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The effect Problem Based Learning “PBL” versus Conventional


education on students in the aspect of enhancing interpersonal skills and
other work related competencies
Introduction:
Coming from Emergency Medicine background, I can till how extremely important for
health care providers to have an excellent interpersonal skills and other work related
competencies. During their practice, Physicians inevitably will face death, disability,
pain, conflicts and depression which some times being daily in certain specialties. As
human being, a feeling person has to find a way to cope with the distress that patient’s
condition and colleague’s interaction brings. Although, physicians are required to be
competent Medical Experts they are also expected to have an excellent communication,
collaboration, leadership, and Professional skills (CanMeds; see diagram-1). (1)
The expectation from health care professionals is not limited to how much they possess
of medical factual knowledge but further beyond that. Doctors must be able to establish
therapeutic doctor-patient relationships and work within multidisciplinary teams in a
manner that facilitates patient care.

CanMEDS Diagram
A diagram was created in 2001 to illustrate
the elements and the interconnections of the
CanMEDS Roles embodied by competent
physicians: Medical Expert (the central
Role), Communicator, Collaborator, Health
Advocate, Manager, Scholar and
Professional. This diagram, also known as
the CanMEDS "cloverleaf," "daisy,"
"flower" and "illustration" was officially
trademarked in 2005 and was revised to
more accurately reflect the fluidity and
overlap amongst the CanMEDS Roles.

Diagram – (1) © 2009 Royal College of


Physicians and Surgeons of Canada.

All of these are vital skills and are becoming increasingly essential subjects in teaching
both undergraduate students and postgraduate doctors.
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As with any human skills, interpersonal skills can be improved through training. And as
shown by Peters, A. S. et al in their study at Harvard Medical School, that the differences
between new pathway program” based on PBL” and traditional students in the humanism
domain first appeared during medical school and residency and remained significant well
into practice, suggesting that humanistic medicine can be taught and learned. (2)
The effect Problem Based Learning “PBL” versus Conventional education on
students in the aspect of enhancing interpersonal skills and other work related
competencies
To examine the effect of PBL versus Conventional education on students in the aspect of
enhancing interpersonal skills and other work related competencies; let us have a brief
description of both methods:
In the conventional curriculum, learning is teacher-centered and comprises large group
lectures, tutorials, structured laboratory experience, and periodic tests of achievement.
Students passively absorb information and the acquisition of skills is left largely to
chance and is subject to little quality control, students are inadequately monitored, and
feedback is seldom given. So, most physicians in unstructured ways try to develop their
interpersonal skills and other work related competencies for the purpose of getting the job
done.
In the contrary, PBL is learner-centered and comprises small group tutorials. Students
learn primarily through self-directed study, guided by the problems designed by their
tutors. The curriculum emphasized the acquisition of medical, interpersonal, and other
professional competencies. A principle element in problem-based learning is the small-
group tutorial, which helps learners to develop social skills, to function as members of a
multidisciplinary team and to learn cooperatively by sharing their newly acquired
information and recently constructed knowledge. The tutorial group is a source of
friendships; hence the group enables students to develop more personal relationships with
their peers and teachers than is possible in the larger classroom. Regular small-group
tutorials in problem-based schools provide peer pressure and natural deadlines for work
to be completed and, therefore, encourage students to develop time management and
accountability skills. PBL encourage students to use various sources of information
effectively. Further more, students in PBL will have the chance to develop other
important skills such as; leading a discussion, expressing thoughts and ideas, listening
and conflict management skills.
From this description, it becomes obvious and explicit that Problem Based Learning
Curriculum will lead to the enhancement of interpersonal skills and other work related
competencies. However, this claim needs to be supported by robust studies. Hereby, I
will try to list them based on my literature search:
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Schmidt et al., conducted a study among a large group of physicians who graduated from
the medical schools in Maastricht and Rotterdam (820 graduates of a problem-based
medical school and a comparison group of 621 graduates of a conventional medical
school were included) in the Netherlands, participants were asked to assess their own
skill levels with regard to eighteen professional competencies. They found that Graduates
of the problem based school rated themselves more highly not only on the competencies
usually associated with PBL, such as skills for collaborating with peers or problem
solving skills, but also on many of the other work related skills. In total, they rated
themselves more highly on 14 of 18 competencies. The competencies concerned
interpersonal skills such as the ability to collaborate with others, cognitive skills such as
the ability to find relevant information quickly, general academic skills such as the ability
to conduct scientific research or write a report, and efficiency skills such as the ability to
comply with deadlines or to work under pressure. Effects showed the problem-based
school to be superior. The overall weighted effect size was equal to .69. The effect of
PBL was largest in the area of interpersonal skills (Md = 1.39). It was attributed in part
to the fact that students in a problem-based curriculum have to work extensively with
others in small groups, so they have more opportunities to practice those interpersonal
skills. (4)
In another study by Schmidt et al, conducted to study the self-reports of professional
competencies by graduates of a problem-based medical curriculum. All graduates from a
medical school and a faculty of health sciences with a problem-based curriculum were
sent a questionnaire asking them to compare their own performances in 19 domains with
those of colleagues trained at schools with conventional curricula. Overall, alumni of the
PBL medical school rated themselves as better than colleagues who were trained at
schools with conventional curricula for cooperation skills, problem-solving skills, skills
relevant to running meetings, and the ability to work independently. And they concluded
that the problem based medical curriculum appears to contribute to the development of
professional competencies. (5)
Hill J. et al in a study to evaluate junior doctors' perceptions of the adequacy of their
undergraduate medical training to prepare them for hospital practice. They assessed eight
subscales relating to key areas of medical hospital-based work. Data showed that
graduates from the problem-based medical school rated their undergraduate preparation
more highly than traditional medical school graduates in preparing them for practice in
the areas of interpersonal skills, confidence, collaboration with other health care
workers, preventive care, holistic care and self-directed learning. This research suggests
that educational experiences in different undergraduate medical courses are important in
preparing doctors for their early working life and favors the PBL. (6)
Koh G. C. et al conducted a systematic review of evidence of the effects that problem-
based learning during medical school had on physician competencies after graduation.
They found that studies offers objective evidence that problem-based learning during
medical school has positive effects on physician competencies after graduation,
especially in the social and cognitive dimensions. (7)
Finally, in another recent study by Schmidt et al, they try to summarize effects of a single
well-established problem-based curriculum ”Maastricht University in The Netherlands”
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rather than to add up sometimes- conflicting findings from different problem-based


