Scaffolding for Success in Problem-Based
School of Information Technology and Mathematical Sciences
The University of Ballarat, Australia
Learning (PBL) is based on an alternative pedagogical model to the
conventional, didactic one, and offers benefits to the quality of
student learning. The approach has been adopted by many institutions.
The focus of this paper is on the influence of the learning support
structure in an environment (such as the typical PBL environment)
that encourages student independence as one of its basic tenets. The
immediate reaction might be to assume that it takes on a reduced importance
in such circumstances. That assumption is challenged in this paper.
The concept of "scaffolding" may take
many forms1; here it is used in a wide context to refer to
all forms of learning support, whether or not they be cognitively-based,
logistical, etc. Thus, the term is used to broadly refer to the range
of services provided to assist learning. This is of interest as Problem-Based
Learning (PBL) approaches to education suggest a strong role for factors
such as authenticity and student independence. With the shift of emphasis
that moving towards a PBL approach implies, a re-examination of the
nature of what it means to offer meaningful support to learners is important.
In this paper the relationship of scaffolding to the success of PBL
programs is examined. In this context, "success" is measured
largely in terms of those benefits with which PBL is associated, principally
in the encouragement of "deep" (or personally meaningful and
potentially transformative) approaches to learning. Elsewhere, deep
approaches to learning have been described in terms of higher levels
of integration of knowledge and greater tolerance to complexity2.
The paper begins by briefly referring to the definitional
dilemma that hinders attempts to compare PBL programs. A working definition
is established. Desirable outcomes of PBL are then presented, with an
emphasis on "deep" learning approaches. This is then countered
by raising some concerns about the performance of existing PBL programs,
while hinting that appropriate scaffolding may offer relief from some
of these concerns. An account of the role of the tutor in PBL follows,
as an obvious source of scaffolding. Scaffolding is then discussed in
terms of improving the likelihood of successfully encouraging meaningful
approaches to learning in PBL students.
A review of the literature reveals an extensive
coverage of PBL case studies, many based on differing concepts of PBL.1 These concepts may directly affect the reported success or failure of
the approach; for example, some authors refer to PBL as a mandate for
"discovery learning" and then report that this introduces
implementation problems in terms of required subject-matter coverage.3 Furthermore, as a reaction to this concern there is a risk of staff
enforcing rigid course objectives to ensure subject-matter coverage,
with a return to what the authors refer to as "curriculopathy"
(disease of the curriculum).
Although some variation in what is labeled as
"PBL" may be aberrant, it is this author's observation that
much of PBL's wide range of possible manifestations is to some extent
inherent to the approach, as one which does not prescribe fixed and
narrow pathways for learning. However, there are some essential criteria
that constrain the definition of PBL. Importantly, PBL is identified
as a constructivist pedagogy. Savery and Duffy4 summarize some of the central tenets of constructivism:
- Understanding is based on experiences with content, context, the
learner's goals, etc., and these factors are inextricably woven together.
Thus, understanding is a construction that is unique to the individual.
- Meaning is not transmitted, although it may be tested for compatibility
with the meanings of others. From another perspective, cognition may
be regarded as being distributed rather than individually localized.
- Puzzlement is the factor that motivates learning.
- Social negotiation and the ongoing testing of the viability of existing
concepts in the face of personal experience are the principle forces
involved in the evolution of knowledge.
The definition of PBL that is used here is that
it is a subset of problem-centered learning methods which is easily
identifiable by the use of typically ill-structured problems which precede
and motivate learning, and act as a vehicle for encouraging student
ownership of the learning environment. Usually there is an emphasis
on contextualization of the learning scenario, providing a basis for
later transference, and the learning is accompanied by reflection as
an important meta-cognitive aspect of PBL. Implementation of PBL programs
usually occurs via group-based work, reflecting the constructivist focus
on the value of negotiated meaning. A characteristic of PBL which follows
from many of these attributes is that it is unconfined by discipline
boundaries, encouraging an integrative approach to learning which is
based on requirements of the problem as perceived by the learners themselves.
Schmidt5 summarizes PBL in terms of three essential
- Activation of prior-learning via the problem;
- Encoding specificity such that the resemblance of the problem
to intended application domains facilitates later transfer (leading
to an emphasis on authentic learning environments); and
- Elaboration of knowledge via discussion and reflection to
consolidate learning experiences.
Desirable Outcomes of PBL: Deep Learning Approaches
Traditional approaches to preclinical medical education
have been criticized as devoid of cross-disciplinary integration, having
insufficient interface with clinical problems, and exhibiting insufficient
retention of basic knowledge and students' inability to apply to actual
cases, as well as concerns over accuracy of the knowledge base.6
As an alternative to traditional methods, Robbs
and Merideth7 list a number of advantages that
are associated with PBL modes of learning:
- an increased retention of information;
- the development of an integrated (rather than discipline-bound)
- an encouragement towards lifelong learning;
- a greater exposure to clinical experience and at an earlier stage
in the curriculum;
- an increased student-staff liaison; and
- an increase in overall motivation.
