Sm Bridges

Educational Technologies in Problem-Based Learning in Health Sciences Education: A Systematic Review

Background As a modern pedagogical philosophy, problem-based learning (PBL) is increasingly being recognized as a major research area in student learning and pedagogical innovation in health sciences education. A new area of research interest has been the role of emerging educational technologies in PBL. Although this field is growing, no systematic reviews of studies of the usage and effects of educational technologies in PBL in health sciences education have been conducted to date. Objective The aim of this paper is to review new and emerging educational technologies in problem-based curricula, with a specific focus on 3 cognate clinical disciplines: medicine, dentistry, and speech and hearing sciences. Analysis of the studies reviewed focused on the effects of educational technologies in PBL contexts while addressing the particular issue of scaffolding of student learning. Methods A comprehensive computerized database search of full-text articles published in English from 1996 to 2014 was carried out using 3 databases: ProQuest, Scopus, and EBSCOhost. Eligibility criteria for selection of studies for review were also determined in light of the population, intervention, comparison, and outcomes (PICO) guidelines. The population was limited to postsecondary education, specifically in dentistry, medicine, and speech and hearing sciences, in which PBL was the key educational pedagogy and curriculum design. Three types of educational technologies were identified as interventions used to support student inquiry: learning software and digital learning objects; interactive whiteboards (IWBs) and plasma screens; and learning management systems (LMSs). Results Of 470 studies, 28 were selected for analysis. Most studies examined the effects of learning software and digital learning objects (n=20) with integration of IWB (n=5) and LMS (n=3) for PBL receiving relatively less attention. The educational technologies examined in these studies were seen as potentially fit for problem-based health sciences education. Positive outcomes for student learning included providing rich, authentic problems and/or case contexts for learning; supporting student development of medical expertise through the accessing and structuring of expert knowledge and skills; making disciplinary thinking and strategies explicit; providing a platform to elicit articulation, collaboration, and reflection; and reducing perceived cognitive load. Limitations included cumbersome scenarios, infrastructure requirements, and the need for staff and student support in light of the technological demands of new affordances. Conclusions This literature review demonstrates the generally positive effect of educational technologies in PBL. Further research into the various applications of educational technology in PBL curricula is needed to fully realize its potential to enhance problem-based approaches in health sciences education.

Multimodality in Problem-Based Learning (PBL): An Interactional Ethnography

Black and Wiliam (Inside the black box: Raising standards through classroom assessment. London: King’s College London School of Education, 1998) introduced the term ‘inside the black box’ to research in educational assessment in the late 1990s. This metaphor can be applied to current research in problem-based learning (PBL). This chapter addresses the need to look inside the ‘black box’ of PBL by exploring two under-researched aspects – independent study and online learning. Using the Interactional Ethnographic (IE) approach to collect and analyse data in context and over time (across contexts), we systematically examined how students learn between tutorials, to explore how online learning supports independent study in a PBL curriculum. The data sources for this chapter are drawn from a single third-year PBL group (n = 8) in a five-year Bachelor of Dental Surgery (BDS) curriculum. By focusing on independent study and online learning, the results provide new insights into how multimodal texts and tools support learning across a blended, problem-based curriculum. Data sources included video and screen capture recordings of naturally occurring classroom and independent study activity across one problem cycle. Audio and video data were transcribed using Transana™. Application of key theories of semiosis provided further explanations of how the multimodal texts and mediating tools appropriated throughout a problem cycle were socially and academically consequential to knowledge construction. Evidence was found that the use of various texts and tools across a problem cycle supported a discursive shift from stimulus for hypothesising to evidence for final hypotheses.

PBL.2.0: blended learning for an interactive, problem-based pedagogy.

Context and setting In 2006, a standard learning management system (LMS) was adapted to support self-directed learning within an integrated, problembased learning (PBL) curriculum for undergraduate Bachelor of Dental Surgery students. Initially, PBL enquiry materials were archived on the LMS as digital learning objects for self-directed learning following the first tutorial. This asynchronous application did not support the increased need for synchronous accessing of in-house and open-access digital resources during face-to-face tutorials. Although the increased use of laptops in tutorials initially addressed this problem, it also contributed to some fragmentation of the group process. Curriculum developers sought a more group-oriented, technologically interactive solution. Why the idea was necessary Digital learning objects for PBL scenarios are increasingly used to stimulate student discussion, increase interest and engage ‘tech-savvy’ Net Generation learners. However, PBL facilitators and students reported that the increased use of individual laptops to access these digital resources led to some fragmentation of PBL discussions. Thus, we recognised the need to move from a digital repository approach towards an interactive blending of technology within face-to-face tutorials, but needed to establish how this progression might be supported and resourced. What was done In 2009, interactive whiteboards (IWBs) were introduced to small-group, problembased tutorials. The aims were: (i) to integrate learning technologies with face-to-face teaching to support group access to both in-house and openaccess digital resources, and (ii) to further enhance the group knowledge construction process through utilising the IWB features. Such features included enhanced visualisation and analysis facilitated by the IWB’s ability to display and manipulate digital objects, as well as to annotate, save and share images. Interactive whiteboards were installed in all PBL tutorial rooms and IT support was provided for all students and facilitators. Year 1 students (n = 55) received additional workshops and IWB support. The project evaluation strategy included the adoption of an interactional ethnographic methodology to analyse student engagement. Evaluation of results and impact The interactional ethnographic approach, which focused on classroom interaction (video) and learning artefacts, facilitated the exploration of knowledge construction both within specific contexts and over time. Analysis was based on 4 hours of learning activities undertaken by a Year 1 undergraduate PBL group (n = 8). This group was video-recorded on three occasions during the same week. These included the first tutorial (T1) with a facilitator, a self-directed learning discussion (directly following T1) without a facilitator, and a second tutorial (T2) with a facilitator. Event mapping focused on student engagement with digital materials. Corresponding talk was transcribed using Transana . Three key findings were: (i) the group accessed a range of in-house and open-access digital materials to support learning within and across all phases of a problem cycle; (ii) the use of learning objects and online resources within a problem cycle supported enquiry learning and the discursive shift in student talk from a stimulus for hypothesising in relatively lay terms in the first tutorial to evidence for making final hypotheses with greater control of medical discourse in the second tutorial, and (iii) the integration of faceto-face and virtual modalities through the use of an IWB within the tutorial was seamless and supported whole-group engagement in the problem process.