curricula compared to the other seven Dutch medical schools ”Conventional Curricula”.
They conducted a Meta-Analysis of Curricular Comparisons, and based on their results
they concluded that students and graduates from the particular curriculum “PBL” perform
much better in the area of interpersonal skills, and with regard to practical medical skills.
(3)
Conclusion:
As evident, from the previous description and the supporting above-mentioned studies
Problem Based Learning “PBL” have much more better effect on students in the aspect of
enhancing interpersonal skills and other work related competencies versus Conventional
education.

References:
(1)-CanMeds accessed online March 25, 2010 at: http://rcpsc.medical.org/canmeds/
(2)-Peters, A. S., Greenberger-Rosovsky, R., Crowder, C., Block, S. D., & Moore, G. T.
(2000). Long-Term outcomes of the new pathway program at harvard medical school: A
randomized controlled trial. Academic Medicine : Journal of the Association of American
Medical Colleges, 75(5), 470-9.
(3)-Henk G. Schmidt, Henk T. van der Molen, and Wilco W. R. te Winkel Constructivist,
Problem-Based Learning Does Work: A Meta-Analysis of Curricular Comparisons
Involving a Single Medical School. EDUCATIONAL PSYCHOLOGIST, 44(4), 227–
249, 2009
(4)-Schmidt, H. G., Vermeulen, L., & van der Molen, H. T. (2006). Longterm effects of
problem-based learning: A comparison of competencies acquired by graduates of a
problem-based and a conventional medical school. Medical Education, 40(6), 562-7.
(5)-Schmidt, H. G. & van der Molen, H. T. (2001). Self-Reported competency ratings of
graduates of a problem-based medical curriculum. Academic Medicine : Journal of the
Association of American Medical Colleges, 76(5), 466-8.
(6)-Hill, J., Rolfe, I. E., Pearson, S. A., & Heathcote, A. (1998). Do junior doctors feel
they are prepared for hospital practice? A study of graduates from traditional and non-
traditional medical schools. Medical Education, 32(1), 19-24.
(7)-Koh, G. C., Khoo, H. E., Wong, M. L., & Koh, D. (2008). The effects of problem-
based learning during medical school on physician competency: A systematic review.
CMAJ : Canadian Medical Association Journal = Journal De L'association Medicale
Canadienne, 178(1), 34-41.