Successful Use of Problem-Based Learning in a Third-Year Pediatric Clerkship

      Objective.—To determine the effect of changing from lectures to a problem-based learning (PBL) curriculum on student knowledge accrual and satisfaction with the didactic portion of a clerkship.
      Design.—Study of cohorts before and after PBL introduction and in comparison with unchanged medicine clerkship.
      Setting.—Third-year pediatric clerkship at 5 clinical sites.
      Participants.—The PBL curriculum was introduced in the 1996 academic year. The 2 classes before the intervention served as historic controls (n = 319), whereas the 2 classes after PBL served as the intervention group (n = 320).
      Intervention.—Small groups of students worked through 6 PBL cases representing common pediatric illnesses.
      Main Outcome Measures.—Knowledge was assessed with the pediatric and internal medicine subject examination of the National Board of Medical Examiners (NBME); student satisfaction was assessed by an anonymous end-of-rotation questionnaire.
      Results.—Scores on the pediatric subject examination improved significantly from means of 69.2 and 70.0 in the historic control group to 73.6 and 74.2 in the PBL cohort (P < .01). Scores on the internal medicine subject exam during the same time periods remained unchanged until the second year after the change (69.1 and 70.2, respectively, before the change; 70.1 and 72.4, respectively, after the change). Analysis of variance results indicated a significant increase in pediatric subject examination scores associated with the introduction of PBL (P < .01). Overall student satisfaction with the pre-PBL lecture series was 3.3, whereas PBL sessions received a score of 4.3.
      Conclusion.—Use of PBL in a clinical clerkship was associated with higher scores on the NBME subject examination and increased student satisfaction. These results should encourage the use of PBL during the clinical years.


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        • Barrows HS
        • Tamblyn RM
        Problem-Based Learning: An Approach to Medical Education. Springer, New York, NY1980
        • Barrows HS
        A taxonomy of problem-based learning methods.
        Med Educ. 1986; 20: 481-486
        • Foley RP
        • Polson AL
        • Vance JM
        Review of the literature on PBL in the clinical setting.
        Teach Learning Med. 1997; 9: 4-9
        • Wendelberger KJ
        • Simpson DE
        • Biernat KA
        Problem-based learning in a third-year pediatric clerkship.
        Teach Learning Med. 1996; 8: 28-32
        • Schwartz RW
        • Donnelly MB
        • Nash PP
        • et al.
        Problem-based learning: an effective educational method for a surgery clerkship.
        J Surg Res. 1992; 53: 326-330
        • Gresham CL
        • Philp JR
        Problem-based learning in clinical medicine.
        Teach Learning Med. 1996; 8: 111-115
        • Albanese MA
        • Mitchell S
        Problem-based learning: a review of literature on its outcome and implementation issues.
        Acad Med. 1993; 68: 52-81
        • Blake RL
        • Hosokawa MC
        • Riley SL
        Student performance on step 1 and step 2 of the United States Medical Licensing Examination following implementation of a problem-based learning curriculum.
        Acad Med. 2000; 75: 66-70
        • Colliver JA
        Effectiveness of problem-based learning curricula: research and theory.
        Acad Med. 2000; 75: 259-266
        • Nayer M
        Faculty development for problem-based learning programs.
        Teach Learning Med. 1995; 7: 138-148