Which medical students like problem-based learning?
Ewan Bigsby DPhil
Medical Student
Graduate Entry Programme
Department of Medical and Healtcare Education
St George’s Hospital Medical School
Cranmer Terrace
London SW17 0RE
I C McManus FRCP
Professor of Psychology and Medical Education
Dept of Psychology
University College London
Gower Street
London WC1E 6BT
P Sedgwick PhD
Lecturer in Medical Statistics
Graduate Entry Programme
Department of Medical and Healtcare Education
St George’s Hospital Medical School
Cranmer Terrace
London SW17 0RE
P McCrorie PhD
Professor of Medical Education
Graduate Entry Programme
Department of Medical and Healtcare Education
St George’s Hospital Medical School
Cranmer Terrace
London SW17 0RE
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Introduction
Problem-based learning (PBL) was first introduced at McMaster University in 1969 and since
then has become increasingly popular in medical schools throughout the world. A number of
UK medical schools have also introduced PBL, including some of the new accelerated
graduate-entry courses. Although the theory and practice of PBL have been much discussed
[1], and meta-analysis has shown it to be as effective as traditional curricula [2,3], we have
been unable to find any research looking at what characterises students who like or do not
like the method. In this study we look at the relationship between personality, learning styles,
and satisfaction with PBL teaching in a London medical school.
Participants, methods and results
A questionnaire was sent to the 137 students in the first three years of the Graduate Entry
Programme at St George’s Hospital Medical School (SGHMS), of whom 99 (72%) replied.
Satisfaction with PBL as a teaching method was assessed by a 26-item questionnaire which
asked about the utility and enjoyment of the various components of the PBL process. Factor
analysis using a scree-slope criterion, showed two clearly distinguishable factors. Factor 1
(26% variance), labelled Personal learning, assessed whether students felt PBL helped them
personally in clarifying and remembering new information; Factor 2 (16% variance),
labelled Contribution to case discussion, assessed whether students enjoyed and found it
useful to take part in the PBL group and found it useful to make suggestions about the case.
Personality was assessed using a 15-item questionnaire assessing the ‘Big Five’ personality
factors [4], and Learning Styles were assessed with an 18-item version of Biggs’ Study
Process Questionnaire [5].
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The table shows the simple correlations between satisfaction with PBL and
personality and learning styles. ‘Personal learning’ is most significantly correlated with a
deep learning style, whereas ‘Contribution to Case Discussion’ shows a strong negative
correlation with neuroticism. Forward entry multiple regression (alpha for inclusion = .05) of
‘Personal learning’ on the eight background measures, showed that only Deep learning was a
significant predictor (Beta=.288; P=.004). A similar analysis for ‘Contribution to Case
Discussion’ showed at the first step that Neuroticism was the most significant predictor
(Beta= –.324; P=.001). Multicollinearity was present; at the final step there was also a
significant prediction of Deep learning (Beta=.327, P=.001), Strategic learning (Beta= –.295,
P=.003) and Agreeableness (Beta=.201, P=.023). Results were unchanged when sex, year,
first degree and age were taken into account.
Comment
Students who find they learn well in PBL tend to have a deep learning style, whereas students
who like to contribute to the group process tend to be less neurotic, more agreeable, to have a
deeper learning style, and to have a less strategic learning style.
Problem-based learning takes place in a complex environment, where students not
only have to select for themselves those aspects that will help their individual learning, but
they also interact socially and contribute to the group process. Although most students in this
study found PBL beneficial overall, not all students were equally satisfied with all of its
components. Our results suggest that deep learners find personal learning is easier and more
enjoyable in the context of feed-back on group generated learning objectives. Presenting
ideas to the group for discussion is more useful and enjoyable for students who have higher
agreeableness and lower neuroticism scores, and who hence find social interaction less
stressful. Idea generation is also more useful and enjoyable for students with a deep learning
style, who see ideas and understanding as their primary motive for learning, and is less useful
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and enjoyable for students with a strategic learning style, for whom there is less emphasis
upon collaboration, and whose main educational motivation is personal success.
Reference List
1.
Kaufman A. Implementing problem-based medical education: Lessons from successful innovations. New
York: Springer, 1985.
2.
Vernon DTA,.Blake RL. Does problem-based learning work? A meta-analysis of evaluative research.
Academic Medicine 1993;68:550-63.
3.
Albanese MA,.Mitchell S. Problem-based learning: a review of literature on its outcomes and
implementation issues. Academic Medicine 1993;68:52-81.
4.
McManus IC, Smithers E, Partridge P, Keeling A, Fleming PR. A levels and intelligence as predictors of
medical careers in UK doctors: 20 year prospective study. British Medical Journal 2003;327:139-42.
5.
Fox RA, McManus IC, Winder BC. The shortened Study Process Questionnaire: an investigation of its
structure and longitudinal stability using confirmatory factor analysis. British Journal of Educational
Psychology 2001;71:511-30.
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Table: Simple (Pearson) correlations between factor scores assessing satisfaction with PBL,
and measures of personality and learning style. Correlations significant with p<.05 are shown
in bold, and those with p<.005 are in bold italics.
N=99
Personal learning
Contribution to
case discussion
Neuroticism
-.066 (P=.513)
-.324 (P=.001)
Extraversion
.080 (P=.430)
.124 (P=.223)
Openness to experience
.219 (P=.029)
.143 (P=.157)
Agreeableness
-.012 (P=.906)
.174 (P=.085)
Conscientiousness
.239 (P=.017)
-.004 (P=.969)
Surface learning
-.226 (P=.025)
-.184 (P=.068)
Deep learning
.288 (P=.004)
.227 (P=.024)
Strategic learning
.164 (P=.104)
-.172 (P=.088)
Big Five personality scores
Learning style measures
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