Marton and Saljo8 and the
Gotteborg educational research group9 have focussed
on qualitative differences in individual approaches to learning, with
the terms "surface" and "deep" used to reflect the
degree of engagement and depth of understanding of the material. The
word "approach" is emphasized here to indicate that this is
not necessarily inherent to the learner, but may be variously (and possibly
even strategically) applied by students in response to external factors.
This establishes a position where the learning environment shares in
the responsibility for encouraging more meaningful ("deep")
approaches to learning.
Problem-Based Learning (PBL) has been claimed
to encourage deep learning in students.10,11.
These studies indicate increased use of meaningful ("deep")
approaches by PBL students in relating to the material, and decreased
use of reproductive ("shallow") approaches.
PBL incorporates a number of factors that seek
to encourage this meaning-orientation to learning approaches, such as
high motivation, learner-centeredness, and group-based activity requiring
peer negotiation.12 A study by Sobral13 generally supports these propositions, finding that "the results
... reinforce the idea that problem-based learning, even in a single-course
experience, may enhance the emotional well-being of the participants
and the quality of the learning environment, as expressed by the learners
themselves" (p.100). The current review relies heavily (although
not exclusively) on student self-perception of the quality of learning,
due to the availability of such information in the literature. It is
reasonable to cast these student perceptions about quality of learning
in the company of other perceptions in order to develop a feel for possible
relationships that may be worth exploring. While this paper is primarily
concerned with relationships between scaffolding and deep learning,
it may not be possible to do so in complete isolation of other factors.
There is evidence in the literature for relationships
between quality of learning and other factors. For example, Kember and
Gow14 summarize arguments which find correlations
between reproductive learning approaches and such factors as high workload,
assessment methods which reward recall, low levels of motivation in
the course, and overly-constrained learning environments.
PBL has a strong reputation for enhancing student
motivation towards learning tasks and providing an unconstrained environment
by means of student empowerment, thereby removing two of these possible
indicators of shallow learning approaches. However, it is the author's
opinion that PBL occasionally occurs in the presence of assessment schemes
that are inappropriate to its orientation, and it is well documented
that PBL may involve perceptions of increased workload. These areas
will be explored here.
Ma15 surveyed 3rd-year students
of database-systems using Biggs' Study Process Questionnaire16,
and compared the results with the outcomes of PBL projects. He found
a linear relationship between good student outcomes in the projects
and indicators of deep or achieving learning processes, and conversely,
shallow learning strategies were found to be negatively correlated with
good marks. However, this relationship is not explored, and the report
suggests that more evidence is needed before claims can be made for
correlations between deep learners and better performance in PBL projects.
The increased motivation associated with PBL and
evident in student surveys and staff observations of increased student
attentiveness17-20 is often regarded as an important
outcome. Certainly, increased motivation is a desirable result. However,
in this survey motivation is given a different emphasis. First, the
focus is on quality of learning. Second, motivation is regarded here
as essential for the success of PBL in the face of some of its strong
demands, and therefore is treated more as input rather than an output.
This will be discussed further in the context of the cognitive demands
made by constructivist approaches to pedagogy.
Concerns Raised in Response to PBL Cases Studies
The literature review conducted by Albanese and
Mitchell1 indicates a number of issues that may
be of concern, as evidenced in the case-study literature. In the current
review such issues are loosely classified in terms of suggested explanations
for them: problems inherent to a process of change, problems emerging
from traditional means of assessment, and problems relating to inherent
difficulties with PBL as a mode of learning.
Issues Inherent to Change
Pereira, and colleagues17 identify a common failing with PBL programs due to entrenched (non-constructivist)
models of learning and power relations. The change to PBL represents
a disruption to these existing assumptions, which then results in resistance:17 "Immediate and/or long term resistance is therefore a general and
foreseeable reaction threatening sustainable reform" (p.352). The
authors note an improvement in student evaluation of the course over
time, however. O'Hanlon, Winefield, Hejka and Chur-Hansen21 refer to the transitional problems associated with students moving to
a group-based learning environment, especially where prior academic
performances were obtained via individual success on a competitive basis.
Moving from a secondary school environment to a tertiary PBL first-year
program is an example of this sort of anxiety-inducing transition. In
the case of PBL, the degree of change is quite dramatic; despite the
appropriateness of PBL as pedagogy in terms of current positions on
human learning, Camp22 still refers the change
to PBL as a "paradigm shift". This indicates differences between
it and traditional approaches to education at very fundamental levels.
