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Problem-based learning: an effective educational method for a surgery clerkship.
R W Schwartz1, M B Donnelly, P P Nash
1Department of Surgery, University of Kentucky College of Medicine, Lexington.
The Journal of Surgical Research
|October 11, 1992
Summary
Problem-based learning (PBL) improved medical student education, enhancing differential diagnosis and clinical data interpretation. While knowledge scores were similar, PBL showed a trend toward better surgical knowledge, especially when controlling for overall achievement.
Area of Science:
- Medical Education
- Curriculum Development
- Problem-Based Learning
Background:
- Traditional medical education methods are widely used.
- Problem-based learning (PBL) is an alternative pedagogical approach being implemented in medical schools.
- The effectiveness of PBL compared to traditional methods requires further investigation.
Purpose of the Study:
- To compare the educational effectiveness of problem-based learning (PBL) versus traditional Socratic teaching (SI) methods.
- To assess student performance in clinical clerkships using objective measures.
- To determine if PBL enhances critical thinking and knowledge acquisition in medical students.
Main Methods:
- A comparative study design involving medical students in their first, third, second, and fourth rotations.
- Students were divided into two groups: one receiving traditional Socratic teaching (SI) and the other problem-based learning (PBL).
- Performance was assessed using a modified essay examination (MEE) focusing on problem-solving and the National Board of Medical Examiners (NBME-II) exam, including its surgery subsection (NBME-II-S).
Main Results:
- The PBL group demonstrated significantly better performance in differential diagnosis formation (P < 0.01) and interpretation of clinical data (P < 0.03) on the MEE.
- Ordering appropriate lab and diagnostic studies approached statistical significance (P = 0.057) with better PBL group performance.
- No significant difference was found between groups on the NBME-II, but a trend favored PBL on the NBME-II-S (P = 0.059).
- Controlling for overall achievement, the PBL group showed significantly better performance on the NBME-II-S (P = 0.046).
Conclusions:
- Problem-based learning (PBL) is a more effective educational method than traditional Socratic teaching (SI) for specific aspects of clinical problem-solving.
- PBL enhances critical skills such as differential diagnosis and clinical data interpretation.
- While knowledge acquisition may be comparable, PBL shows potential for improving surgical knowledge and overall clinical competence.