Problem-Based Learning in North American Primary Care Postgraduate Medical Education: A Rapid Review

Problem-based learning (PBL) in medical education is centered around a problem or case and is learner-led, involving small groups and problem-solving. PBL is ubiquitous in North American undergraduate medical education (UGME) due to reported learner satisfaction, efficacy, and long-term knowledge retention; however, its application to postgraduate medical education (PGME) is less defined. This review addresses the knowledge gap on the use and efficacy of PBL in PGME, specifically among primary care specialties due to their unique training needs, using the Kirkpatrick model as the theoretical basis for interpreting results. A search for articles using PubMed resulted in 17 selected articles that included primary care PGME learners undergoing at least one PBL session led by another learner. Learners were overwhelmingly satisfied with PBL, reporting increased confidence and comfort in the subject area. While none of the studies measured behavior change objectively, over half reported increased comfort in diagnosing, prescribing, and managing patients. This review extends the positive feedback found from PBL in UGME settings to apply to PGME and highlights the suitability of PBL for primary care due to increased confidence, learner satisfaction, perceived knowledge gain, and objective learning outcomes.