Problem based learning
Problem-based learning ( PBL ), also problem-oriented learning ( POL ), is a form of learning whose characteristic is that the learner should find a solution to a given problem largely independently. The following explanations relate to use in medical training, but they can mainly be transferred to other areas of education. For problem-oriented teaching, however, not all of the features listed below are mandatory (even a lecture that invites you to think along can be problem-oriented).
Problem-based learning stands for self-determined and discovering learning , action-oriented teaching , interdisciplinary learning and self- evaluation . The participants learn to analyze a topic or a question, to find and use suitable sources of information and finally to compare, select and implement solutions. The lecturer is replaced by a tutor in the classic sense or is completely absent. The participants are expected to have initiative and thus self-directed learning . The practical training units are based directly on the topic. The learning material is problem-oriented and developed outside of traditional teaching subjects, ie always across subjects, in case studies by the learners.
The origins of the PBL lie in the educational ( John Dewey , laboratory school around 1900) and technical area: A publication Shoemakers from 1960 describes a procedure in the context of the training of engineers. In medical education, PBL was first introduced in 1969 by McMaster University in Canada. In some cases, university foundations were also specifically geared towards problem-based learning, such as the Medical Faculty at Maastricht University , which opened in 1976 .
PBL in Germany
At the private university in Witten / Herdecke there was PBL as a form of teaching in medicine for the first time in Germany since 1992. PBL could officially be offered in medical training for the first time in the winter semester 1999/2000 at the Charité Berlin parallel to the standard course of study. After a test phase of several years from 1996, PBL / POL became a compulsory component of the HeiCuMed reform course introduced in 2001 (Heidelberg Curriculum Medicinale). Since then, lecturers have been familiarized with the special features of this teaching and learning format in regular training courses. This became legally possible through an experimentation clause in the German license to practice medicine at the time. In the 2003/2004 winter semester, for example, a reform course in medicine was introduced at the Ruhr University in Bochum , parallel to the standard course . Reform and model courses with PBL elements have also been introduced at faculties such as Cologne and Aachen. With the introduction of the medical model course at the Charité in the 2010/2011 winter semester, the reform and standard course was replaced and PBL and POL were introduced as a compulsory teaching format for all students. At Bielefeld University, too, problem-oriented learning is used for larger learning groups in a bachelor's degree in economics.
How PBL works
An authentic and complex written problem is usually the starting point.
The teaching method described here, developed at Maastricht University, is also called the “seven-jump method”.
- Clarify unknown terms
- The text is discussed by the participants in group work (usually five to eight participants). Terms in the sense of simple vocabulary questions are clarified, ideally by the participants themselves, if necessary by a tutor (see below).
- Finding a topic or defining a problem
- The participants determine the type of task and define problems. It can be very desirable that “problems on the meta level ” are also defined (for example, lack of previous knowledge, lack of experience in dealing with the PBL method or group dynamics problems).
- Brainstorm to generate hypotheses
- In the next step, hypotheses are generated that can be used for further processing of the text or the case. These hypotheses can relate, for example, to how the problems came about, what additional information may have to be collected and, of course, how the problems could be solved. It is important that this step is held in the form of a value-free brainstorming , i.e. H. is not discussed, questioned or justified.
- Systematic ordering and evaluation of the hypotheses
- The discussion is reserved for the fourth step, which ultimately serves to confirm useful, further hypotheses and to be able to discard unusable hypotheses (justified!).
- Formulation of learning objectives
- The learning objectives are formulated. These should cover knowledge deficits revealed in the previous steps and ultimately help to edit the text finally (for example to solve problems described in the text).
- Research ("learning time")
- At this point, the group work is initially over, and each participant now conducts research independently or in small group work in order to work out the formulated learning goals. The Internet, articles from specialist journals and books can and should be used for this purpose.
- At the next meeting of the teaching group, the participants bring together the results of their work, work out a synthesis , review the information obtained and evaluate their own work.
In medical education, the problem is often a specially constructed case. As a rule, the case is presented in a small group moderated by a specially trained PBL tutor (whether the tutor has to be an expert in the subject area or only in the topic dealt with in the case or even only in the application of the PBL method is in medical education controversial). After the presentation of the case, questions on the respective case are formulated together. At the beginning of the course in particular, the aim is not to make a specific diagnosis at the end (a PBL case is not a "guessing thriller"), but rather to work out and understand fundamental relationships. Within the framework of PBL, students are expected to independently work out the questions they have formulated by the next PBL seminar and then discuss the results with the PBL tutor. PBL can also mean that the students have the opportunity between the seminars to work on the macroscopic anatomy of cadavers or to carry out biochemical or physiological experiments in order to work out their learning goals in this way.
