Impact of problem-based learning in a large classroom setting: student perception and problem-solving skills

Problem-based learning (PBL) can be described as a learning environment where the problem drives the learning. This technique usually involves learning in small groups, which are supervised by tutors. It is becoming evident that PBL in a small-group setting has a robust positive effect on student learning and skills, including better problem-solving skills and an increase in overall motivation. However, very little research has been done on the educational benefits of PBL in a large classroom setting. Here, we describe a PBL approach (using tutorless groups) that was introduced as a supplement to standard didactic lectures in University of British Columbia Okanagan undergraduate biochemistry classes consisting of 45-85 students. PBL was chosen as an effective method to assist students in learning biochemical and physiological processes. By monitoring student attendance and using informal and formal surveys, we demonstrated that PBL has a significant positive impact on student motivation to attend and participate in the course work. Student responses indicated that PBL is superior to traditional lecture format with regard to the understanding of course content and retention of information. We also demonstrated that student problem-solving skills are significantly improved, but additional controlled studies are needed to determine how much PBL exercises contribute to this improvement. These preliminary data indicated several positive outcomes of using PBL in a large classroom setting, although further studies aimed at assessing student learning are needed to further justify implementation of this technique in courses delivered to large undergraduate classes.     

University health sciences students rating for a blended learning course framework

ObjectivesOnline teaching methods are used to identify the effectiveness of blended learning. The present study aimed to evaluate the attitudes and satisfaction of health sciences students in Saudi Arabia towards blended learning.MethodsThe study used mixed research approach by recruiting students from academic year 2017–2019. Phenomenography technique were used to examine the qualitative data for research.ResultsThe instrument was a valid measurement outcome for blended learning courses. Students generally preferred team-based learning rather than face-to-face lectures, which serves as a collaborative learning pedagogy. A high positive attitude and motivation was revealed among the students with respect to the blended model in teaching the research course.ConclusionThe attitude and satisfaction of students seemed to play a vital role in teaching and learning outcomes. Moreover, it was found that the e-learning tools provided flexible learning environment to the students, regardless of location and time zone.     

A blended approach to active learning in a physiology laboratory-based subject facilitated by an e-learning component

Learning via online activities (e-learning) was introduced to facilitate existing face-to-face teaching to encourage more effective student preparation and then informed participation in an undergraduate physiology laboratory-based course. Active learning was encouraged by hypothesis formation and predictions prior to classes, with opportunities for students to amend their e-learning submissions after classes. Automatic or tutor feedback was provided on student submissions. Evaluation of the course was conducted via student questionnaires, individual student interviews, and analysis of student marks in examinations and of the e-learning component. Student feedback on this entire subject in the university-wide quality of teaching survey was very high by University of Melbourne standards and most encouraging for the first implementation of such a curriculum modification. Results from further detailed surveys of student interactions and engagement and correlation analysis between student responses were also very supportive of the effectiveness of the course. There were no significant differences between examination marks in the new course with e-learning and the previous year without e-learning. However, there was a significant correlation between assessment of student e-learning work and their final examination mark. Correlation analysis between various survey responses helped interpret results and strengthened arguments for e-learning and suggested future improvements for student use of e-learning. This mode of e-learning used to support face-to-face learning activities in the laboratory can be adapted for other disciplines and may assist students in developing a greater appreciation and a deeper approach for learning from their practical class experiences.     

PBL教学法在细胞生物学讨论课中的应用

目的：探讨PBL教学法在临床医学专业本科生细胞生物学讨论课中的应用效果。方法：以2011级第四军医大学临床医学专业本科生为对象,随机分为PBL教学组和传统教学组,通过考试与问卷调查的方式,对应用PBL教学法的细胞生物学讨论课的教学效果进行分析与比较。结果：PBL教学组课后随堂测试成绩和学生满意度均明显高于传统教学组,PBL教学法能激发学生的学习兴趣、提高学习效率、培养学生分析与解决问题能力和团结协作的能力。结论：PBL教学法有利于提高教学效果和学生综合素质,值得在细胞生物学教学中推广和应用。     

Improving Education in Medical Statistics: Implementing a Blended Learning Model in the Existing Curriculum

Background

Although recent studies report on the benefits of blended learning in improving medical student education, there is still no empirical evidence on the relative effectiveness of blended over traditional learning approaches in medical statistics. We implemented blended along with on-site (i.e. face-to-face) learning to further assess the potential value of web-based learning in medical statistics.

