for junior doctors reduces, the effect of PBL will become more evident. Further research is needed examining the occupational and psychological outcomes of medical students taught by problem-based methods indifferent settings.