References	Journal	Year	Objectives	Design	Instrument	Main conclusion
1*	Serife (2011)	Current issues in education	2011	To investigate the effects of computer supported PBL on students’ approaches to learning	One group pre- and post-test design. PBL implementation during 5 weeks	LAQ	Problem based learning has a significant effect on adopting a predominantly deep approach to learning by students and a negative effect on adopting surface approach to learning
2*	Papinczak et al. (2008)	Advances in Health Sciences Education	2008	To determine the influence of metacognitive activities—self and peer-assessment—within the PBL tutorial environment on the development of deep learning approach, reduction in surface approach, and enhancement of individual learning self-efficacy	Control group pre-test, post-test design was implemented	ASSIST	Over the course of first-year medical studies, students lose self-efficacy and move away from deep-strategic learning approaches towards more surface approaches. The program of metacognitive activities failed to reverse this trend. The substantial swing towards surface learning raises questions about the perceived capacity of PBL curricula to promote deep approaches to learning in dense curricula
3*	Abraham et al. (2008)	Advances in Physiology Education	2008	To study the differences in learning approaches to physiology of undergraduate medical students in a partially PBL and non-PBL oriented curriculum	Control group post-test only design. PBL curriculum from September 2006 admissions onward	SIAL	Scores for deep and strategic approaches of PBL students were found to be significantly higher compared with NPBL students. No difference between PBL and NPBL in surface approach
4*	Wong and Lam (2007)	Research on social work practice	2007	To evaluate the effects of problem-based learning (PBL) in social work education	One group pre-test post-test design. 132s-year social work students who were spread across the 3 academic years of 2000–2001, 2001–2002, and 2002–2003	SPQ + R-SPQ	The results indicated positive learning outcomes, with the most significant gains occurring in knowledge and lesser gains being made in skills and values. No significant positive gain in deep learning and no significant change in surface learning. Surface approach is negatively correlated with learning outcomes. The findings suggest that students with deep learning motives and approaches reap the most benefit from PBL. The switch to the PBL mode increased the students’ workload and did not necessarily result in a deeper learning approach for all of them
5*	Segers et al. (2006)	Studies in Educational Evaluation	2006	To determine if students in a redesigned course, firstly, hold different perceptions of the assessment demands and, secondly, adjusted their learning strategies towards deeper learning	Control group post-test only design—two subsequent cohorts of second-year students	SPQ	Contrary to expectations, the students in the original assignment-based (ABL) course adopted sign. more deep-learning strategies and sign. less surface-learning strategies than the students in the problem-based (PBL) course. Additionally, the results show clearly that the students who express their intentions to employ a certain learning strategy perceive the assessment demands as such and actually employ a related learning strategy
6*	Groves (2005)	Advances in Health Sciences Education	2005	To assess the influence of graduate-entry PBL curriculum on individual learning style and investigate the relationship between learning style, academic achievement and clinical reasoning skill	One group pre-test post-test design	SPQ	Net shift towards a more surface approach over the period of the study (but not significant). Significant decrease in deep-learning scores
7*	Mok et al. (2009)	International journal of speech-language pathology	2009	To better understand the relationship between student learning approaches and academic performance in a problem-based learning (PBL) curriculum	One group pre-test post-test design Cross sectional research design (comparison of 3 cohorts)	R-SPQ-2F	Exposure to PBL led to significant increase in DA (deep approach) and SA (surface approach) to learning during an academic year for students in years 1–3. Students who did well in a PBL examination showed a much stronger DA than SA to learning, while students who performed less well showed a smaller difference between DA and SA to learning
8*	Gurpinar et al. (2013)	Advances in Physiology Education	2013	Determine the satisfaction of medical students with problem-based learning (PBL) and their approaches to learning	Control group post-test only design (three curricula were compared; one full PBL vs. two hybrid) Cross-sectional	R-SPQ-2F	Of the study group, 64.6 % were found to adopt a deep approach to learning, and it is confirmed that these students were reasonably more satisfied with PBL. When the three different curricula were compared in terms of student satisfaction with PBL among surface and deep learners, no significant differences among surface learners in different curricula was found in terms of satisfaction. However, in the full PBL curriculum a higher percentage of students adopted a deep approach and a lower percentage a surface approach as compared to the other curricula (control groups)
9*	Grant et al. (2012)	BMC Research Notes (Biomedicalcentral)	2012	To compare the effect of context on learning at different UK medical schools, schools with conventional and PBL curricula	Control group post-test only design Mixed method—two stages, first qualitative phase and then, quantitative phase where findings from the qualitative phase were tested	ALSI (Entwistle)	Students with PBL curriculum scored significantly higher for reflection in learning, self-efficacy in self-directed leaning and for deep approach to learning. Students surface approach did not differ significantly
10*	Reid et al. (2012)	Medical Education Online	2012	To investigate the hypothesis that the redesigned curriculum was successfully promoting a deep approach to learning and studying and deterring a surface approach in undergraduates during years 1–5 of a medical degree program	One group pre-test post-test design Quantitative Longitudinal	ASSIST	Medical students have high scores for deep and strategic approaches to learning and studying and lower scores for a surface approach, but that, even when efforts were made to promote deep approach, little significant change in these scores occurred during the whole of the medical degree program, apart from some tendency for the surface approach to lessen. Either their approaches are not susceptible to change or else the learning environment may need to alter more drastically than hitherto
