Advertisement

PBL Tutorials in a Hybrid Curriculum: Opportunities and Challenges

  • Sigrid Harendza
  • Olaf Kuhnigk
  • Franziska Puttnies
  • Sven Anders
Chapter
Part of the Innovation and Change in Professional Education book series (ICPE, volume 8)

Abstract

Problem-based learning (PBL) appears to have a potentially long-lasting impact on self-directed learning. Especially in hybrid PBL programs the quality of student learning seems to depend on PBL tutors being effective in their role. From our hybrid curriculum at Hamburg medical school 60 PBL tutorial groups including 495 students were investigated in 2007 from three perspectives: trained auditors observed the tutorial groups, and their PBL tutors and the participating students answered standardized questionnaires. Groups taught always by the same tutor during the whole term felt more satisfied with their tutor than groups with substitute tutors. Students with male tutors stated more frequently that they benefited from their tutorial. Students with a tutor who did not wear hospital clothing felt much more comfortable in their tutorial group. Tutors, students, and curricular planners need to regularly review the PBL tutorial process to improve the learning outcome.

References

  1. Albanese, M., Schuldt, S., Case, D., & Brown, D. (1991). The validity of lecturer ratings by students and trained observers. Academic Medicine, 66, 26–28.CrossRefGoogle Scholar
  2. Azer, S. A. (2005). Challenges facing PBL tutors: 12 tips for successful group facilitation. Medical Teacher, 27, 676–681.CrossRefGoogle Scholar
  3. Barrows, H. S., & Tamblyn, R. M. (1980). Problem-based learning, an approach to medical education. New York: Springer.Google Scholar
  4. Bransford, J. D., Brown, A. L., & Cocking, R. R. (1999). How people learn: Brain, mind, experience, and school. Washington, DC: National Academy Press.Google Scholar
  5. Bundesministerium für Gesundheit und Soziale Sicherheit. (2002). Approbationsordnung für Ärzte vom 27. Juni 2002, Bundesgesetzblatt Teil I Nr. 44. Retreived from http://www.hamburg.de/contentblob/124122/data/approbationsordnung.pdf
  6. Chan, L. C. (2008). The role of a PBL tutor: A personal perspective. Kaohsiung Journal of Medical Sciences, 24, S34–S38.CrossRefGoogle Scholar
  7. Chan, L. C. (2009). Factors affecting the quality of problem-based learning in a hybrid medical curriculum. Kaohsiung Journal of Medical Sciences, 25, 254–257.CrossRefGoogle Scholar
  8. Conolly, C., & Seneque, M. (1999). Evaluating PBL in a multilingual student population. Medical Education, 33, 738–744.CrossRefGoogle Scholar
  9. Dammers, J., Spencer, J., & Thomas, M. (2001). Using real patients in problem-based learning: Students’ comments on the value of using real, as opposed to paper cases, in a problem-based learning module in general practice. Medical Education, 35, 27–35.CrossRefGoogle Scholar
  10. Das, M., Mpofu, D., Dunn, E., & Lanphear, J. H. (1998). Self and tutor evaluations in problem-based learning tutorials: Is there a relationship? Medical Education, 32, 411–418.CrossRefGoogle Scholar
  11. Davis, M. H., & Harden, R. M. (1999). AMEE medical education guide no. 15: Problem-based learning: A practical guide. Medical Teacher, 21, 130–140.CrossRefGoogle Scholar
  12. de Grave, W. S., Dolmans, D. H. J. M., & van der Vleuten, C. P. M. (1998). Tutor intervention profile: Reliablitiy and validity. Medical Education, 32, 262–268.CrossRefGoogle Scholar
  13. Des Marchais, J. E., & Chaput, M. (1997). A comprehensive continuous preclinical PBL tutor training system. Teaching and Learning in Medicine, 9, 66–72.CrossRefGoogle Scholar
  14. Distlehorst, L. H., Dawson, E., Robbs, R. S., & Barrows, H. S. (2005). Problem-based learning outcomes: The glass half-full. Academic Medicine, 80, 294–299.CrossRefGoogle Scholar
  15. Dolmans, D., van den Hurk, M., Wolfhagen, I., & van der Vleuten, C. (1996). Limiting tutorial-group size. Academic medicine, 71, 4a.CrossRefGoogle Scholar
  16. Dolmans, D. H. J. M., Gijselaers, W., Moust, J. H. C., de Grave, W. S., Wolfhagen, I. H. A. P., & van der Vleuten, C. P. M. (2002). Trends in research on the tutor in problem-based learning: Conclusions and implications for educational practice and research. Medical Teacher, 24, 173–180.CrossRefGoogle Scholar
