Jerome I. Rotgans

The process of problem-based learning: what works and why

Medical Education 2011: 45: 792–806

Cognitive engagement in the problem-based learning classroom

The objective of the present study was to examine to what extent autonomy in problem-based learning (PBL) results in cognitive engagement with the topic at hand. To that end, a short self-report instrument was devised and validated. Moreover, it was examined how cognitive engagement develops as a function of the learning process and the extent to which cognitive engagement determines subsequent levels of cognitive engagement during a one-day PBL event. Data were analyzed by means of confirmatory factor analysis, repeated measures ANOVA, and path analysis. The results showed that the new measure of situational cognitive engagement is valid and reliable. Furthermore, the results revealed that students’ cognitive engagement significantly increased as a function of the learning event. Implications of these findings for PBL are discussed.

The themes, institutions, and people of medical education research 1988–2010: content analysis of abstracts from six journals

The present study aimed at providing an overview of the most common themes of research into medical education. Changes in frequency of occurrence of these themes over time and differences between US and European journals were studied. The most productive institutions and researchers in the field were examined. A content analysis was carried out on 10,168 abstracts extracted from the six most influential journals in medical education published since 1988. Twenty-nine major themes were identified, of which student assessment, clinical and communication skills, clinical clerkships, and problem-based learning were the most prominent ones. Some of these themes, such as multiple-choice examinations or computer-assisted instruction seemed to have had their day, whereas other topics, such as the study of clinical clerkships, clinical reasoning, and scholarship in education were on their way up. Medical education research turned out to be a thoroughly international affair to which both US and European research centers contribute. The medical education literature shows an overwhelming emphasis on the preparation of medical students for professional practice. Moreover, the emphasis is very much on the individual student; most research seems to have been conducted with a psychological perspective in mind. It is argued that medical education research would profit from broadening its scope, including sociological, economical, ecological, and system perspectives. These perspectives might bring answers to new questions relevant to the quality of medical education. It is suggested that medical education is in need of moving beyond the conventional effectiveness-driven research approach to a more theory- and discovery-driven approach.

Examination of the context‐specific nature of self‐regulated learning

The purpose of the present study was to investigate to what extent self‐regulated learning (SRL) is context‐dependent. The Motivated Strategies for Learning Questionnaire (MSLQ) was repeatedly administered to 155 first‐year students at a Singaporean polytechnic – a general version of the MSLQ before students entered the polytechnic and a course‐specific version at the end of the first semester for mathematics, science and English courses. Data were analysed using structural equation modelling. The analyses included: (1) tests for invariance of factorial structures, (2) tests for invariance among latent means, and (3) a comparison of the predictive validity of the general and the course‐specific versions of the MSLQ. The results showed that no significant differences could be found in the underlying structure of SRL between subject domains. In addition, average subscale responses were rather invariant across domains. Finally, course‐specific measures of SRL were generally not more accurate in predicting academic achievements than the general version. These findings taken together do not support the notion that SRL is context‐dependent. Rather, SRL as measured by the MSLQ appears to be a stable disposition of the learner.

Are tutor behaviors in problem-based learning stable?: a generalizability study of social congruence, expertise and cognitive congruence.

The purpose of this study was to investigate the stability of three distinct tutor behaviors (1) use of subject-matter expertise, (2) social congruence and (3) cognitive congruence, in a problem-based learning (PBL) environment. The data comprised the input from 16,047 different students to a survey of 762 tutors administered in three consecutive semesters. Over the three semesters each tutor taught two of the same course and one different course. A generalizability study was conducted to determine whether the tutor behaviors were generalizable across the three measurement occasions. The results indicate that three semesters are sufficient to make generalizations about all three tutor behaviors. In addition the results show that individual differences between tutors account for the greatest differences in levels of expertise, social congruence and cognitive congruence. The study concludes that tutor behaviors are fairly consistent in PBL and somewhat impervious to change. Implications of these findings for tutor training are discussed.

The relationships between problem characteristics, achievement-related behaviors, and academic achievement in problem-based learning

This study investigated the influence of five problem characteristics on students’ achievement-related classroom behaviors and academic achievement. Data from 5,949 polytechnic students in PBL curricula across 170 courses were analyzed by means of path analysis. The five problem characteristics were: (1) problem clarity, (2) problem familiarity, (3) the extent to which the problem stimulated group discussion, (4) self-study, and (5) identification of learning goals. The results showed that problem clarity led to more group discussion, identification of learning goals, and self-study than problem familiarity. On the other hand, problem familiarity had a stronger and direct impact on academic achievement.

