Problem-Based Learning

Introduction:
Problem-based learning is a teaching or training method characterized by the use of "real
world" problems as a context for individuals to learn critical thinking and problem solving skills
and acquire knowledge. It involves both knowing and doing.

Definition:
Problem-based learning can be explained as “the learning that results from the process of
working toward the understanding or resolution of a problem”
- Barrows, (1980).
Problem-based learning is “a conception of knowledge, understanding and education that is
profoundly different from the more usual concept underlying subject-based learning.”
- (Margetson, 1991).
Problem-based learning is “a curriculum development and instructional system that
simultaneously develops both problem solving strategies and disciplinary knowledge bases and
skills by placing students in the active role of problem solvers confronted with an ill-structured
problem that mirrors real-world problems”.
- Finkle and Torp (1995).
Problem-based learning can be best defined as the individualized learning that results from the
processes involved in working toward the solution or resolution of a problem.

Purpose:
1. To gain an understanding of principles that underline phenomenon.
2. Helps to aim at problem analyzing skills training in particular professional situation.
3. To exercise that students learn to take decision independently.
4. Helps to activate prior knowledge and to integrate that knowledge.

Characteristics:
 1. The starting point for learning should be a problem, a query or puzzles that the learner
wishes to solve.
2. Learning for ‘capability’ rather than sake of acquiring knowledge.
3. Student centered nature of approach which its emphasis on “self directed learning”.
4. The structuring of learning within the clinical context.
5. The development of an effective clinical reasoning process.
6. The development of effective self directed learning skills.
7. Increase in motivation for learning.

Principles of PBL
1. Understanding comes from our interaction with the environment.
2. Cognitive conflict stimulates learning.
3. Knowledge evolves through social negotiation and evaluation of the viability of
individual understanding.

Organization of PBL sessions

Problem-based learning means cooperative learning starting off with a problem. The problem is
in the centre of the focus should foster a process among the students of assessing and
discussing the issues of the problem. The goal is to activate prior knowledge of the students and
to help them to start a learning process by reconstructing their knowledge and making new
sense of it. Problem-based learning takes place in two/more sessions per week. Some with only
one week. Within each block a PBL group will likely to encounter 5 to 8 problems.
A typical PBL tutorial consists of a group of students (usually six to ten) and a tutor, who
facilitates the session. The length of time and number of sessions a group spends together may
vary, but the time allocated should permit group dynamics to develop.
Students may elect a leader, scribe and chair for each PBL-session. The roles may rotate for
each session. Flip charts, whiteboards or cards may be used during sessions to collect and
structure items.
Team members
1. Group leader
2. Scribe
3. Group members
4. Tutor
Student’s Role
The students are expected to somehow achieve the learning outcomes of the programs, but
there is no mapped path for them to follow. So they have to assume a high degree of
responsibility for their own education through effective self-learning, working with others and
setting relevant goals for themselves and the group as a whole. Also, the students must take
the initiative in using appropriate assessments of their progress, and be able to present
demonstrations of their learning achievements.
Group members’ roles include:
1. Active participation
2. Active listening
3. Asking questioning
4. Answering questioning
5. Giving information
6. Make decisions
Tutor’s/Facilitator’s Role
The role of the tutor in PBL is different than that of a course instructor in a traditional or lecture
based course. They are rather facilitators. Tutors play a crucial role in helping the group to
establish itself, setting norms for the group function, ensuring group trust, attending to the
group dynamics and unique characteristics of the group. They need to be adept at listening,
provoking activity when necessary, even playing devil’s advocate. They have to know when to
intervene in the group discussion, and when to sit back and let the students resolve their own
difficulties. An effective facilitator must be proficient in the PBL process, have insight into group
dynamics, and understand the assessment of learning and curriculum issues.
A good tutor must possess
1. Good knowledge
2. Elaborate skills
3. Attitudes
Group leader’s role:
1. Keeping discussion goal oriented
2. Guiding the PBL steps
3. Clarifying discussion
4. Stimulating participation
5. Guiding documentation
6. Argument mediator
7. Motivator
8. Equal participation
 9. Complete record
10. Time gate keeper

Scribe’s role:
1. Records points.
2. Helps group to order their thoughts
3. Participates in discussion
4. Records resources used by the group
5. Making clean and short notes
6. Summarizing information
7. External memory
8. Not to be selective
Chair’s role:
1. Heads the group through the process
2. Encourage all group members to participate
3. Maintains group dynamics
4. Ensures group keeps to task-in-hand
5. Ensure scribe can keep up and is making an accurate record.