  17. Dolmans, D. H. J. M., & Ginns, P. (2005). A short questionnaire to evaluate the effectiveness of tutors in PBL: Validity and reliability. Medical Teacher, 27, 534–538.CrossRefGoogle Scholar
  18. Dolmans, D. H. J. M., Wolfhagen, H. A. P., Scherpbier, A. J. J. A., & van der Vleuten, C. P. M. (2003). Development of an instrument to evaluate the effectiveness of teachers in guiding small groups. Higher Education, 46, 431–446.CrossRefGoogle Scholar
  19. Dolmans, D. H. J. M., Wolfhagen, H. A. P., & van der Vleuten, C. P. M. (1996). Long-term stability of tutor performances. Academic Medicine, 71, 1344–1347.CrossRefGoogle Scholar
  20. Eagle, C. J., Harasym, P. H., & Mandin, H. (1992). Effects of tutors with case expertise on problem-based learning issues. Academic Medicine, 67, 464–469.Google Scholar
  21. Farmer, E. A. (2004). Faculty development for problem-based learning. European Journal of Dental Education, 8, 59–66.CrossRefGoogle Scholar
  22. Gijselaers, W. H. (1997). Effects of contextual factors on tutor behavior. Teaching and Learning in Medicine, 9, 116–124.CrossRefGoogle Scholar
  23. Gilkison, A. (2003). Techniques used by ‘expert’ and ‘non-expert’ tutors to facilitate problem-based learning tutorials in an undergraduate medical curriculum. Medical Education, 37, 6–14.CrossRefGoogle Scholar
  24. Hak, T., & Maguire, P. (2000). Group process: The black box of studies on problem-based learning. Academic Medicine, 75, 769–772.CrossRefGoogle Scholar
  25. Hendry, G. D. (2009). Problem-based learning tutors’ conceptions of their development as tutors. Medical Teacher, 31, 145–150.CrossRefGoogle Scholar
  26. Hitchcock, M., & Mylona, Z. (2000). Teaching faculty to conduct problem-based learning. Teaching and Learning in Medicine, 12, 52–57.CrossRefGoogle Scholar
  27. Houlden, R. J., Collier, C. P., Frid, P. J., Jon, S. L., & Pross, H. (2001). Problems identified by tutors in a hybrid problem-based learning curriculum. Academic Medicine, 76, 81.CrossRefGoogle Scholar
  28. Jung, B., Tryssenaar, J., & Wikins, S. (2005). Becoming a tutor: Exploring the learning experiences and needs of novice tutors in a PBL programme. Medical Teacher, 27, 606–612.CrossRefGoogle Scholar
  29. Kassab, S., Abu-Hijleh, M., Al-Shboul, Q., & Hamdy, H. (2005). Gender-related differences in learning in student-led PBL tutorials. Education for Health Journal, 18, 272–282.CrossRefGoogle Scholar
  30. Kingsbury, M. P., & Lymn, J. S. (2008). Problem-based learning and larger student groups: Mutually exclusive or compatible concepts – A pilot study. BMC Medical Education, 8, 35–44.CrossRefGoogle Scholar
  31. Kinkade, S. (2005). A snapshot of the status of problem-based learning in U.S. medical schools (2003–2004). Academic Medicine, 80, 300–301.CrossRefGoogle Scholar
  32. Leung, K. K., Lue, B. H., & Lee, M. B. (2003). Development of a teaching style inventory for tutor evaluation in problem-based learning. Medical Education, 37, 410–416.CrossRefGoogle Scholar
  33. Machado, J. L. M., Machado, V. M. P., Grec, W., Bollela, V. R., & Vieira, J. E. (2008). Self- and peer assessment may not be an accurate measure of PBL tutorial process. BMC Medical Education, 8, 55–60.CrossRefGoogle Scholar
  34. Matsui, K., Ishihara, S., Suganuma, T., Sato, Y., Tang, A. C., Fukui, Y. et al. (2007). Characteristics of PBL graduates. Annals Academic of Medicine Singapore, 36, 67–71.Google Scholar
  35. Maudsley, G. (1999). Roles and responsibilities of the problem-based learning tutor in the undergraduate medical curriculum. British Medical Journal, 318, 657–661.CrossRefGoogle Scholar
  36. Miflin, B. M., Campbell, C. B., & Price, D. A. (2000). A conceptual framework to guide the development of self-directed, lifelong learning in problem-based medical curricula. Medical Education, 34, 299–306.CrossRefGoogle Scholar
  37. Moust, J. H. C., van Berkel, H. J. M., & Schmidt, H. G. (2005). Signs of erosion: Reflections on three decades of problem-based learning at Maastricht University. Higher Education, 50, 665–683.CrossRefGoogle Scholar