PBL curricula are not classically divided into pre-clinical, clinical-theoretical and clinical-practical subjects. Rather, the content is usually divided into thematic blocks, such as “The musculoskeletal system” or “Before the birth”, according to the interdisciplinary nature of this approach.
Problem-based learning is intended to promote the acquisition of knowledge that can be used flexibly, the development of interdisciplinary skills and better problem-solving skills. Social competence and the ability to work in a team are key qualifications that can be acquired as part of this training. PBL cannot replace traditional teaching and learning methods such as classic lectures, but it can complement them.
Scientific studies indicate that students who have completed a PBL curriculum have a little less knowledge of the theoretical foundations of medicine, but compensate for this with better clinical knowledge. It can be considered largely certain that students of medicine who have primarily studied PBL-based studies are not inferior to students of other curricula in the state exams and other "conservative" written examinations (here primarily in the form of multiple choice questions) .,
PBL-based teaching is very time-consuming to implement and also means significant investments for the faculty. A completely new curriculum has to be created, members of the faculty have to be trained to become PBL tutors, and last but not least, a certain minimum equipment is required. For example, a far larger number of seminar rooms than usual is required, and the library must be equipped in such a way that students can research your PBL cases there. Finally, PBL calls for a rethink on the part of the teachers (“from saying at the stage to guide by the side”). However, higher investments in the sense of higher financial expenditures are not necessarily to be expected, for example if fewer highly paid specialist staff are used through the use of student tutors or research assistants in the PBL.
- Volker Ladenthin: Problem-oriented history lessons. In: History, Politics and their Didactics. 10, 1982, pp. 30-34.
- E. Kiel, J. Kahlert, L. Haag, T. Eberle: Challenging situations in school. A case-based workbook. Klinkhardt, Bad Heilbrunn 2011.
- JHC Moust, PAJ Bouhuijs, HG Schmidt: Problem-oriented learning . Ullstein Medical, Wiesbaden 1999.
- H. Shoemaker: The functional context method of instruction. Human Resources Research Office, George Washington University. In: IRE Transactions on Education. 3, 2, 1960, pp. 52-57. doi : 10.1109 / TE.1960.4322128
- Human medicine course. ( Memento from July 2, 2007 in the web archive archive.today ) at: wga.dmz.uni-wh.de
- T. Steiner, J. Jünger, J. Schmidt, H. Bardenheuer, M. Kirschfink, M. Kadmon, G. Schneider, H. Seller, HG Sonntag: HEICUMED: Heidelberger Curriculum Medicinale - A modular reform course to implement the new license to practice medicine . In: Med. Training . No. 20 , 2003, p. 87-91 .
- S. Skelin, S. Huwendiek, S. Nikendei, P. Dieter, M. Kirschfink, HM Hans-Martin Bosse: The good POL tutor - to be or not to be: Educational films for tutors. In: Z. Evid. Forbild. Qual. Healthcare (ZEFQ) . No. 102 , 2008, p. 634-641 .
- Model course in medicine. ( Memento from July 23, 2012 in the web archive archive.today ) on: charite.de
- Problem-oriented learning. to: wiwi.uni-bielefeld.de
- HG Schmidt: Problem-based learning: Rationale and description. In: Medical Education. 17, 1983, pp. 11-16.
- Dolmans et al .: Trends in research on the tutor in problem-based learning: conclusions and implications for educational practice and research. In: Med Teach. 24, 2002, pp. 173-180.
- SP Menin, M. Friedman, B. Skipper et al: Performances on the NBME I, II, and III by medical students in the problem-based learning and conventional tracks at the University of New Mexico. In: Acad Med. 68, 1993, pp. 616-624.
- Mark Newman: A pilot systematic review and meta-analysis on the effectiveness of problem-based learning. ( Page no longer available , search in web archives ) Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. (PDF file; 321 kB) - On behalf of the Campbell Collaboration Systematic Review Group on the Effectiveness of Problem-based Learning. Learning and Teaching Support Network-01, Special Report 2. Newcastle: LTSN 2003.
- Mark A. Albanese, S. Mitchell: Problem-based learning: a review of literature on its outcomes and implementation issues. In: Acad Med. 68 (1), 1993, pp. 52-81.
- RM Harden, J. Crosby: AMEE Guide No 20: The good teacher is more than a lecturer - the twelve roles of the teacher . In: Medical Teacher . tape 22 , no. 4 , July 2000, p. 334-347 .
- ACN Kruseman, M. Kolle, AJJ Scherpbier: Problem-based learning at Maastricht: An assessment of cost and outcome. In: Education for Health. 10, 1997, pp. 179-187.