Steps
PBL sessions are usually organized according to the Maastricht seven step procedure but may
be modified. Generally, those seven steps are:
1. Clarifying terms
2. Defining the problem
3. Brainstorming
4. Structuring and hypothesis
5. Learning objectives
6. Searching for Information
7. Synthesis
At the end of each session: Feedback

1. Clarifying terms Step 1. Identify and clarify unfamiliar terms

presented in the scenario.
At the beginning of the session, the problem(s)
 should be presented to students. If you use paper
cases one of the students reads it aloud to get the
group talking from the beginning. The first activity
of the group should be the clarification of
problems, terms and concepts not understood at
first moment.
The purpose of the first step is to agree on the
meaning of the various words and terms and on
the situation described in the problem. Use can be
made of the knowledge possessed by the group
members or retrieved from a dictionary.

2. Defining the problem Step 2. Define the problem or problems to be

discussed.
Definition of the problem is the main goal during
this phase. The group should discuss and reach an
agreement on the tricky events, which need
explanation. Occasionally, a problem has been
intentionally described on the way to test
students’ ability to recognize certain symptoms.
Though they have some prior knowledge to
recognize a problem, the prior knowledge doesn’t
allow them to resolve the problem straight away.

3. Brainstorming Step 3. Aspects on basis of prior knowledge are

collected.
This should result in ideas to structure the
problem.
Each individual may express his or her ideas free
and without immediate discussion: it is important
not to discuss and not to comment the ideas of
others during this step, but to collect many ideas
(prior knowledge). Together, students will compile
ideas of the underlying circumstances of the
problem (explanatory approach) and/or of
 implications arising from the problem (procedural
approach).

4. Structuring and hypothesis Step 4. Review steps 2 and 3 and arrange

explanations into tentative solutions. During the
fourth step, which forms the core of the analysis,
the problem is explained on different ways. Ideas,
which seem to be related, are worked out in
relation to each other. Each group member is
allowed to fully present ideas about matter. Group
members can draw on all the prior knowledge they
possess.
This prior knowledge may be based on information
acquired in earlier education, facts and insights
obtained by reading different articles or on
another way. The other members of the group and
the tutor are allowed to probe the students’
knowledge to the full, to introduce other
explanations and question certain opinions. The
process of brainstorming and discussion is a
collaborative approach. It leads to more creativity
and output than each member of the group could
generate on his own.

5. Learning objectives Step 5. Formulating learning objectives; group

reaches consensus on the learning objectives;
tutor ensures learning objectives are focused,
achievable, comprehensive, and appropriate. The
systematic approach and discussion may result in
several outlines written down on the blackboard.
These outlines are like possible explanations for
particular problem.
However, since student prior knowledge is limited,
questions will come up and dilemmas will arise. In
this phase of the discussion, conflict between
members of the tutorial group should arise.
 The students will find out that certain aspects are
not yet explained and resolved in the process of
their discussion. PBL encourages students to define
these aspects as learning goals putting them in
charge of to learn. This state of cognitive
dissonance between what I know and what I have
to know to understand the outside world is an
essential condition for PBL. Questions and
dilemmas, which appeared during session, can be
used as learning goals for individual self-directed
learning. So, the main aim of this step is to
formulate learning objectives on which group will
concentrate their activities during phase six. In this
stage it is possible to use conceptual map as a tool
for research summary, making associations,
integrating information and proceeding
information and transferring it to long-term
knowledge, but also a tool for defying new learning
objectives.