Kenley23 claims that professional
domains such as medicine, architecture, etc., are inherently teacher-centered
in that great emphasis is based on the knowledge accumulated in the
teacher, which is often more highly regarded than the knowledge available
in reference works. Kember and Gow14 suggest that
lecturers that adopt highly instructivist approaches to teaching tend
to see personal subject-based knowledge as the prime attribute of the
professorate, and (therefore) regard their courses as a means of training
of students for their professional roles. In terms of building and architecture,
Kenley23 describes the desired attributes of the
teacher in such a system:
Thus the ideal candidate for teaching management of construction
is someone who has learnt all the relevant material during their own
education and undertaken continuing education during a long and successful
career which has included a wide range of experience of all facets
of the industry. For good measure they are an experienced researcher
able to guide students as they explore the bounds of the teacher's
knowledge. Such individuals may be difficult to locate. Importantly
this description excludes the professional academic - who in many
ways forms the lifeblood of the university system. (pp. 3-4)
However, it is in just such broad discipline areas
(most noticeably medicine) that PBL has made its greatest impact. The
high value placed on experience may support a teacher-centered model
of education in which the teacher embodies experience which is transmitted
to students, or it may equally support a constructivist model which
encourages the exposure to such experience by students. Much of this
commentary on discipline-based inherent propensity for transmissive
pedagogies is likely to be attributable to historical and political
forces, and may more productively be associated with inherent difficulties
brought about by the more general process of change itself.
O'Hanlon, Winefield, Hejka & Chur-Hansen21 report on student evaluations of a first-year medical program run in
parallel PBL and traditional modes, and note that although students
were highly motivated by the PBL approach, overall the traditional approach
was favored (found "more beneficial"). Many students were
undecided. Occurring as a first-year program it is likely that one influencing
factor on these results was student inability to acclimatize to the
PBL philosophy, which is fundamentally different from the individualistic
and competitive approaches typically rewarded during secondary schooling.
This current paper identifies in this an opportunity for improving the
situation with appropriate scaffolding to lessen the severity of the
impact associated with any dramatic change. That is, change can be managed
in order to reduce the severity of its impact; this represents one aspect
of the need for scaffolding within PBL.
Issues of Performance and Traditional Assessment Instruments
One of the focus questions of the literature review
by Albanese and Mitchell1 concerned the performance
of PBL medical students in basic science exams such as the NBME I (the
acronym refers to the National Board of Medical Examiners) and the USMLE
I (the United States Medical Licensure Examination). They refer to a
number of studies which suggest that PBL students may exhibit lower
performance in such exams compared to students from conventional courses;
it is important that they note that this is not a universal finding,
and suggest that one explanation for the varying results may be due
to different approaches to the delivery of PBL.
In a PBL course that integrated pharmacology into
1st and 2nd year medicine,24 it was found that
performance of PBL students in the traditional evaluation system was
favorable, despite the concerns expressed elsewhere. Two of three groups
studied performed in the NBME I with slightly lower means than the national
average (for pharmacology) while the remaining group equaled the national
average in the USMLE I. The latest three groups equaled and bettered
the USMLE I national average. They note, however, that the USMLE I examination
often integrates questions across discipline boundaries, and raise the
question as to whether or not this offers an advantage to PBL students.
McGregor and colleagues19 were unable to register
differences between didactic and PBL modes of learning in subject-based
performance tests of medical students in their third-year clerkship.
Lieux25 resents the results of a study of PBL
and conventional stream students in a food and nutrition course, and
finds that they do equally well in exams, although PBL students exhibited
a significantly higher attendance rate.
Inherent Demands Associated with Valued Learning
It is reasonable to suppose that more valued learning
may involve greater demands on student learning processes. Lieux25 notes that student surveys of parallel PBL versus conventional-stream
modes of learning show that PBL students see themselves as working harder.
Perkins26 examines three broad ways in which constructivism
makes strong demands on learners:
- Cognitive complexity is a feature of constructivist learning
environments, in which authenticity is sought. This is particularly
the case where pre-existing knowledge may be naive (such as is common
in science). Perturbation is a constructivist device that exposes
these misconceptions, and forces the learner to confront them. It
may be likened to an induced anxiety in which the testing of concepts
against reality exposes significant (and unexpected) shortcomings
in the existing concepts and intuitions. Thus, the resulting cognitive
load may be high. However, if this is the cost of non-avoidance of
misconceptions, then it is a cost that may be regarded as worthwhile.
Perkins suggests that a middle ground exists (which he refers to as
the "conflict deferred" approach), where learners may postpone
dealing with misconceptions until some grounding in the new domain
is achieved. This is essentially an argument for early scaffolding,
although it is not presented as such. Clearly, regardless of cognitive
cost concerns, the "conflict buried" approach which allows
misconceptions to continue is not an option if meaningful learning
is desired; such an approach may be permitted in non-constructivist
environments in which assessment and presentation of content reward
shallow, reproductive learning strategies.
- Task management is increased in constructivist settings,
as a necessary condition for students to exhibit learning independence
and a function of the emphasis on student-centerdness. The danger
is in not permitting time for gradual development of these essential
managerial skills, something that would be magnified in the presence
of cognitive complexity. This is where constructivist techniques such
as "cognitive apprenticeship" may be useful in reducing
the load. Savery and Duffy4 identify cognitive
apprenticeship as a natural device for assisting in metacognitive
processes in PBL environments. That is, early scaffolding of skills
essential to the constructivist process can benefit the functioning
of those processes. Peterson27 establishes a
number of important skills that enhance PBL. Their ability to offer
such enhancement suggests the importance of developing them, rather
than simply expecting them to grow in response to need.
