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Problem-based learning at the receiving end: A ‘mixed methods’ study of junior medical students’ perspectives

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Abstract

Qualitative insights about students’ personal experience of inconsistencies in implementation of problem-based learning (PBL) might help refocus expert discourse about good practice. Aim This study explored how junior medical students conceptualize: PBL; good tutoring; and less effective sessions. Methods Participants comprised junior medical students in Liverpool 5-year problem-based, community-orientated curriculum. Data collection and analysis were mostly cross-sectional, using inductive analysis of qualitative data from four brief questionnaires and a ‘mixed’ qualitative/quantitative approach to data handling. The 1999 cohort (end-Year 1) explored PBL, generated ‘good tutor’ themes, and identified PBL (dis)advantages (end-Year 1 then mid-Year 3). The 2001 cohort (start-Year 1) described critical incidents, and subsequently (end-Year 1) factors in less effective sessions. These factors were coded using coding-frames generated from the answers about critical incidents and ‘good tutoring’. Results Overall, 61.2% (137), 77.9% (159), 71.0% (201), and 71.0% (198) responded to the four surveys, respectively. Responders perceived PBL as essentially process-orientated, focused on small-groupwork/dynamics and testing understanding through discussion. They described ‘good tutors’ as knowing when and how to intervene without dominating (51.1%). In longitudinal data (end-Year 1 to mid-Year 3), the main perceived disadvantage remained lack of ‘syllabus’ (and related uncertainty). For less effective sessions (end-Year 1), tutor transgressions reflected unfulfilled expectations of good tutors, mostly intervening poorly (42.6% of responders). Student transgressions reflected the critical incident themes, mostly students’ own lack of work/preparation (54.8%) and other students participating poorly (33.7%) or dominating/being self-centred (31.6%). Conclusion Compelling individual accounts of uncomfortable PBL experiences should inform improvements in implementation.

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Acknowledgements

Thanks to the participants for their input, and to John Bligh (JGB) for initial guidance in the early stages of the overall project and valuable discussions of the early textual data from the 1999 cohort. Contributors: GM designed, undertook, and analysed this study as part of an MD thesis, supervised by EMIW and DCMT, who also contributed to the interpretation of the findings and critical revision of the article drafted by GM. GM is guarantor. Funding: Nil. Competing interests: None declared. Ethical approval: The authors complied with the Faculty of Medicine (The University of Liverpool) approval processes operating at that time, i.e., the Director of Medical Studies approved the research.

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Authors and Affiliations

  1. Division of Public Health, The University of Liverpool, Whelan Building, Quadrangle, Liverpool, L69 3GB, Merseyside, UK

    Gillian Maudsley & Evelyn M. I. Williams

  2. School of Medical Education, The University of Liverpool, Cedar House, Liverpool, L69 3GE, UK

    David C. M. Taylor

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  1. Gillian Maudsley
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  2. Evelyn M. I. Williams
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  3. David C. M. Taylor
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Correspondence to Gillian Maudsley.

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Maudsley, G., Williams, E.M.I. & Taylor, D.C.M. Problem-based learning at the receiving end: A ‘mixed methods’ study of junior medical students’ perspectives. Adv in Health Sci Educ 13, 435–451 (2008). https://doi.org/10.1007/s10459-006-9056-9

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