6. Searching for Information Step 6. Self-independent learning; during this

phase students are going home and study. This
phase is supposed to provide answers to the
questions evoked in the problem-analysis phase
and offer students possibility to acquire a more
profound knowledge of theories at the root of the
problem. The group members collect information
individually with respect of defined learning
objectives.
Information is collected from the literature but
also from other sources (library, journals, internet
etc.). PBL is also important because it gives
possibility to students to find their own resources.
Minimal time for their individual study is two days
but could be longer. Students can learn individually
but also in pairs or in groups. It is important to
already decide in advance, how the results of the
self-study period will be presented: by an
individual, a small group or as discussion of all the
groups. Students explore relevant sources of
knowledge and then put the new information
together, possibly resolving all the issues that were
left open.
7. Synthesis Step 7. Group shares results of private study. The
tutor checks learning and may assess the group.
So, the final step is synthesizing and testing the
newly acquired information. Members of the
group are sharing information gathered at home
among each other. They also discussed whether
they now acquired more proficient, accurate,
detailed explanation and understanding about
what is going on behind the problem.
If some of the students haven’t understood the
issues well, task of other students is to try to
explain them methodology of their work.
In this step it would be necessary for the certain
types of the problems to check for students’
decision-making process and the algorithm behind
their decisions.

8. Feedback Step 8: “Feedback” as described by Thoemen

(1998, in German). We found it very helpful to
institutionalize this step. It includes feedback of all
students on the case, the process and the tutor, to
improve the learning process. Also it is very
important the students validate the course and
give their comments on the quality of the problem
as well as on the quality of the group process and
the tutor’s performance

Advantages:
1. Increase self direction in learning and students assume increased responsibility for their
own learning by using journals, online searches and library resources.
2. Higher comprehensive and better skill development
3. Helps develop better interpersonal skills and team work
4. Increases self motivated attitude
5. Help the student to adapt to rapid changes in information occurring in the world
6. Students will feel free to express ideas
7. Helps students to develop analytical thoughts and interpret knowledge
 8. It bridges the gap between theory and practice.
9. Helps to maintains up-to-date clinical knowledge.

Disadvantages:
1. Resource- expensive
2. Students may be initially uncomfortable with PBL because they are used to subject-
based learning, and they don’t really understand how to proceed in PBL
3. PBL sessions are time consuming
4. It is difficult to generate appropriate problem
5. Measurement of learning outcomes is difficult

Method of Evaluation:
1. Clinical reasoning exercise
2. Written assignment
3. Modified essay question (problem analysis question)
4. Multiple choice question
5. The objective structured clinical examination
6. Port-folios self evaluation – provide freedom to explore the personal meaning of their
educational experiences and demonstrate their increased self-awareness and skills
7. Triple jump / double jump method

Conclusion
Problem based learning is an innovative method which facilitates effective learning experience
for the participants. It ensures active participation of learners. Also helps the learner to acquire
firsthand knowledge and skills. It is useful for the students in clinical practice.
Bibliography:-

1) Bavantappas B.T. Nursing Education, (1st ed.), 2003, Jaypee brothers’ publication: New
Delhi.
2) Devi, E.S. Manipal Manual of Nursing Education, (1st ed.), 2006, CBS Publishers &
Distributors: New Delhi
3) Neeraja, K.P. Text book of Nursing Education (1st ed.), 2003, Jaypee brothers medical
publishers: Delhi

Journals:
1. Sumathi, M. (2009). Problem Based Learning. Trends in Nursing Administration and
Education, 2(3), 17-22

Online Reference:

1. http://www.studygs.net/pbl.htm
2. http://www.bhmed-emanual.org/book/export/html/1
3. http://www.kem.edu/dept/METC/PBL%20Ramnarayan.pdf
4. http://www.ntlf.com/html/pi/9812/pbl_1.htm
5. http://www.cotf.edu/ete/teacher/teacherout.html