in progress edited by Daniel
Department of Adult Education, Community Development and Counselling Psychology,
The Ontario Institute for Studies in Education of the University of Toronto (OISE/UT)
learning (PBL) is an educational
approach that is based on andragogy, philosophy, psychology, educational
research, teaching and learning, curriculum design and various other important
areas. According to Barrows,
(1980), PBL can be explained as “the
learning that results from the process of working toward the understanding or
resolution of a problem.” This
approach is usually case based, small group (of no more than eight),
self-directed learning, in which a group is given a problem to solve.
The group has a tutorial leader or facilitator who shares information,
rather than an expert, imparting knowledge. In sum, PBL learning is a process of
building on prior knowledge, problem solving, using critical thinking approaches
and reflecting (Maudsley 1989). This
self-directed, collective approach is a very different way to teaching and
learning than lecture-based designs.
the introduction of PBL, the standard practice in medical schools has been to
create lecture-based curricula in which to impart knowledge to our up and coming
physicians. This began to change in
the late 1960’s with the introduction of McMaster University’s new approach
to medical education. This moment
in history has changed the way many medical schools all over the world design
and implement their curricula. Howard Barrows is usually credited for being the
first person in Canada to apply problem-based learning to medical education.
Barrow’s work in PBL during the mid-1960s developed from the concepts
around adult learning. PBL was thought to provide a method for students to
integrate knowledge across subject boundaries and to develop problem-solving
skills. Barrows grouped the objectives of PBL into four areas: structuring of
knowledge in clinical contexts, clinical reasoning, self-directed learning
skills and intrinsic motivation (Barrows, 1980). McMaster University was the
first Canadian Medical School to adopt this model.
first class to experience McMaster’s PBL approach to medical education began
in 1969. This, of course, was
preceded by many years of questioning, critiquing and final planning. Dr. John
Evans, the Dean that had the courage to break with tradition and launch this new
approach, perceived this model as a significant change in the standard approach
to teaching students in medicine. Pioneered
in Canada, PBL curriculum was predominantly found at McMaster University for
many years. However, in recent decades it has been adopted elsewhere in
different forms and to various degrees.
until the development of PBL curriculum, there seemed to be less of a holistic
approach around the management of patient’s, disease, treatment and cure,
(particularly in medicine versus some of the other health professions).
Undergraduate training was based on an ‘organ-based’ curriculum,
primarily made up of didactic lectures on anatomy, physiology, pathology, and
treatment. Since 1969, McMaster continued to cover this material, but
within the cased-based problems they present to students.
During the 1970’s and 1980s PBL has been a growing trend.
This author’s recent literature search resulted in 178 references on
PBL in the health professions that were published in the last two years alone.
Many of these references specifically focussed on medical undergraduate
curriculum. It seems to some that
PBL may in fact be a ‘fad’, but more than a temporary fad, it seems to be a
long-term trend, as this approach is being adopted internationally by many
undergraduate and graduate medical education programs and by other fields and
disciplines. Indeed, problem-based learning has been used in several European,
South American and Asian medical schools, some of which include the U.K.,
Sweden, Switzerland, Brazil, Chile, and Hong Kong. The Canadian approach has
influenced the planning in Australian medical schools, which have historically
been known for their advanced knowledge, research and practice within adult
education. In 1983, McMaster
experienced a slight change in their curriculum. This was thought to be a
positive readjustment in their efforts to adapt to the needs of the learner and
the proposed learning outcomes. When
reviewed in the 1990’s, PBL had been incorporated into 19 disciplines around
the world, including the Harvard School of Business (Kaufman, 1995)
H., Tamblyn, R., 1980. Problem-based
learning: an approach to medical education.
Volume 1. New York: Springer Publishing Company.
J., A. 2000. Effectiveness of problem-based learning curricula: research
and theory. Academic Medicine. 75(3):
D., G. 1989. Change in medical education: the courage and will to be
different. Editorial. Academic Medicine.
D., M. 1995. Preparing faculty as tutors in problem-based learning.
Teaching Improvement Practices:
Successful Strategies for Higher Education.
Bolton, MA. Anker Publishing.
D., M. 2000. Problem-based learning
– time to step back? Medical Education. 34: 509-511.
W., Kwan, C., Y. Nov 23, 2001. Overview:
PBL, What is it?
G. 2000. Promoting professional knowledge, experiential learning and critical
thinking for medical students. Medical
Education. 34: 535-544.
G, 1999. Do we all mean the same
thing by “problem –based learning” a review of the concepts and a
formulation of the ground rules. Academic Medicine. 74(2): 178-185.
S. 1989. Physicians for the twenty-first century. Report of the
project panel on the general professional education of the physician and college
preparation for medicine. J Med Educ.
V., R., Woodward, C., A., MacLeod, S., M. 1989.
The McMaster M.D. program: a case study of renewal in medical education. J Med Educ. 64:423-432.
G., Little, P. 1991. Innovation
in a nursing curriculum: a process of change. In: Boud, D., Feletti G. The challenge of problem based learning. London, UK: Kogan
H. 2000. Assumptions underlying
self-directed learning may be false. Medical
Education. 34: 243-245
medical education. McMaster Medical School. The early years 1965-1974.
Hamilton: B.C. Decker Inc.
Prepared by Lynn Haslett (OISE/University of Toronto)
Citation: Haslett, Lynn (2001). 1969: McMaster University introduces problem-based learning in medical education. In Daniel Schugurensky (Ed.), History of Education: Selected Moments of the 20th Century [online]. Available: http://fcis.oise.utoronto.ca/~daniel_schugurensky/assignment1/1969mcmaster.html (date accessed).
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