- "Buying in" to the PBL approach is another area
of possible difficulty. Students may not identify with the reasons
given for not simply being told the information which teachers want
them to know. That they are asked to adopt such a vastly different
paradigm of learning to that in which they typically feel comfortable
at the same time as they are asked to learn new material adds up to
a potentially significant set of obstacles. These difficulties alter
the way in which the motivational benefits associated with PBL are
perceived. It is not apparent how scaffolding can bridge such perceptions,
and it may be argued that the change required of the culture of student
learning is so fundamentally different as to be incapable of full
appreciation from within the instructivist, transmissive world-view.
If such a proposition is valid, then the motivational benefits of
PBL are not simply a desirable side effect, but essential to its success.
If the importance of meaningful approaches to learning is obscured
by preconceptions of education then high levels of motivation offered
by PBL approaches may be an essential bridge towards new learning
habits. One may be moved to suggest that in this context motivation
itself is a form of scaffolding that is fundamental to the success
The Effect of Tutors on PBL Success
The last section presented some reasons for scaffolding.
The tutor may be recognized as its most evident source. Zimitat and
colleagues18 report that student surveys revealed
that 70% of students in a PBL course found the tutors' roles essential
to the success of the method.
The desired role of the tutor in PBL must be quite
different in nature to that of a tutor in a didactic system. Jones,
Donnelly, Nash, Young and Schwartz28 refer to
two essential roles of the PBL tutor: facilitation of the learning process
via prompting, and assisting in group processes to ensure that they
maintain focus. They also mention that tutor training includes refraining
from assuming the role of an authoritative source of knowledge. It is
not apparent that the tutor's desirable relationship to subject content
is well-understood; this is an issue which is relevant to a pedagogy
such as PBL which values student-centered approaches to learning, thus
bringing the role of the teacher's relationship to knowledge into question.
Ambury29 refers to tutor subject-based expertise
as a disadvantage to student-centered learning and independence. However,
Eagle, Harasym and Mandin30 find that tutor expertise
favors greater congruence between learning issues and case objectives,
and stimulates greater numbers of learning issues to be explored. Sobral,13 in comparing staff-tutored groups with peer-tutored groups in a PBL
medicine course at the University of Brasilia, witnessed no significant
difference between them in terms of problem solving or student self-evaluation
of skills. However, scores for meaningfulness of learning and usefulness
of group work were found to be significantly higher in peer-tutored
groups. The level of tutor expertise is clearly one area that would
benefit from continued research.
The importance of the tutor (without specification
as to whether or not that role is filled by staff or advanced peer)
is emphasized by Gijselaers and Schmidt.31 They
found a causal relationship between tutor involvement in PBL and group
processes, which in turn affects student motivation towards learning.
The importance of such motivation to the success of PBL has already
Other correlations have been proposed. It is widely
recognized that the tutor role in PBL (or more widely, constructivist)
learning environments should be one of facilitation rather than instruction.14 More widely, Kember and Gow14 have found correlations
between staff attitudes to teaching roles (facilitatory vs. instructional)
and student approaches to learning (deep vs. surface):
...in departments where the predominant orientation is toward knowledge
transmission, the students' use of deep approach is likely to decline
through the period of the course of study. On the other hand, departments
with a propensity toward learning facilitation tend to discourage the
use of surface approaches. The effect of an orientation toward learning
facilitation is perhaps more likely to manifest itself in this way rather
than as a positive advance in the use of a deep approach because of
the difficulty of inducing students with a propensity toward a surface
approach to consistently adopt a deep approach. (pp.67-8)
Thus, there is a relationship between teaching
role and quality of learning adopted by students. It may be suggested
that the facilitatory role of the tutor in PBL is essentially one of
providing scaffolding, and that the relationships that have been attributed
to tutors may possibly be attributable to appropriate use of scaffolding
in general, with the implication that this may extrapolate to other
forms of scaffolding. This may be a valuable area of further research.
Clearly, if the effect of tutors play such an important
role in the success of PBL, it is important to recognize that a mechanism
for feedback regarding tutor performance is desirable. Dolmans, Wolfhagen
and Snell-Balendong32 developed an evaluation
form to allow formative assessment of tutor performance by students.
It focuses on three areas: guidance of students through the learning
process (6 questions), content knowledge input (4 questions), and commitment
to the group's learning (3 questions). These areas were validated by
a confirmatory factor analysis. Questions were responded to simply by
indicating on a three-point Likert scale whether the result was judged
to be insufficient, neutral, or sufficient. The experiences with such
evaluations at the Medical School at the University of Limburg have
been rated positive, and has resulted in a increase in teaching focus.
Attributes of PBL in Relation to Scaffolding Needs
It is clear that the effect of the tutor is an
important one in PBL, and that the tutor is well placed to provide scaffolding
to learners. Here, the discussion turns to consider scaffolding in terms
of the main attributes of PBL.