Methods

This was a prospective study conducted with third year medical undergraduate students attending the Faculty of Medicine, University of Belgrade, who passed (440 of 545) the final exam of the obligatory introductory statistics course during 2013–14. Student statistics achievements were stratified based on the two methods of education delivery: blended learning and on-site learning. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course.

Results

Mean exam scores for the blended learning student group were higher than for the on-site student group for both final statistics score (89.36±6.60 vs. 86.06±8.48; p = 0.001) and knowledge test score (7.88±1.30 vs. 7.51±1.36; p = 0.023) with a medium effect size. There were no differences in sex or study duration between the groups. Current grade point average (GPA) was higher in the blended group. In a multivariable regression model, current GPA and knowledge test scores were associated with the final statistics score after adjusting for study duration and learning modality (p<0.001).

Conclusion

This study provides empirical evidence to support educator decisions to implement different learning environments for teaching medical statistics to undergraduate medical students. Blended and on-site training formats led to similar knowledge acquisition; however, students with higher GPA preferred the technology assisted learning format. Implementation of blended learning approaches can be considered an attractive, cost-effective, and efficient alternative to traditional classroom training in medical statistics.     

Can learning style predict student satisfaction with different instruction methods and academic achievement in medical education?

The curriculum of our medical school has a hybrid structure including both traditional training (lectures) and problem-based learning (PBL) applications. The purpose of this study was to determine the learning styles of our medical students and investigate the relation of learning styles with each of satisfaction with different instruction methods and academic achievement in them. This study was carried out with the participation of 170 first-year medical students (the participation rate was 91.4%). The researchers prepared sociodemographic and satisfaction questionnaires to determine the characteristics of the participants and their satisfaction levels with traditional training and PBL. The Kolb learning styles inventory was used to explore the learning styles of the study group. The participants completed all forms at the end of the first year of medical education. Indicators of academic achievement were scores of five theoretical block exams and five PBL exams performed throughout the academic year of 2008-2009. The majority of the participants took part in the "diverging" (n = 84, 47.7%) and "assimilating" (n = 73, 41.5%) groups. Numbers of students in the "converging" and "accommodating" groups were 11 (6.3%) and 8 (4.5%), respectively. In all learning style groups, PBL satisfaction scores were significantly higher than those of traditional training. Exam scores for "PBL and traditional training" did not differ among the four learning styles. In logistic regression analysis, learning style (assimilating) predicted student satisfaction with traditional training and success in theoretical block exams. Nothing predicted PBL satisfaction and success. This is the first study conducted among medical students evaluating the relation of learning style with student satisfaction and academic achievement. More research with larger groups is needed to generalize our results. Some learning styles may relate to satisfaction with and achievement in some instruction methods.     

军校五年制学员营养学PBL教学模式的构建及效果评价

目的:探讨PBL教学模式在营养学教学中的作用及不足,并评价其教学效果。方法:采用随机抽样的方法,选取第四军医大学2012级五年制营养学专业学员(114名)实施PBL教学,2011级五年制临床专业学员(159名)实施传统教学;从四个方面(考试成绩、教学满意度、学员解决未知问题的方式、学习兴趣及积极性)综合评价PBL教学效果。结果:与传统教学组相比较,PBL教学组的考试成绩、教学满意度、学员解决未知问题的方式以及学习兴趣均显著升高。结论:PBL教学模式不仅提高了学员的考试成绩,还提高了学员的学习能力与素质,有必要进一步优化并大力推广。     

Toward meaningful learning in undergraduate medical education using concept maps in a PBL pathophysiology course

Problem-based learning (PBL) is now an established method in undergraduate medical education that aims to develop reasoning skills based on clinical problems. More recently, the use of concept mapping in medical education aims to improve meaningful learning. At the New University of Lisbon, we have been using PBL as a major educational method in a pathophysiology course. In 2003-2004, we started to use Inspiration, a computer-based concept mapping tool, with a single tutorial PBL group. A total of 36 maps were constructed related to short cases, already used in the PBL course, in which a certain number of key nodes were hidden to allow the students to fill in the gaps. The results obtained appear to indicate that the use of concept maps stimulated meaningful learning within a PBL course.     