Does time pressure have a negative effect on diagnostic accuracy

Purpose Studies suggest time pressure has negative effects on physicians’ working conditions and may lead to suboptimal patient care and medical errors. Experimental evidence supporting this is lacking, however. This study investigated the effect of time pressure on diagnostic accuracy. Method In 2013, senior internal medicine residents at three hospitals in Saudi Arabia were divided randomly into two groups: a time-pressure condition and a control condition without time pressure. Both groups diagnosed eight written clinical cases presented on computers. In the time-pressure condition, after completing each case, participants received information that they were behind schedule. Response time was recorded, and diagnostic accuracy was scored. Results The 23 participants in the time-pressure condition spent significantly less time diagnosing the cases (mean = 96.00 seconds) than the 19 control participants (mean = 151.97 seconds) (P < .001). Participants under time pressure had a significantly lower diagnostic accuracy score (mean = 0.33; 95% CI, 0.23–0.43) than participants without time pressure (mean = 0.51; 95% CI, 0.42–0.60) (F[1, 41] = 6.90, P = .012, &eegr;2 = 0.15). This suggests participants in the time-pressure condition made on average 37% more errors than control participants. Conclusions Time pressure has a negative impact on diagnostic performance. The authors propose that the effect of time pressure on diagnostic accuracy is moderated by both the case difficulty level and the physician’s level of experience. Post hoc analyses demonstrated that time pressure affects diagnostic accuracy only if cases are not too difficult and physicians’ expertise level is intermediate.

Introduction: studies on the learning process in the one-day, one-problem approach to problem-based learning.

Problem-based learning (PBL) as a method of instruction in the health sciences has attracted considerable attention over the years (Barrows 1996; Colliver 2000; Norman 2002). Research in this field has predominantly focused on curriculum comparisons between PBL and more conventional instructional methods, with only limited interest in what happens to the learner in PBL (ten Cate 2001). The seven papers comprising this special issue all focus on the latter: research on the learning process in PBL. The research to be presented here took place in the context of a new polytechnic in Singapore: the Republic Polytechnic. This polytechnic employs an unconventional version of PBL across its educational programs. The PBL approach the polytechnic developed and implemented is referred to as the one-day, one-problem approach (Alwis and O’Grady 2002).

Problem-based Learning and Student Motivation: The Role of Interest in Learning and Achievement

One of the underlying assumptions of Problem-Based Learning (PBL) is that it motivates students to study. For instance, feeling of being in charge of one’s own learning, working in small groups under the limited guidance of a teacher, working on real-life problems and puzzles are all factors that are expected to make learning more interesting. To date, there are, however, only a very little number of studies that investigate whether PBL has indeed a motivating effect on student learning. In this chapter, the results of two recently conducted studies are summarized that measured student motivation by means of students’ levels of situational interest in the PBL classroom. The first study examined how interest developed during a PBL lesson of one day. For instance, it was measured whether presenting a problem increases student interest, and what happens to their levels of interest during self-study and reporting of findings at the end of the day. The second study explored in how far facilitators impact student interest in PBL. To that end, three facilitator characteristics were measured: (1) subject-matter expertise (i.e. the knowledge a facilitator has); (2) social congruence (i.e. how well a facilitator is able to “tune in” to the students); and (3) cognitive congruence (i.e. a facilitator’s ability to encourage and enable student learning). It was then investigated which of these factors has the largest impact on student interest. The results of both studies provide more insights in the intricate mechanisms responsible to motivate students to study in PBL. The finding and implications of these studies for PBL research and practice are discussed.

How Individual Interest Influences Situational Interest and How Both Are Related to Knowledge Acquisition: A Microanalytical Investigation.

ABSTRACT The extent to which a student experiences situational interest during a learning task is dependent on at least two factors: (1) external stimuli in the learning environment that arouse interest and (2) internal dispositions, such as individual interest. The objective of the present study was to disentangle how both factors influence situational interest during task engagement. Two data sets were collected from primary school science (N = 186) and secondary school history students (N = 71). Path analysis was used to examine the influence of individual interest on seven situational interest measurements and knowledge acquisition. The results suggest that individual interest has only a significant influence on situational interest at the beginning of a task and then its influence fades. In addition, individual interest is not a significant predictor of learning. Only situational interest predicts knowledge acquisition. Implications of these findings for interest research are discussed.