Editor—In 1993 the General Medical Council recommended that medical schools should develop student centred curriculums to discourage memorising detail in favour of information gathering and problem solving.1 In response, most UK schools2 have adopted a form of problem based learning, which, compared with traditional courses, at best produces graduates with only marginally better diagnostic acumen.3 This has recently raised concerns about the cost effectiveness of introducing new learning formats without substantial validation,4 a situation that is confounded by uncertainty about whether problem based learning courses conform to the GMC guidelines.
To ascertain whether problem based learning can deliver on these recommendations, 86 students from a traditional course and 246 graduates from a problem based learning course were asked to quantify on a five point Likert scale (1 = small amount, 5 = large amount) the extent to which memorising detail and gathering and analysing information featured in their courses. Statistical analysis was performed by χ2 test and effect size.
Over 90% (75/83) of students attending the traditional course considered memorising details a prominent part of their course (grade 4/5, figure), whereas only 40% (115/284) of the students on the problem based learning course thought this a significant feature of theirs (P < 0.000001, effect size - 1.56). By comparison, gathering and analysing information was a major characteristic for < 75% (198/284) of students on the problem based learning course (grades 4/5, figure 1), whereas only 22% (18/84) of students on the traditional course considered it was relevant in their curriculum (P < 0.00001, effect size 1.6).
Figure 1.
Students' perceptions of extent to which each variable characterised traditional and problem based learning courses
Problem based learning is reported to stimulate life long learning,5 but the curriculum change followed education and psychology theories with only a limited evidence base that it improves clinical performance. These data show compelling, comparative, and objective proof that students perceive that the GMC objectives are being attained through problem based learning because it has altered their learning techniques. This therefore provides further justification for its assimilation into medical school curriculums.
Competing interests: None declared.
References
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