Abstract
In this chapter, we will describe the emergence of problem-based learning as an approach to higher education, first at McMaster University Faculty of Health Sciences in Canada and then worldwide. Problem-based learning did not appear out of the blue but had several precursors: First in the work of Dewey who established an experimental school at the University of Chicago based on the idea that learning is more interesting if the learner is actively involved in his own learning. The second source of influence was the Case Study Method pioneered at Harvard University in the 1930s of the previous century. And the third source of influence to be described is Jerome Bruner’s “learning by discovery” from which the idea that a problem could be the starting point for learning originated. Problem-based learning has eventually developed into three different strands or “Types,” that agree on the basic elements of the approach but see different goals for it.
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Notes
- 1.
The others were John Evans, first dean of the Faculty of Health Sciences, Jim Anderson, Bill Walsh and J. Fraser Mustard.
- 2.
What makes the McMaster educational innovation unique is perhaps not the ideas themselves but the daring mix of these ideas. From its inception, the McMaster curriculum featured small-group tutorials, emphasis on self-directed and life-long learning, the use of varied resources in learning, and the integration of biomedical and clinical sciences in the curriculum.
- 3.
From the descriptions given by Spaulding (1991) and Mustard et al. (1982), it is not clear whether John Evans was the sole author of the premises appended under A, or that others contributed as well. Spaulding speaks about a position paper written by dean Evans that played an important role in the early discussions. We have, however, not been able to unearth the original paper in question.
- 4.
Students knew this better than their tutors. Even in the seventies, when the first author visited McMaster for the first time, there was a hidden curriculum at McMaster, through which students acquired the knowledge deemed necessary to understand the processes, principles and mechanisms involved in health and disease. In addition, at the end of their years of training, just before the licensing examinations, they took a course aimed at “cramming” the necessary information. Nevertheless, for years, McMaster graduates scored below average on these national examinations, which can be attributed to the emphasis on process rather than content. With a shift in emphasis on knowledge during a 1990s curriculum reform, this difference has disappeared.
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Appendix A: Basic Premises of the McMaster M.D. Program
Appendix A: Basic Premises of the McMaster M.D. Program
These premises arose out of the strong beliefs of the early planners at the McMaster Medical School that we should be innovative and prepared to experiment Mustard et al. (1982). Dissatisfaction with: traditional course work consisting largely of lectures and laboratory exercises; admission to medical school chiefly on the basis of high grades in science courses; emphasis on achieving high marks in content-oriented examinations; and a tendency to stress teaching while paying little attention to helping students learn, lay behind much of the early thinking.
Premise # 1: A curriculum which is based on biomedical problems, and stresses acquiring knowledge to solve problems, will help to establish a lifelong pattern of questioning, seeking and formulating solutions.
Expressions:
-
(a)
The core curriculum consists of a series of biomedical problems.
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(b)
Students learn to: identify major issues and questions in problems; hypothesize; seek information; formulate solutions.
Premise # 2: Interweaving basic science and clinical medicine from the outset helps students learn to approach clinical problems with the methods, general principles, and pertinent facts of basic science.
Expressions:
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(a)
From the outset there is a blend of clinical and basic science.
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(b)
Pertinent clinical situations are used to introduce concepts of basic science.
Premise # 3: Too much teaching may inhibit learning how to learn what one needs to know; students need unscheduled time to learn on their own.
Expressions:
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(a)
No mandatory laboratory sessions.
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(b)
Few lectures.
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(c)
Students schedule own activities.
Premise # 4: Different ways of learning are to be encouraged and require a variety of learning resources.
Expressions:
-
(a)
Faculty have prepared or provided a wide variety of learning resources: monographs, journals, reprints of articles; slide-tape programs, videotapes, dissections, pathological specimens, charts, models, etc.
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(b)
These are catalogued and stored for quick access.
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(c)
Students are encouraged to approach problems in individual ways. Small group tutorials can facilitate varied approaches to learning.
Premise # 5: In order to cope with increasingly complex problems in the future, society needs doctors with diverse attitudes and backgrounds.
Expressions:
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(a)
Students are selected with diverse educational and work backgrounds.
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(b)
Able students need not have a science background at university before admission:
Premise # 6: Students can learn from each other and from tutors who are fellow-learners.
Expressions:
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(a)
The class is divided into groups of five with a faculty tutor who is familiar with the topics but not necessarily expert, and wishes to learn more.
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(b)
Attention is paid to the individual styles of students and tutors and to group dynamics in order to promote effective learning in the group.
Premise # 7: Doctors work more and more in groups, which include a variety of health professionals. Practice increases effectiveness as a group member.
Expressions:
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(a)
In tutorials participants should learn to recognize behavior which facilitates and stimulates productivity and to avoid behavior which inhibits progress in the group.
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(b)
Students observe and take part in various groups in community practice, hospital work, medical school planning and research.
Premise # 8: Empathy and compassion can be enhanced by interviewing skills and understanding of behavior.
Expressions:
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(a)
Interviewing skills are learned in small groups with expert preceptors.
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(b)
Behavioral issues are included in biomedical problems.
Premise # 9: A 3-year medical course should be sufficient to prepare most students for postgraduate work.
Expressions:
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(a)
By limiting summer holidays to 1 month, 31 months are available compared to the usual 34 months of a 4-year course.
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(b)
The same financial assistance is available from government over the 3 years as is provided for students in 4-year courses.
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(c)
Details of such fact-filled subjects as anatomy and biochemistry are reduced by requiring students to learn only what is needed to deal with the biomedical problems.
Premise # 10: Students benefit by opportunities to select experiences for themselves, explore subjects in more depth and try novel approaches.
Expressions:
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(a)
A wide variety of electives are available.
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(b)
Blocks total 26 weeks.
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(c)
These electives enable students to explore areas of interest or, where necessary, do remedial work on topics in which they are deficient.
Premise # 11: Competition for marks, standing, prizes and scholarships inhibits cooperative learning and encourages rote memorization and cramming.
Expressions:
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(a)
There are no examinations with marks, or class standings, or prizes. Students are identified as satisfactory or unsatisfactory in each unit.
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(b)
Monies for scholarships and bursaries are awarded on the basis of financial need.
Premise # 12: Faculty and students will be more enthusiastic about learning if both have responsibility for planning a flexible curriculum.
Expressions:
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(a)
Phase and unit faculty planners and students are chosen to be responsible for segments of the course. Choice is made on the basis of aptitude and interest, without regard to seniority.
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(b)
Departmental chairmen are responsible for deploying their staff throughout the course, but have no official responsibility for content.
-
(c)
No courses are provided in disciplines, e.g. anatomy or physiology.
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Schmidt, H.G. (2012). A Brief History of Problem-based Learning. In: O'Grady, G., Yew, E., Goh, K., Schmidt, H. (eds) One-Day, One-Problem. Springer, Singapore. https://doi.org/10.1007/978-981-4021-75-3_2
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