The acronym PBL is used widely in academic literature, but what does it stand for? Problem-based learning, practice-based learning, or even project-based learning? As Cambell (2014) points out, having so many possible meanings can be unhelpful and confusing. So, how can healthcare educators make sense of PBL and choose the right teaching style for their students?
Problem-based learning originated back in the 1960s. Since then, learning through problem-solving has become widely valued as a way to empower learners to conduct their own research, integrate theory and practice and apply their knowledge to create workable solutions to a problem.
It’s also the most frequently used definition of PBL within healthcare education.
Why?
Because all healthcare educators are tasked to create learning outcomes that prepare students for real-world work placements. Problem‐based learning meets this need and offers a workable approach that allows students to gain knowledge in a safe environment, whilst at the same time solving real-life problems (Vardi and Ciccarelli 2008).
To put it simply, when students study using problem-solving skills, they can learn both content and thinking strategies at the same time. For teachers, this means their role has to shift in focus from providing knowledge to simply facilitating the process of learning.
As Hmelo-Silver (2004) puts it, the goals of problem-based learning include helping students develop:
It’s also an excellent way of strengthening teamwork, practising self-directed learning and presentation skills, and encouraging learners to show respect for their colleagues' views.
Wood (2003) adds to these thoughts, explaining that the main value of problem-based learning lies in encouraging students to use 'triggers' from the problem case or scenario to define their own learning objectives. This leads to self-directed study before students return to the group to discuss and refine their knowledge. It’s not about problem-solving per se, but about using appropriate problems to increase knowledge and understanding. The process is clearly defined, and all variations of this teaching method tend to follow a similar series of steps.
Other key benefits of problem-based learning are its long‐term memorability, along with research-based evidence suggesting that problem-solving skills seem to arouse interest and drive learning forward (Schmidt et al. 2011).
Problem-based learning typically follows the following format:
(Larmer 2015)
In the view of The Problem Based Learning Institute (2019), taking a problem-based approach to learning stands in some contrast to more traditional didactic lectures. As they point out, research has shown that lectures alone have little significant or long term impact, either on a learner’s professional practices or on improved patient outcomes.
That said, although problem-based learning has gained immense popularity in recent years, it also has its limitations, with concerns that some students might not prepare adequately for classwork and may not discuss or engage with problems to an appropriate depth (Vardi and Ciccarelli 2008).
Overall, there is good support for problem-based learning within healthcare education as not only does it encourage the activation of prior knowledge, but it also gives students a platform to further and deepen their knowledge.
Both problem-based learning and project-based learning are types of experiential learning.
In problem-based learning, students need to use critical thinking skills to examine problems that lack a well-defined answer. On the other hand, in project-based learning, students are challenged to develop a plan and create a product that addresses a specific problem (University of North Texas 2019).
Much the same could be said about the practical nature of practice-based learning, though in this case, students don’t produce a physical product. Instead, the focus here is on maintaining or improving practice, or even preventing poor practice.
Practice-based learning is also often referred to as work-based learning or work-centred learning, and whilst this has the advantage of using a different acronym, Phillips (2013) cautions against using the two terms interchangeably, as work-based learning often means that students lose their supernumerary status and are considered part of the workforce.
To avoid confusion, some educators prefer the term practice-based professional learning (PBPL) as this helps to put the focus on professional learning and the preference for 'practice' rather than 'work'.
Generally speaking, students engaged in problem-based learning tend to share their learning outcomes which are jointly set with a tutor. On the other hand, project-based learning tends to take a longer, more structured and interprofessional approach and a key feature of practice-based learning is its value in addressing authentic problems in real-world situations (Cambell 2014).
Ultimately, though, as Larmer (2015) points out, other than the more formal structure of problem-based learning, there's really not much conceptual difference between the various forms of PBL. It’s really more a question of style and scope.
Academic literature is replete with systematic reviews and meta-analyses, highlighting the value of problem-based learning (Neville 2009). However, divergent opinions remain as not all educators are convinced about its value or suitability in practice. As Hung (2011) points out, debates surrounding problem-based learning have largely focused only on its theoretical conception and students’ learning outcomes, without thoroughly exploring the practicalities of its implementation.
It’s an area that needs more research to complete the picture, yet, in spite of these residual concerns about its benefits, problem-based learning is here to stay.
Perhaps then, there really are more similarities than differences between the various forms of PBL. It could probably be argued that completing any type of project involves solving a problem.
So, in the view of Larmer (2015), the semantics really aren't worth worrying about, because whatever type of PBL you decide to call the learning experience just depends on how you frame it. The bottom line remains the same. PBL is a powerful and effective way to encourage learning, and at the end of the day, that’s all that matters.
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