A Review of the Use of Simulation in Dental Education

Summary Statement In line with the advances in technology and communication, medical simulations are being developed to support the acquisition of requisite psychomotor skills before real-life clinical applications. This review article aimed to give a general overview of simulation in a cognate field, clinical dental education. Simulations in dentistry are not a new phenomenon; however, recent developments in virtual-reality technology using computer-generated medical simulations of 3-dimensional images or environments are providing more optimal practice conditions to smooth the transition from the traditional model-based simulation laboratory to the clinic. Evidence as to the positive aspects of virtual reality include increased effectiveness in comparison with traditional simulation teaching techniques, more efficient learning, objective and reproducible feedback, unlimited training hours, and enhanced cost-effectiveness for teaching establishments. Negative aspects have been indicated as initial setup costs, faculty training, and the lack of a variety of content and current educational simulation programs.

Designing, implementing and evaluating an online problem-based learning (PBL) environment – A pilot study

Abstract Problem-based learning (PBL) has been shown to be effective for promoting student competencies in self-directed and collaborative learning, critical thinking, self-reflection and tackling novel situations. However, the need for face-to-face interactions at the same place and time severely limits the potential of traditional PBL. The requirements of space and for meeting at a specific location at the same time create timetabling difficulties. Such limitations need to be tackled before all potentials of PBL learning can be realized. The present study aimed at designing and implementing an online PBL environment for undergraduate speech/language pathology students, and assessing the associated pedagogical effectiveness. A group of eight PBL students were randomly selected to participate in the study. They underwent 4 weeks of online PBL using Adobe Connect. Upon completion of the experiment, they were assessed via a self-reported questionnaire and quantitative comparison with traditional PBL students based on the same written assignment. The questionnaire revealed that all participating students enjoyed online PBL, without any perceived negative effects on learning. Online PBL unanimously saved the students travel time to and from school. Statistical analysis indicated no significant difference in assignment grades between the online and traditional PBL groups, indicating that online PBL learning appears to be similarly effective as traditional face-to-face PBL learning.

Blended learning, knowledge co-construction and undergraduate group work

(designated ‘Learning from Lives’ [LFL]), and the other with medical and interprofessional students (‘Interprofessional Learning Pathway’ [IPLP]). Learning from Lives aims to provide a practical, in-depth understanding of the nature and effect of impairment on people’s lives and societal reactions towards disability and is situated at the beginning of clinical rotation. In IPLP medical students work with 13 other student health and social care professionals as they follow an authentic patient journey (Callum) aimed at developing their understanding of the roles, cultures and beliefs of their colleagues. In LFL, the students, working in clinical partnerships, meet with patients face-to-face in their homes or clinical settings. They are also able to access a pilot online patient journey. The same patient journey was used in the virtual IPLP. Ethical permission was not required. Why the idea was necessary The idea in LFL arose because service problems in accessing patients made it difficult for us to ensure that students were able to meet their learning outcomes. We chose to provide online patient and professional cases. Student evaluation suggested that e-learning cases enriched the module, but did not replace face-to-face learning. The patient journey was scripted from the original scenario, with each health professional talking about Callum and his or her role in his care. This was in contrast to the IPLP, where Callum was text-based and his story was told objectively. Student evaluation commented that it would be beneficial to have video and audio clips intertwined with the text-based scenario. What was done Video and audio clips were professionally created using an actress and scripts derived from the original text-based version. In LFL medical students were able to watch four introductory clips depicting Callum’s journey from his mother’s and his paediatrician’s perspectives. They then had a restricted choice of viewing further clips of the mother discussing particular issues with other professionals involved in his care. Students had to identity their reasons for their choice of clips. Once they had given this information, they were able to view the clips, which added to the story. In IPLP the video clips were divided across four episodes. The clips were chosen to supplement and enhance the storyline at each point. Evaluation of results and impact Students’ evaluation of LFL supported the idea of using of e-cases, but the comparison of e-cases and the experience of face-to-face contact showed clearly that e-cases could not replace such contact. Students considered that e-learning precluded their ability to utilise the body language and verbal cues that are available in face-to-face contact. By contrast, students’ participating in IPLP valued the multimedia input, stating that it had enhanced their learning by providing them with insights into other perspectives. Evidence of the students’ connection with the mother’s anxiety and concerns was apparent only in discussions with the multimedia student group. Evaluations suggest that multimedia clips serve to enrich each module, but cannot replace face-to-face or text-based cases.