It is important to note that PBL's emphasis on
student independence and learner ownership of problems does not preclude
the use of scaffolding to assist in the development of these attributes
and other skills required to enable meaningful learning. PBL lays the
responsibility and, ultimately, the control of the learning process
essentially at the feet of the student; however, this is not a process
of abandonment. Koschmann and colleagues6 state
that "there is a well-defined curricular infrastructure under girding
the process. Cases are developed from actual patient records and are
presented in the way actual patients present for care: as an ill-structured
problem that must be built by inquiring to gather necessary information..."
Authenticity requires a level of "fidelity"
to ensure that learning occurs in sufficiently real-world context, and
also avoidance of the provision of information that a real-world context
would not provide.6
Honebein, Duffy and Fishman33 identify a number of elements, which lend authenticity to a task:
- Learner ownership: This is supported by the argument that
metacognition is essential to function well in complex environments
and therefore they must be supported in developing a sense of responsibility
for their management of problem-solving tasks, which suggests problems
- Project-based nature: This suggests a holistic representation
of the task, with opportunities for authentic global (wider context)
entities as well as more localized ones.
- Multiple perspectives: The empowerment of students to consider
multiple perspectives when examining a problem domain is an important
mechanism for developing expertise. One means for encouraging this
is in the use of collaborative learning environments, as are typically
used in PBL programs.
Problem authenticity is a feature of constructivist
approaches to education, and is a readily recognized aspect of PBL,
as shown by the above criteria.
the nature of six PBL problem documentation sets (via a process of content
analysis) over three medical schools that revealed a number of factors
influencing the construction of problem fidelity:
- Presentation format may vary from patient simulations and
video recordings of cases (high fidelity) to "written simulations"
in which the case is described on paper (exhibiting low fidelity).
- Manifestation may be ill structured and given as an individual
variant on the range of possibilities (high fidelity) or may be a
comprehensive list of the pool of manifestation possibilities (low
- Associated problems may be included which complicate the
scenario with possibly unrelated factors such as symptoms produced
by medication or behavioral problems (high fidelity); alternatively,
the problem may be filtered to present an isolated set of conditions
- Context may resemble that of actual situations such as those
that afford the opportunity to talk to family members of the patient
(high fidelity), or may be more contrived (low fidelity).
- Objectives may be defined in terms of the health of the
patient (high fidelity and integration across disciplines) or may
be discipline-bound (low fidelity and artificial).
He found that low-fidelity problems such as those
stylistically borrowed from textbook models of problems to be "counterproductive
in terms of the objectives of PBL. In this context textbook derived
health problems are not considered very appropriate" (p. 281).
A study by Tipping, Freeman and Rachlis35 reveals that observed group dynamics don't necessarily match those,
which are reported by staff or students:
Data collected from the observations and videotapes were markedly
different from the self-reported data obtained from the students and
faculty. The observers noted patterns of interaction and involvement,
such as some students not participating at all for the full two hours,
communication directed mostly toward the tutor and not among the group,
one member sleeping during the tutorial, and a group in which the
sole female member was relegated to a secretarial role. No cohesion
was evident in these groups. Several aspects of productivity were
not addressed. Goals were not articulated, methods for achieving goals
were unclear, measurement of achievement was non-existent, and no
time was spent in planning for future sessions. There was no evidence
of reflection on any aspect of group behavior. (p.1052)
Students later claimed that reasons for this difference
between observed and reported behaviors included the intrusive effect
of the video (although video was only one means of observation, and
doesn't appear to be a mechanism that would permit some of the behavior
more easily guarded against, such as sleeping!); lack of certainty as
to expected roles (which is akin to suggesting that the group dynamics
didn't work because they didn't work!); and lack of tutor guidance.
It is suggested here that the last one is the only one with any plausibility,
and emphasizes the importance of the role of the tutor in PBL. It is,
most emphatically, a request for greater scaffolding. The authors suggest
reasons of minimal prior exposure to group dynamics (especially as individual
competitiveness is a characteristic of premedical curricula) and lack
of formal training in this area; it was further suggested that students
lacked a model of group effectiveness. Tutors, despite some training
in the area, did not facilitate reflection on group processes, leading
to the conclusion that even greater emphasis needs directing at this
area in future staff training programs. Such failures in group processes
may be interpreted as failures in the provision of appropriate scaffolding
in both tutor facilitation of group processes and in establishing a
successful mental model of interaction within the group.
While on the topic of perceptual incongruities,
Lieux25 mentions the results of student course
evaluations that revealed that PBL students perceived themselves as
learning less content than lecture-stream students, and, conversely,
lecture-stream students regarded themselves as learning more; this is
in spite of the equality of performance even in traditional assessment
schemes. Certainly, despite some implementations of PBL leaning towards
discovery learning, content is deliverable within a PBL approach .36 In addition to learning content, however, PBL students regarded themselves
as learning problem-solving, communication skills, and developing a
sense of "personal responsibility"; these were not found in
the feedback from the lecture-based students. Similar results have occurred
in the author's experiences.20,37,38
St-Arnaud39 as cited in
Hebert and Bravo40 describes four directions in
- Production is the contribution of individuals towards a
fixed group goal, and may take the form of critiques, proposals, summaries,
- Solidarity is individual contribution towards group communication,
and involves supportiveness, attention to (and recognition of) the
contributions of others, etc.