Teaching baroreflex physiology to medical students: a comparison of quiz-based and conventional teaching strategies in a laboratory exercise

Quiz-based and collaborative teaching strategies have previously been found to be efficient for the improving meaningful learning of physiology during lectures. These approaches have, however, not been investigated during laboratory exercises. In the present study, we compared the impact of solving quizzes individually and in groups with conventional teaching on the immediate learning during a laboratory exercise. We implemented two quizzes in a mandatory 4-h laboratory exercise on baroreflex physiology. A total of 155 second-year medical students were randomized to solve quizzes individually (intervention group I, n = 57), in groups of three to four students (intervention group II, n = 56), or not to perform any quizzes (control; intervention group III, n = 42). After the laboratory exercise, all students completed an individual test, which encompassed two recall questions, two intermediate questions, and two integrated questions. The integrated questions were of moderate and advanced difficulty, respectively. Finally, students completed an evaluation form. Intervention group I reached the highest total test scores and proved best at answering the integrated question of advanced difficulty. Moreover, there was an overall difference between groups for student evaluations of the quality of the teaching, which was highest for intervention group II. In conclusion, solving quizzes individually during a laboratory exercise may enhance learning, whereas solving quizzes in groups is associated with higher student satisfaction.     

Integrating an open-source course management system (Moodle) into the teaching of a first-year medical physiology course: a case study

Educators in medical schools around the world are presently experimenting with innovative ways of using web-based learning to supplement the existing teaching and learning process. We have recently used a popular open-source course management system (CMS) called the modular object-oriented dynamic learning environment (Moodle) to construct an online site (DPhysiol) to facilitate our face-to-face teaching of physiology to a group of first-year students in the Bachelor of Medicine and Bachelor of Surgery program. The integration of the Moodle site into our teaching was assessed using online log activity, student examination marks, and feedback from students. The freely available Moodle platform was simple to use, helped to effectively deliver course materials, and has features that allowed cooperative learning. Students who used the CMS throughout their academic year and commented favorably regarding its use as a complement to the face-to-face classroom sessions. The group of students used the CMS obtained significantly higher scores in the final examination compared with the previous class that did not use the CMS. In addition, there was a significant correlation between student participation and performance in online quizzes and their final examination marks. However, students' overall online usage of the CMS did not correlate with their examination marks. We recommend Moodle as a useful tool for physiology educators who are interested in integrating web-based learning into their existing teaching curriculum.     

Student-centered introductory biology course: evidence for deep learning

Our interpretative study that was carried out in a science and engineering oriented university examined the ways students in an introductory biology course perceived their learning in the course that was substantially changed to allow student-centered learning. The instructional change was framed by the view of learning as a sociocultural activity as well as a cognitive process that can take place face-to-face or through online interaction. Most of the lectures were substituted with individual learning and project-based, small-group learning that lasted one month. Data were collected through interviews with students and instructors, and through observations. In the paper, we show evidence for deep learning that was associated by the students and the instructors with short-term, meaningful activities in a setting that included collaborative peer learning; and replacing most lectures by small group learning that ended in a mini-conference. Deep learning was evidenced by the ways students reflected on how they organised and applied knowledge using deep learning strategies.     

Enhancing learning through optimal sequencing of web-based and manikin simulators to teach shock physiology in the medical curriculum

The Association of American Medical Colleges has encouraged educators to investigate proper linkage of simulation experiences with medical curricula. The authors aimed to determine if student knowledge and satisfaction differ between participation in web-based and manikin simulations for learning shock physiology and treatment and to determine if a specific training sequencing had a differential effect on learning. All 40 second-year medical students participated in a randomized, counterbalanced study with two interventions: group 1 (n = 20) participated in a web-based simulation followed by a manikin simulation and group 2 (n = 20) participated in reverse order. Knowledge and attitudes were documented. Mixed-model ANOVA indicated a significant main effect of time (F(1,38) = 18.6, P < 0.001, η(p)(2) = 0.33). Group 1 scored significantly higher on quiz 2 (81.5%) than on quiz 1 (74.3%, t(19) = 3.9, P = 0.001), for an observed difference of 7.2% (95% confidence interval: 3.3, 11.0). Mean quiz scores of group 2 did not differ significantly (quiz 1: 77.0% and quiz 2: 79.7%). There was no significant main effect of group or a group by time interaction effect. Students rated the simulations as equally effective in teaching shock physiology (P = 0.88); however, the manikin simulation was regarded as more effective in teaching shock treatment (P < 0.001). Most students (73.7%) preferred the manikin simulation. The two simulations may be of similar efficacy for educating students on the physiology of shock; however, the data suggest improved learning when web-based simulation precedes manikin use. This finding warrants further study.     

