Problem-Based Learning and the Promotion of Problem Solving: Choices for Physical Therapy Curricula

Article excerpt

ABSTRACT: Proponents of problem-based learning (PBL) have stated that its approach helps students develop effective and efficient problem-solving skills. The purpose of this article is threefold: (1) to explain the differences between PBL and problem solving, (2) to review the current literature on PBL for evidence that PBL promotes the development of problem-solving skills, and (3) to suggest alternative strategies to promote problem solving in physical therapy curricula. Problem-based learning uses problem solving but is much more than just problem solving. Problem-based learning is a curriculum-wide approach, it is a problem-first approach, it is integrative across disciplines, and it is metacognitive in its form of evaluation. The literature suggests that repeated exposure to PBL sessions does not improve students' problem-solving skills. Recent evidence suggests that clinical expertise is related to the extent of a person's knowledge base, and in that respect PBL, with it's de-emphasis on content, may actually be deterring the problem-- solving process. The use of PBL should be selective, and highly structured, if our instructional goal is the promotion of clinical problem-solving skills.

INTRODUCTION

"How do I get my students to think?" is a question asked by many faculty members, regardless of their disciplines. In physical therapy curricula, the task of promoting higher-level cognitive abilities, such as problem solving, and not just lower-level activities, such as rote memorization, is not an easy one. As professional programs, physical therapy curricula are mandated by the Commission on Accreditation in Physical Therapy Education (CAPTE) to include an enormous amount of information, which is taught in a relatively short period of time. There are literally hundreds of factual items to be learned-the names and function of anatomical parts, the signs and symptoms of medical conditions, the meaning of diagnostic tests and assessment procedures-as well as the verbal, manual, and kinesthetic skills of hundreds of different treatment procedures. Physical therapy faculty constantly have to balance taking time to encourage students to use higher-level cognitive skills such as problem solving, with the necessity of teaching them this bulk of factual information and verbal, manual, and kinesthetic skills.

One of the teaching methods used to encourage problem solving is problem-based learning (PBL). Proponents of PBL have stated that its approach helps students develop effective and efficient problem-solving and clinical reasoning skills.1-7 The purpose of this article is threefold: (1) to explain the differences between PBL and problem solving, (2) to review the current literature on PBL for evidence that PBL does indeed promote the development of problem-solving skills, and (3) to suggest alternative strategies to promote problem solving in physical therapy curricula.

WHAT IS PROBLEM-BASED LEARNING, AND HOW DOES IT DIFFER FROM PROBLEM SOLVING?

Although definitions of PBL vary in different settings, "true" PBL refers to a comprehensive curricular strategy and not just a single teaching method. Many single-subject courses within traditional curricula claim to use PBL, but in fact do not use PBL at all.8 They merely use case history problems in a primarily lecture-- based format. Problem-based learning involves much more than utilizing case history types of clinical problems. One of the main characteristics of PBL is that it is a type of cooperative learning. In cooperative (or "collaborative") learning, students work in small groups to achieve a common goal. The teacher becomes a tutor, a role that is one of a facilitator rather than a content expert, and the learning becomes dependent upon the self-directed efforts of the small group. This method creates a more active, student-centered learning environment, as opposed to the more passive teacher-centered environment of the traditional lecture setting. …