- Maintenance involves the addressing of overall group cohesiveness,
and involves clarification, organization, and facilitation of individual
interactions within the group.
- Residual processes are those negative energies that are
typically recognized by the symptoms of absenteeism, separate and
unrelated work, etc. Group functionality lies in the ability to dwarf
residual processes by those more positive energies above.
If the group is to work effectively, some effort
must be directed towards it, and facets of group dynamics such as those
described need to be given recognition within the course. Hebert and
Bravo40 have used these processes in developing
an instrument for measuring all facets of PBL behavior. Tipping and
colleagues35 recognize a number of aspects of
group dynamics in their Group Observation Guide: physical and emotional
climate, individual involvement, interaction, cohesion, productivity
and leadership. Their study reveals that both students and staff were
largely limited in their reporting of group processes to climate, interaction,
productivity, and leadership, with varying levels of detail. Involvement
and cohesion were unmentioned.
The concerns regarding performance of PBL students
in traditionally-valued assessment modes is matched, as we have seen,
by results which indicate comparable performance. The variation in these
results becomes as interesting as the initial question. Robbs and Merideth7 refer to a number of "myths" which have surrounded PBL. Their
observations at the University of Southern Illinois School of Medicine
are that PBL students do as well in the USMLE I exams as conventional
students. They also refer to PBL as having a hidden structure; perhaps
it is the case that this structure is absent in some PBL programs. Albanese
and Mitchell1 also raise the matter of different
forms of expression of PBL in explaining these variations with respect
to such exams. It remains a matter for further research to investigate
the possibility of correlations between structure and success in these
exams, and what possibilities exist for establishing such scaffolding
without threatening the essential nature of PBL. Phelan, Jackson and
Berner41 also report no statistical differences
between clinical scores for PBL versus traditional students. Furthermore,
they note that this confirms findings of other recent studies, and state
that it is primarily the early studies that found this to be a possible
problem. Is it possible that the results are reflecting a maturation
of PBL in progress? One possible scenario is that educators are discovering
the delicate balance between appropriate scaffolding within constructivist
Student surveys present one possible means of
exploring the issues. O'Hanlon and colleagues21 used open questions with students engaged in a first-year PBL program.
The questions and all answers with double-figure percentages (only)
are reproduced here (n = 119):
1. "What were the best aspects of this module?"
- Working in a group or as a team (27.7%);
- Independent learning; active participation; research (19.3%);
- The presentation; public speaking (16.0%); and
- Case studies; clinical applications (10.1%).
These results reflect the advantages commonly associated
with the PBL approach. Interestingly, (as this is a first-year course)
the transition to group work does not seem to have been problematic.
The favorable impression of group work that is consistently reported
is interesting in light of Sobral's13 findings
that there is a statistically significant positive correlation between
PBL scores for meaningfulness of learning and both group-work and self-evaluation.
Similarly, motivation was shown to correlate positively with problem-solving
2. "How could this module be improved?"
- More time; less preparation (34.5%);
- More guidance; clearer instructions and expectations (19.3); and
- Give background information (12.6%).
There are essentially two factors here - time demands
and the need for scaffolding.
3. "Do you have any comments on the general use of a problem-based
approach to teaching medical knowledge?"
- Time consuming (29.4%); and
- More guidance required (23.5%).
Once again the emphasis on scaffolding, and time
is evident. Of course it is difficult to extract a sense of the extent
to which this is an expression of the resistance to change (recalling
that this is a first-year medical PBL program).
Cawley42 produces a summary
of results for PBL survey student evaluation in a mechanical engineering
course (as a final-year option) on a 5-point Likert scale over 3 years,
with sample sizes ranging from 21 to 37. The stable results (i.e., those
which maintain their result over the years) indicate positive results
for a number of factors, scoring well for interest (mean of approx.
4.6), enjoyment (mean approx. 4.3), relevance due to authenticity (approx.
mean of 4.5), and an understanding of technical knowledge equal to that
expected from a conventional approach (mean of approx. 4.0).
Trends indicated through the results over the years
are increasing feelings of quantity of knowledge being equal to conventional
approaches as the course progresses (progressive means of 3.2, 3.2,
and 3.8), and an increase in time required of PBL in comparison with
lectures (means of 3.2, 4.2, and 4.4).
With respect to the time required, the first result
of 3.2 (indicating that it takes about as much time as the conventional
course) is discussed in terms of the time being greater than student
estimations, since (p. 183) "students could frequently be heard
discussing the problems in the coffee room, an almost unknown occurrence
on conventional courses, and this valuable peer learning may not have
appeared in their estimates". The perceived rise in time demands
of PBL in the 2nd and 3rd years of the course is proposed as possibly
due to increased coursework requirements in other courses, and accompanied
by staff perceptions of less time spent on PBL projects in those years.