11*	McParland et al. (2004)	Medical Education	2004	To measure the effectiveness of a problem-based learning course compared to traditional teaching in undergraduate psychiatry	Control group pre-post test design. A PBL psychiatry course versus a lecture-based psychiatry course	SPQ	The PBL attachment/course resulted in significantly better examination performance than did the traditional teaching course. No differences in surface, deep or strategic learning before and after the course were found. No differences between the two courses. Students were significantly more successful in the examinations if they had received the PBL course, were female, and used deep and strategic learning
12*	Selçuk (2010)	International Journal of the Physical Sciences	2010	To evaluate the effects of (PBL) method on students’ achievement in and approaches and attitudes towards an introductory physics course	Control group pre-test post-test design. One control group (or traditional lecture-based instruction group) and one experimental group (PBL group)	ALS	The results indicated that the problem-based learning method encouraged the students’ deep approach to learning as compared to the control group (sign), and also improved interest (a component of attitude) towards the physics course. The results also signalled that PBL-based physics instruction impacted the students’ achievement in physics positively. No sign. difference between PBL and control group in terms of surface approach were found before and after the course
13*	Kieser et al. (2005)	European Journal of Dental Education	2005	To analyze the influence of context on students’ approaches to learning	One group pre-test post-test design. Low N!	R-SPQ-2F	Those who entered the course with a surface approach (n = 5) left with a deep-learning approach, and quality learning outcomes. There were 7 students who started the course with a deep-learning approach and cohesive conception and had a deep at the end (no change). There were twowho moved from deep to surface. Test results were better for students with a deep approach and worse for students with a surface approach
14*	Schultz and Christensen (2004)	European Journal of Engineering Education	2004	To evaluate the implementation of the highly structured seven-step problem-based learning (PBL) procedure as part of the learning process in a human–computer interaction (HCI) design course	One group post-test only design. Low N! Mixed methods (both qualitative and quantitative methods)	SPQ-modified	The qualitative and quantitative evaluation showed that students took responsibility for their own learning. The quantitative evaluation shows that PBL clearly stimulated the students to take a deep approach to learning and not a surface approach (i.e. the mean scores on items related to deep approach differed from the items dealing with a surface approach; in favour of the deep approach [1.4 difference, scale 1–5)]
15*	Tiwari et al. (2006)	Nurse Education Today	2006	To evaluate the effect of PBL on students’ approaches to learning in clinical nursing education	One group pre-test post-test design	R-SPQ-2F	Study provides empirical support for the suggestion that PBL promotes a deep approach to learning. The R-SPQ-2F scores indicated that for the deep approach to learning, the post-test mean score was significantly higher than at the pre-test. No significance was observed between the pre-test and post-test mean scores for the surface approach to learning
16*	Nijhuis et al. (2005)	Learning Environ-ments Research	2005	To determine if students, firstly, perceived the redesigned course as being more challenging and, secondly, adjusted their learning strategies towards deeper learning	Control group post-test only design. Quantitative methods comparing two groups	SPQ-adapted	The results indicated that the students from the redesigned course showed a higher degree of surface learning and a lower level of deep learning than the students from the assignment-based learning course
17*	Reid et al. (2005)	Medical Teacher	2005	To determine to what extent the early medical course succeeded in promoting a deep approach and deterring a surface approach to learning	Control group pre-test post-test design. Longitudinal study	ASSIST	The results are remarkably consistent from cohort to cohort with relatively high scores for deep (60 out of 80) and strategic approaches and lower for surface (45 out of 80). Disappointingly, the students’ learning approaches did not show any increase in deep approach during year 2, also no change in surface approach was reported
18*	Adiga and Adiga (2010)	Biomedical Research	2010	To study the changing pattern of learning approaches to pharmacology adopting PBL by undergraduate students of an Indian medical school	One group pre-test post-test design. Quantitative method. Mean scores of surface, deep and strategic approaches of students during pre-PBL (end of 2nd block) and post-PBL phase (end of the 4th block) were compared	SIAL	Scores for deep approaches of students in post-PBL phase (3rd and 4th blocks) were found to be significantly higher compared with pre-PBL phase. The score for the surface and strategic approaches did not differ significantly between the two phases even though there was a small change
19*	Newble and Clarke (1986)	Medical Education	1986	To explore the relationship between educational context and approach to learning	Control group (i.e., traditional medical school vs. a PBL medical school) Posttest only	Lancaster Approaches to Studying Inventory	PBL students appear to have an approach to learning which more closely approximates the aims of most medical schools (i.e., high on deep approach and low on surface)
20*	Coles (1985)	Medical Education	1985	To compare PBL and non-PBL students in their approaches to learning	Control group Pre-Posttest design (on entry and after one year)	Short Inventory of Approaches to Studying	The approaches to studying of students at the conventional school appcar to be detrimentally influenced by the experience of the first year Those of PBL students do not, and probably are improved
21*	De Volder and De Grave (1989)	Medical Education	1989	To investigate how the introductory phase of a PBL medical program affects the study methods of students	Pre-posttest design (on the first day of academic year and again after the introductory period, i.e., 6 weeks)	Short inventory of study Approaches (Entwistle 1981)	Results indicate that approaches to learning are made desirable by the training in PBL, but are not desirable on entry