  38. Mpofu, D. J. S., Das, M., Stewart, T., Dunn, E., & Schmidt, H. (1998). Perceptions of group dynamics in problem-based learning sessions: A time to reflect on group issues. Medical Teacher, 20, 421–427.CrossRefGoogle Scholar
  39. Norman, G. R., & Schmidt, H. G. (1992). The psychological basis of problem-based learning: A review of the evidence. Academic Medicine, 67, 557–565.CrossRefGoogle Scholar
  40. O’Malley, K. J., Moran, B. J., Hoidet, P., Seidel, C. L., Schneider, V., Morgan, R. O., et al. (2003). Validation of an observation instrument for measuring student engagement in health professions setting. Evaluation & the Health Professions, 26, 86–103.CrossRefGoogle Scholar
  41. Pinto, P., Rendas, A., & Gamboa, T. (2001). Tutors’ performance evaluation: A feedback tool for the PBL process. Medical Teacher, 23, 289–294.Google Scholar
  42. Regehr, G., Martin, J., Hutchison, C., Murnaghan, J., Cusimano, M., & Reznick, R. (1995). The effect of tutors’ content expertise on student learning, group process and participant satisfaction in a problem-based learning curriculum. Teaching and Learning in Medicine, 7, 225–232.CrossRefGoogle Scholar
  43. Schmidt, H. G. (1994). Resolving inconsistencies in tutor expertise research: Does lack of structure cause students to seek tutor guidance? Academic Medicine, 69, 656–662.CrossRefGoogle Scholar
  44. Schmidt, H. G., & Moust, J. H. (1995). What makes a tutor effective? A structural-equations modelling approach to learning in problem-based curricula. Academic Medicine, 70, 708–714.CrossRefGoogle Scholar
  45. Schmidt, H. G., Vermeulen, L., & van der Molen, H. T. (2006) Longterm effects of problem-based learning: A comparison of competencies acquired by graduates of a problem-based and a conventional medical school. Medical Education, 40, 562–567.CrossRefGoogle Scholar
  46. Segouin, C., Jouquan, J., Hodges, B., Bréchat, P. H., David, S., Maillard, D., et al. (2007). Country report: Medical Education in France. Medical Education, 41, 295–301.CrossRefGoogle Scholar
  47. Shields, H. M., Guss, D., Somers, S. C., Kerfoot, B. P., Mandell, B. S., Travassos, W. J., et al. (2007). A faculty development program to train tutors to be discussion leaders rather than facilitators. Academic Medicine, 87, 486–492.CrossRefGoogle Scholar
  48. Skelin, S., Huwendiek, S., Nikendei, C., Dieter, P., Kirschfink, M., & Bosse, H. M. (2008). The good PBL tutor – to be or not to be: Instructional films for tutors. Z Evid Fortbild Qual Gesundhwes, 102, 634–640.CrossRefGoogle Scholar
  49. Steinert, Y., Mann, K., Centeno, A., Dolmans, D., Spencer, J., Gelula, M., et al. (2006). A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8. Medical Teacher, 28, 497–526.CrossRefGoogle Scholar
  50. Stephen, E., Harry, G. M., & Philippe, J. R. (1985). Personality, classroom behaviour, and student ratings of college teaching effectiveness: A path analysis. Journal of Educational Psychology, 77, 394–407.CrossRefGoogle Scholar
  51. van Berkel, H. J. M., & Schmidt, H. G. (2000). Motivation to commit oneself as a determinant of achievement in problem-based learning. Higher Education, 40, 231–242.CrossRefGoogle Scholar
  52. van den Bussche, H., Anders, S., Ehrhardt, M., Göttsche, T., Hüneke, B., Kohlschütter, A., et al. (2005). Lohnt sich eine Reform der klinischen Ausbildung? – Die Qualität des Hamburger Curriculums unter der alten und der neuen Approbationsordnung im Vergleich. Z Evid Fortbild Qual Gesundhwes, 99, 419–423.Google Scholar
  53. Wilkerson, L., & Hundert, E. M. (1991). Becoming a problem-based tutor: Increasing self-awareness through faculty development. In D. Boud & G. Feletti (Eds), The challenge of problem-based learning (pp. 159–171). New York: St Martin’s Press.Google Scholar
  54. Wood, D. F. (2005). ABC of learning and teaching in medicine – Problem based learning. British Medical Journal, 326, 328–330.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Sigrid Harendza
    • 1
  • Olaf Kuhnigk
    • 2
  • Franziska Puttnies
    • 2
  • Sven Anders
    • 2
  1. 1.Department of Internal MedicineUniversity Hospital Hamburg-EppendorfHamburgGermany
  2. 2.Medical FacultyHamburg UniversityHamburgGermany

Personalised recommendations