Expanding the traditional physiology class with asynchronous online discussions and collaborative projects

Discussion and writing are very powerful ways to support learning. This article describes the use of a free, asynchronous online forum to expand student-teacher discussions beyond the time/place constraints of the physical physiology classroom. The main participants were medical students enrolled in physiology class at the University of Zagreb Medical School and their teachers. The assessment data were collected by the electronic administration of the software, by anonymous paper questionnaires, and by the results of the final examination in physiology. During one academic year, 25% (n = 55) of 220 students enrolled in a traditional physiology course participated in online discussions. Physiology teachers and other faculty also joined the forum. All forum members (n = 99) posted 395 messages. Nine documents were published by six students who participated in two online collaborative projects. The difference in the mean grade of the final examination in physiology between student members and nonmembers was statistically significant (P = 0.0328, t = 2.1526). Students who participated in Web discussions were self-selected. Likely, they are the most motivated students, who would perform better on the final examination with or without this resource. Nevertheless, using an online forum could be very successful in teaching critical thinking in physiology because the Internet removes traditional time/place barriers. However, new barriers related to technology and behavioral changes are created. For most teachers and students, the main obstacles to information technology implementation are lack of motivation and lack of professional incentives. To overcome these barriers, institutional support is needed for both students and teachers.     

基于BOPPPS的混合式教学模式在生物化学中的应用

随着互联网时代的到来,大规模开放式在线课程(慕课,MOOC)为教育改革提供了新的研究思路和方向。为了提高生物化学的学习效果,本文结合该课程知识点杂而多、理论性强和学生学习兴趣不高的特点,设计了一种基于BOPPPS教学的线上线下混合式教学模式,并在生物化学课程中进行了实践。BOPPPS中的情景案例激发了学生的学习兴趣,逐层递进的课堂练习让学生沉醉其中。研究结果表明,体验过混合式学习的学生与通过传统学习方式学习的学生相比,实验组学生对知识的理解深度明显好于对照组,在学习效果上也存在显著差异(P<0.05),试验组学生的平均成绩(81.13)比对照组学生的平均成绩(76.21)提升5分左右。问卷调查结果显示,与传统教学模式相比,学生更愿意接受新的教学模式,并愿意在未来的学期里支持继续使用新型的教学模式。学生认为,能从新的教学模式学到比传统的授课形式要多的知识,而且新的教学模式还促进了团队合作能力,提高了学生的学习兴趣,学生课前愿意花费较长时间自主预习。该方法激发了学生的学习主动性,促进了学生更好地学习。     

Study of physiological responses to acute carbon monoxide exposure with a human patient simulator

Human patient simulators are widely used to train health professionals and students in a clinical setting, but they also can be used to enhance physiology education in a laboratory setting. Our course incorporates the human patient simulator for experiential learning in which undergraduate university juniors and seniors are instructed to design, conduct, and present (orally and in written form) their project testing physiological adaptation to an extreme environment. This article is a student report on the physiological response to acute carbon monoxide exposure in a simulated healthy adult male and a coal miner and represents how 1) human patient simulators can be used in a nonclinical way for experiential hypothesis testing; 2) students can transition from traditional textbook learning to practical application of their knowledge; and 3) student-initiated group investigation drives critical thought. While the course instructors remain available for consultation throughout the project, the relatively unstructured framework of the assignment drives the students to create an experiment independently, troubleshoot problems, and interpret the results. The only stipulation of the project is that the students must generate an experiment that is physiologically realistic and that requires them to search out and incorporate appropriate data from primary scientific literature. In this context, the human patient simulator is a viable educational tool for teaching integrative physiology in a laboratory environment by bridging textual information with experiential investigation.     

LBL与PBL相结合的教学模式在生理学教学中的应用及效果评价

目的:探讨LBL(Lecture-based Learning)结合PBL(Problem-Based Learning)教学在生理学教学中的应用及效果。方法:以山西医科大学汾阳学院2012级影像专业本科生为研究对象,学生随机分为两个教学班(A班与B班)。A班(102人)采用LBL教学,B班(42人)采用LBL结合PBL教学。其中,B班在PBL教学中分为7个小组,每组6人。课程结束后,两班采取相同试卷考试,对考试总成绩及论述题成绩比较分析,采用DREEM量表对教育环境进行评估。结果:B班论述题成绩显著高于A班(P0.05),但两班总成绩差异无统计学意义(P0.05);DREEM量表调查显示,B班学生的学习知觉、环境知觉、社交自我知觉、教育环境评估得分显著高于A班(P0.05);两班对教师的知觉、学术自我知觉得分差异无统计学意义(P0.05)。结论:LBL结合PBL教学可有效改善生理学教学环境,提高教学效果。     

Learning approaches of undergraduate medical students to physiology in a non-PBL- and partially PBL-oriented curriculum

