Problem Based Learning In Nursing Education
What Is Problem Based Learning
Problem based learning (PBL) is a strategy for facilitating learning that requires students to think critically, be self directed, and become proficient at problem solving using real world scenarios (Schmidt, Rotgans, & Yew, 2011). The strategy is based on adult learning theory principles using student centered problem solving approaches.
Principles and Guidelines for Problem Based Learning
PBL principles guide the application of this method in nursing education. This method is student centric in that it empowers the student to take control of the learning process as he or she makes decisions about solving problems in practice-based scenarios. Students are able to obtain their learning goals through the use of facilitation as they discover the gaps in their knowledge necessary for application into clinical practice. Students take more responsibility for their learning, resulting in increased learning skills and job skills (Billings & Halstead, 2011).
Faculty using PBL must act as facilitators of the process, not the subject matter expert. This may be contrary to past teaching philosophies for some faculty and therefore may serve as a block to using PBL in the classroom (Distler, 2008). Students' past experiences are valued and respected as they become more responsible for learning, resulting in the development of critical thinking and problem solving skills.
As a result, students synthesize data, interact with the faculty and students, and use critical thinking to problem solve. The use of case studies is an integral part of PBL The case studies are loosely structured by faculty, creating opportunities for students to engage in critical thinking and problem solving (Oermann & Gaberson, 2013).
The purpose of the case study is to develop an interactive dialogue among students as they work toward understanding the case study while gathering information and filling knowledge gaps. The loosely structured cases may not have a well defined answer, providing students the opportunity to explore the problem in more detail. It is this level of exploration and discussion that results in the bridging of the theory practice gap (Hodges, 2011). This strategy is suitable for adult learners who learn experientialy and value the immediate application of information to practice.
History of Problem Based Learning In Nursing Education
PBL began with the education of medical students at Mc Master University in 1969 (Distler, 2008). PBL requires the application of adult learning theory, the application of knowledge into practice, and the identification of learning needs of students. Students analyze information that is readily available through various media regarding the problem-based scenario. The traditional method of lecture does not offer opportunities to gather information, process information, and apply the information to practice (Crawford, 2011)
Schmidt et al. (2011) discussed scaffolding in the use of PBL (p. 797). Faculty facilitate meaningful learning during the problem-solving process through the use of scaffolds. Scaffolds are both soft and hard; soft scaffolds are dynamic and based on the action of the faculty to support the learning needs of students, whereas hard scaffolds are static and may include worksheets and other cognitive tools (Schmidt et al., 2011). As students become more comfortable with the PBL process, the scaffolds are removed over time as expertise increases, thereby requiring fewer resources.
This is also referred to as flexible scaffolding can be used in face to face, hybrid, and fully online nursing education programs. Rounds and Rappaport (2008) found that the use of PBL is time intensive for faculty and students. With face to face educational programs, students may work in teams to address the case studies. Teamwork may be more difficult in an asynchronous environment. Faculty who use this method of interactive discussion have found that it fosters a unique closeness between faculty and students.
In their work on the use of PBL with graduate level nursing, White, Rowland, and Pesis Katz (2012) looked at a peer led team learning model. This model emphasized student interaction using a collaborative approach among students. They found that there was a greater opportunity for students to discuss and apply research findings on current evidence related to the problem solving case study.
Their work was centered on the use of PBL principles including case studies that focused on solving complex real world problems. Students involved in this model of learning were better able to explore and synthesize knowledge in greater depth.
Implementation of Problem Based Learning In Nursing Education
The implementation of PBL into nursing curricula requires effort and development of faculty (Distler, 2008). All faculty involved in the implementation of PBL in the curricula should be oriented to the principles. In addition, students must also understand the rationale for changing to PBL, how they will be learning, and how they will be evaluated. While this process is time consuming in the early phases, there will be improved student satisfaction and subsequent clinical competence.
Faculty may find themselves tempted to revert to traditional methods of learning, however, the rewards for innovation are far reaching (Distler, 2008).It is important to distinguish between assessment and evaluation when evaluating the results of PBL. Assessment is identifying student learning and evaluation is the out-comes of PBL as a learning strategy (Billings & Halstead, 2011).
Faculty need to use both formative and summative evaluation using quantitative and qualitative methods. This will include evidence that students can apply previously acquired knowledge, discuss and debate the case study, and become proficient at critical thinking and problem solving.
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