Caffeinating the PBL return session: Curriculum innovations to engage students at two medical schools

At the David Geffen School of Medicine at the University of California, Los Angeles, and the George Washington University School of Medicine and Health Sciences, authors observed that problem-based learning (PBL) return sessions for first- and second-year medical students often lacked the energy and engagement of first sessions. Unlike in first sessions, where students took on the physician's role and actively problem solved, in return sessions students spent much of their time passively, listening to research reports on learning objectives. Time spent listening to reports dilutes return session impact, with the patient receding from view as the level of abstraction increases and learning issues take center stage. In this Perspective, the authors present innovations, developed separately at their respective medical schools between 2009 and 2012, designed to reenergize the return session.To frame the discussion of the return session slump and their innovations in response to it, the authors used self-determination theory (SDT) and active learning theory (ALT), both of which are supported by a considerable body of evidence. SDT provides understanding of how to maximize PBL learners' motivation, and ALT sheds light on how to promote PBL learners' incorporation of concepts into long-term memory. As motivation and memory are key factors in learning, both theories are appropriate tools to help understand and maximize the effectiveness of PBL. Finally, guided by these theories, the authors present reflections on future directions for the development of PBL.