Melaka Manipal Medical College (Manipal Campus; Manipal, Karnataka, India) conducts the Bachelor of Medicine and Bachelor of Surgery program, for which the admission intakes are during the months of March and September. The present study was undertaken to study the differences in learning approaches to physiology of undergraduate medical students in a partially problem-based learning (PBL)- and non-PBL-oriented curriculum. PBL was introduced as a curricular reform for the September 2006 batch of students (partially PBL group), whereas it was not incorporated for the March 2006 batch of students (non-PBL group). Learning approaches to physiology of both groups of students were compared using the short inventory of approaches to learning. Mean scores for deep and strategic approaches were found to be significantly higher for the partially PBL group compared with the non-PBL group. The results of the present study support the earlier observation that PBL promotes a deep approach to learning.     

Combination of didactic lecture with problem-based learning sessions in physiology teaching in a developing medical college in Nepal

Physiology teaching as an essential part of medical education faces tremendous criticism regarding curriculum design, methods of implementation, and application of knowledge in clinical practice. In the traditional method of medical education, physiology is taught in the first year and involves little interdisciplinary interaction. The Manipal College of Medical Sciences, Pokhara, Nepal (affiliated with the Kathmandu Univ.) started in 1994 and adopted an integrated curriculum drawn along the lines of the student-centered, problem-based, integrated, community-based, elective-oriented, and systematic (SPICES) medical curriculum. Here, physiology is taught for the first 2 yr of the 4.5-yr Bachelor of Medicine, Bachelor of Surgery course. Methodology adopted is as follows. For a particular topic, objectives are clearly defined and priority content areas are identified. An overview is given in a didactic lecture class to the entire batch of 100 students. Tutorial classes are conducted thereafter with smaller groups of students (25/batch) divided further into five subgroups of five students each. In these sessions, a problem is presented to the students as a focus for learning or as an example of what has just been taught. Each problem was accompanied with relevant questions to streamline the students' thought processes. A tutor is present throughout the session not as an instructor but as a facilitator of the learning process. A questionnaire sought students' opinion on the usefulness of this approach, relevance of the combination of problem-based learning (PBL) sessions and didactic lectures in understanding a particular topic and relating clinical conditions to basic mechanisms, and improvement of performance on the university final examination. The majority of the students opined that the combination of didactic lectures and PBL sessions was definitely beneficial regarding all the above-mentioned aspects of learning. The university results corroborated their opinion. Thus it may be considered that a judicious mixture of didactic lectures and PBL sessions is beneficial as a teaching module of physiology in medical schools.     

PBL教学在内科学教学中的应用

目的：探讨以问题为基础PBL教学在内科学临床教学中的应用。方法：对在内科学课程教学中50位内科临床医学本科专业学生随机分为2组,对26人采用PBL教学、24人采用传统教学之后,进行理论考试和临床技能考试,并调查学生的满意度。结果：PBL教学组的理论考试成绩（94.12±8.56 vs 83.76±7.79）、临床技能考试成绩（95.93±9.73 vs 81.08±8.06）、总成绩得分（95.03±9.01 vs 82.42±7.91）均较传统教学组明显提高,学生对PBL教学方法的满意率为96.15%,对教学效果的满意率为100%,对小组功能的满意率为92.31%,对教师评价的满意率为96.15%。结论：PBL教学法在内科学教学中优于传统教学方法,学生的基础理论和临床技能均有明显提高,教学满意度高。     

Comparing biology majors from large lecture classes with TA-facilitated laboratories to those from small lecture classes with faculty-facilitated laboratories

The teaching faculty for this course sought to address their own concerns about the quality of student learning in an impersonal large lecture biology class for majors, the difficulties in getting to know each student by name, and difficulties in soliciting answers and reactions from the students during the lecture. Questions addressed by this study were, Do active-learning activities in a small and personal lecture setting enhance student learning more than active-learning activities in large impersonal lectures? and Are students more satisfied with an educational experience in a small and personal lecture setting? Based on faculty perceptions of how they best relate to their students, the prediction was that the students in the experimental group with small lecture classes and increased direct contact with the teaching faculty would learn physiological principles better than the students in the control group in the large impersonal lecture portion of the course. One of the laboratory sections of this large enrollment biology course was randomly selected to be taught with separate small lectures by the teaching faculty. In addition, the teaching faculty participated in the laboratory with these students during their experiments correlated with the lecture material. The students in both groups were compared by pre- and posttests of physiological principles, final course grades, and class satisfaction surveys.