Although it may not be immediately apparent, one
means of support of the student in the presence of perceptions of increased
workload may be via alterations to the assessment scheme, offering greater
recognition of the work performed. Zimitat and colleagues18 found that over half of students surveyed in a PBL course (n=231), and
of whom 70% were motivated by the approach, expressed the opinion that
the assessment weight for PBL cases should be increased due to the perceived
extra workload in PBL.
Other mechanisms of support through the assessment
system are possible. Ma15 employed a negotiated
assessment program in a course on database systems (of course, staff
are essential elements in the negotiation!).
The change to a PBL curriculum may inherently
suggest redesign of assessment. Sokas and colleagues43 suggest that PBL may have benefits that are difficult to quantify, and
note that in response to this supposition some PBL programs have opted
for modification of testing towards reduced emphasis on recall, or have
been satisfied with lower scores on traditional testing methods such
that they are not significantly worse than conventional teaching approaches
It is important to cast PBL in terms of its original
motivations, and note that it does not explicitly attempt to satisfy
assessment schemes which reward shallow learning approaches. Additionally,
PBL implies wide-ranging changes to the values of traditional education,
and cannot be realistically applied "on top of" existing infrastructure.
Ambury29 refers to PBL in medicine as part of
a larger move away from "basic sciences and organ systems as the
organizing principle for the curriculum" (p.1). None of this, as
has been seen, necessitates a disregard for factual information. Pereira
and colleagues17 studied student evaluations of
PBL medical programs at the University of the West Indies, and found
that only 4 percent were dissatisfied with their knowledge base obtained
via PBL learning modes. DesMarchais and Vu3 state
that a move to emphasize analytic and problem-solving skills in areas
of (medical) basic and clinical science using small groups increases
a need for assessment. The issue of accountability becomes an important
one. With respect to preclinical skills reproduction of facts is still
valued and is measured by multiple-choice questions, and short-answer
questions with a content-based focus. The problem-solving and analytic
skills are tested with newly-developed instruments in the form of problem-analysis
questions and by oral exam. Small-group competencies (such as self-directed
learning, etc) are tutor-evaluated by use of a form completed after
each session. Initial (staff/student) concern over the subjectivity
of the tutor-based evaluation instrument subsided once it was established
that it was able to identify students with problems. It was found that
tutor-based assessment shows most discrimination in the presence of
long-term problems and when mean ratings are sufficiently high to encourage
tutors to use low rating scores for weaker students. In the absence
of a high mean all scores tend to be clustered rather than exhibit this
Sivam and colleagues24 state
that subjective attributes associated with PBL modes of learning may
be difficult to measure objectively. The question as to the continued
desirability of attempts at assessment objectivity remains an open one.
Savery and Duffy14 use peer-evaluation and self-assessment
as the only form of assessment in the medical school, with focus on
self-directed learning, problem-solving, and group dynamics. This is
placed in wider context where external (Medical Board) exams must still
be passed at the end of second year. Other forms of assessment focus
on what the learners identify as valuable.
Hebert and Bravo40 developed
a tutorial-based test for PBL students (the Tutotest). The test uses
4-point Likert scales over 44 questions to allow tutors evaluate their
students. A trial of the test (n=270) incorporated a factor analysis
which revealed four factors (accounting for 82% of the variance) which
were described as
- group effectiveness - 61% of the variance;
- communication and leadership - 11% of variance;
- scientific curiosity - 6% of variance; and
- respect for colleagues - 4% of variance.
The factor analysis was unable to support their
initial position that effective use of PBL and effective group communication
were separately identifiable, and indicated existence within the one
factor. They retrospectively identify this as a natural association,
due to the group-based nature of PBL. Here, it strengthens the argument
for emphasizing the group processes in PBL environments as a factor
for increased successful usage of the PBL style (i.e., "getting
with the program" requires feeling comfortable with small group
dynamics). This inevitably carries through to the tutor, given that
1) group dynamics are important 2) the tutor has facilitation of group
dynamics as one of the tasks associated with the job, and 3) the (previously
indicated) importance that students give to the role of the tutor in
success of the approach.
Des Marchais and Vu 3 state
A student's learning evaluation system has so great an effect
on the way students dedicate their energy in learning medicine that
any institution must pay great attention to developing an evaluation
congruent with its curriculum philosophy, its educational goals, and
its students' learning needs. (p. 282)
They illustrate the development of such a scheme
that has been found to successfully meet these demands.
O'Hanlon and colleagues21 stress an important aspect of the evaluation of PBL programs that is
under-represented in the literature, and that is the implications of
PBL modes of learning on students with a non-English background and
from a cultural perspective where the nature of learning is likely to
consist of different values. They report that an optional supplementary
tutorial to offer support for these learners. Those who attended rated
the supplementary tutorial highly (76.7% found it helpful) and they
indicated higher responses to the overall favoring of PBL on the general
survey than those who chose not to attend. Furthermore, those higher
responses were significant statistically for questions relating to "guidance
in group work" and "spread of work". This is a good indication
of the value of scaffolding in this area. Clearly, more research should
be directed at ESL and cultural issues, given the cultural mix of students
and the prevalence of PBL modes of learning.