International peer review in undergraduate dentistry: enhancing reflective practice in an online community of practice.

To stimulate and enhance student learning in the areas of global citizenship, critical reflection and e-learning, an online international peer review using a purpose-built web platform, has been developed between international dental schools. Since its inception in 2007, n = 6 dental schools from six different countries have participated with n = 384 dental students engaged in online peer review. Project development was conceptually analysed utilising Lave and Wengers notion of a community of practice (CoP). Analysis drew on the three core components within the CoP organising framework: domain, community and practice. All three components were evident in building project identity. The domain focused on both curriculum and institutional co-operation. The community was evident for both educators and students. Finally, analysis of practice was found to be significant in terms of sustained interaction and collaboration. Empirical evaluation is recommended as the next phase of project design.

Problem-based learning (PBL) and speech-language pathology: a tutorial.

Abstract The aim of this tutorial is to provide an introduction to problem-based learning (PBL), particularly as applied to speech-language pathology (SLP) programs. The tutorial is aimed at the reader who is less familiar with this learning approach. Additionally, it serves as a framework for the articles that follow in this special issue on PBL programs in SLP and other clinical education programs. A brief history of PBL is provided and the rationale and context for this approach are identified. PBL is defined and differentiated from related educational approaches. Different models and variations of PBL are outlined. The key components of PBL are further illustrated using the tutorial cycle. Finally, we present one specific case of a PBL-based SLP program in detail. This tutorial will provide a deeper understanding of PBL for many higher educators in SLP. The strengths of this approach are outlined and the challenges are identified, particularly for those contemplating converting an existing “traditional” course or curriculum.

Blended learning in situated contexts: 3‐year evaluation of an online peer review project

BACKGROUND Situated and sociocultural perspectives on learning indicate that the design of complex tasks supported by educational technologies holds potential for dental education in moving novices towards closer approximation of the clinical outcomes of their expert mentors. A cross-faculty-, student-centred, web-based project in operative dentistry was established within the Universitas 21 (U21) network of higher education institutions to support university goals for internationalisation in clinical learning by enabling distributed interactions across sites and institutions. This paper aims to present evaluation of one dental facultys project experience of curriculum redesign for deeper student learning. METHODS A mixed-method case study approach was utilised. Three cohorts of second-year students from a 5-year bachelor of dental surgery (BDS) programme were invited to participate in annual surveys and focus group interviews on project completion. Survey data were analysed for differences between years using multivariate logistical regression analysis. Thematic analysis of questionnaire open responses and interview transcripts was conducted. RESULTS Multivariate logistic regression analysis noted significant differences across items over time indicating learning improvements, attainment of university aims and the positive influence of redesign. Students perceived the enquiry-based project as stimulating and motivating, and building confidence in operative techniques. Institutional goals for greater understanding of others and lifelong learning showed improvement over time. Despite positive scores, students indicated global citizenship and intercultural understanding were conceptually challenging. CONCLUSIONS Establishment of online student learning communities through a blended approach to learning stimulated motivation and intellectual engagement, thereby supporting a situated approach to cognition. Sociocultural perspectives indicate that novice-expert interactions supported student development of professional identities.

The Next Generation: Research Directions in PBL

This edited volume was conceived as an attempt to share recent scholarship investigating our understandings and implementations of problem-based learning (PBL) in clinical education. Globally, we are witnessing a rapid shift in the way higher education perceives itself and how it is perceived by society. Social theorists have asked us to consider society in the era of ‘liquid modernity’ (Baumann, 2000), characterized by uncertainty, continuous risk and shifting loyalties and trust. Liquidity is evident not only in our desktop designs but our views of time and knowledge as we have come to expect instant access to information on demand. In terms of higher education, the impact of these social changes can be described as an educational ‘climate change’ signalled by fundamental shifts in the way we perceive knowledge and learning (Goodyear & Ellis, 2010). First, our conception of knowledge is moving from inert and fragmented knowledge to a notion of working knowledge. Second, the focus is moving from an individualistic model of the learner to one of learning communities. Third, the teaching dynamic is changing from teacher-directed to learner-managed learning. This logically forces a shift from learning experiences that focus on content and presentation, i.e., information transmission and presentation pedagogies, to those that focus on student activity through the design of learning tasks and environments and the provision of tools for individual and collaborative work.