In changing from a subject-based discipline to
an integrated PBL mode, it is often difficult to anticipate the need
for scaffolding in non-discipline areas (such as group dynamics, metacognition,
etc.). The assumption of some unspecified, automatic development of
these processes may be at the heart of some results, which we have seen
where PBL improves over time, both academically and in terms of student
perception. It may be a measure of the difficulty associated with transition
from subject-based learning approaches to PBL, in fear that less content
may be covered if too much time is devoted to group processes, etc.
It may need to be accepted that PBL involves a slower start-up in terms
of the discipline-based content that is covered. This may be due to
the development of important "hidden" skills, which will ultimately
facilitate deep approaches to learning. This is an important time in
which to ensure that adequate scaffolding exists to support this type
of development. That such generic skills are important is widely recognized,
as may be seen in the following quote by Koschmann and colleagues:6
In summary, educating competent physicians is difficult. The
amount of material that must be learned is vast, and is conceptually
complex. Patient problems are ill-structured; information about the
problem must be uncovered, dynamically changing the problem as it
emerges, and decisions must be made and action taken in the absence
of complete information. Finally, medical knowledge and techniques
for acquiring patient information are changing at a phenomenal rate,
but little is done in traditional medical education to develop the
cognitive disposition and competence necessary for the student to
become an effective lifelong learner. (p. 240)
One of the difficulties in measuring learning outcomes
is that PBL advocates frequently claim that the differences between
it and conventional, subject-based learning approaches occur principally
at deep learning levels, and many conventional evaluation processes
measure this inadequately.1 It is not always clear
that assessment is matched to PBL modes of learning, which may be a
hidden source of anxiety for many students, who may recognize the assessment
criteria as "shallow", but not feel sufficiently acquainted
with them (through lack of practice). Morrison and Murray,44 in discussing the results of a student survey of PBL course which provided
evidence of high motivation but low relevance, suggest that at least
some of basis for the low scores in perceived relevance could be directly
related to exam anxiety, stating that
By the time the students enter the final rotation of their
medical course they are already preoccupied with passing their final
examinations. As their course so far has tended to encourage superficial
learning likely to aid in passing examinations, the problem-based
learning, which was felt to be time-consuming although promoting
deep learning .... was judged to be less relevant. (p.145)
Support structures need to consider the wider context
in which students find themselves. The benefits of PBL are often constrained
by implementation factors, such as consideration for external (non-PBL)
courses and student perceptions of time requirements, or by gradual
introduction of the PBL environment (such as gradated fidelity), or
by bounding the degree to which ideals are attempted to be implemented.
This may mean temporary departure from some of the principles in order
to introduce them in a way that is meaningful to the student. For example,
excessive adherence to the belief in student-centerdness could lead
to a position where students react against the learning environment
as a whole. Such biases are not necessarily inherent to the PBL philosophy,
but rather more likely to be an implementational over-correction in
adopting PBL for the first time. Some studies indicate that student
reaction to PBL becomes more favorable in later incarnations of the
course, and this may possibly be a result of incorporating pragmatism
into perhaps an initially overly-idealized curriculum.
Drinan45 suggests that PBL
demands a level of maturity that may not be applicable to all undergraduate
scenarios, although it is appropriate to postgraduate expectations.
Others report similar feelings with different aspects of the PBL environment,
such as in group dynamics.35 Clearly, PBL requires
certain skills in order to be optimally effective. These skills should
not be assumed. They require a process of development in order to empower
the student with the ability to realize the ideals of PBL. It does not
weaken the case for PBL to actively address the learning of such skills,
but rather is likely to strengthen the success of the approach.
Related to this is the importance of not assuming
that "peripheral" aspects such as logistics, politics, and
staff concepts about learning are secondary. In many ways they become
crucial to the success of a PBL program, due to the ability for change
to result in upheaval, and the fact that they are capable of being limiting
factors despite their non-pedagogical position in the scheme of things.
Schilling, Ginn, Mickelson and Roth46 discuss a need to change the nature of library services (and librarian
training) in response to the different emphasis suggested by PBL programs.
This reaction to PBL is a strong suggestion of the support structure
that PBL may generate, and indirectly indicates the need for a broad
approach to scaffolding in PBL. Other research confirms that at least
some of the excess time that students associate with PBL may be directed
at information gathering, and therefore suggests that it is the nature
of a problem that can be fixed44 "in a packed
medical curriculum the advantages of ease of retrieval of information
from textbooks and the compact presentation of facts possible in lectures
are all too readily appreciated" (p.144).
Finally, it is suggested that PBL may operate as
its own support mechanism, by offering it in early years in a more structured
format than its ideals suggest, so that the desired skills may be accommodated
and enable a more mature approach to senior courses offered in PBL style.
The author is grateful for the important feedback on this paper given
by Ken Appleton. Comments made by the MEO reviewers were also useful
in bringing this paper to its final form.
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Tony Greening is a lecturer at the School
of Information Technology and Mathematical Sciences, University of Ballarat,
Australia. He can be reached by e-mail at email@example.com.
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