Problem Based Learning

History, Philosophy and Criticisms of Problem Based Learning
in Adult Education
by Em M. Pijl Zieber, June 2006

Contents learning is a curriculum development and
instructional approach that challenges
Problem‐Based Learning 1 students to work collaboratively in small
History of PBL in Adult Education 1 groups of 5‐10 students to find solutions to
Philosophical Underpinnings of PBL 3 real‐world problems (Azer, 2001a; Baker,
Criticisms of PBL 8 2000; Barrows, 1998; Barrows, 2002; Camp,
Conclusion 12 1996; Hmelo‐Silver, 2004; Margetson, 1998;
References 13 Morrison, 2004; O’Kelly, Monahan, Gibson
& Brown, 2005; Rideout, 2001; Tan, 2004;
Introduction Wood, 2003). Students engage with
P
roblem‐based learning is a curricular carefully constructed complex situations
methodology that is seeing that are
increasing implementation across a presented to
variety of disciplines. Based on progressive them, decide
and constructivist thought it espouses many what they know
benefits for the adult learner. In this paper I and what they
will establish a common understanding of need to find out,
problem‐based learning, explore the history and determine
of problem‐based learning, including which skills they
antecedents to its introduction in need to manage
healthcare education, and discuss the the situation effectively (Alexander et al,
philosophies that underpin problem‐based 2005; Baker, 2000; Rideout, 2001; Savin‐
learning. I will then turn to a review of the Baden, 2000). Problem based learning
criticisms of problem‐based learning places the action of learning on the student
concerning andragogical and clinical (Alexander et al, 2002; Camp, 1996). In a
success. PBL approach to learning learners are
Problem‐Based Learning actively constructing knowledge in
M
cMaster University, pioneers in collaborative groups (Hmelo‐Silver, 2004).
the problem‐based learning History of PBL in Adult Education
P
(PBL) approach, describes PBL roblem‐based learning has been one
as “a pedagogical approach which uses of the most influential curricular
cases and problems as the starting point for innovations in higher education (Tan,
acquiring the desired learning objectives” 2004). Problem‐based learning as a general
(Walsh, 2005, p. 26). Problem‐based concept originated in medical education in
PBL in Adult Education 1
Em M. Pijl‐Zieber RN, BScN University of Calgary
the mid‐1950s at Case Western Reserve Finucane, 2000). Since then, medical
University (Baker, 2000; O’Kelly et al, 2005; schools around the world have introduced
Savery & Duffy, 1996). This model consisted PBL into their curricula (Alexander et al,
of a hybrid format that combined problem‐ 2005; Baker, 2000; Tanner, 1999).
based learning with more traditional According to McMaster University, out of
teaching methods (Baker). 125 medical schools in the United States,
Problem‐based learning gained 120 follow a PBL curriculum (B. Brown,
popularity as a more advanced concept personal communication, June 14, 2006).
during the late 1960s as a result of the work PBL has seen the most widespread
of Harold Barrows, a medical educator at application in the first two years of medical
McMaster University who researched and school, where it commonly replaces lecture‐
observed the reasoning capabilities of both based approaches to core courses (Savery &
medical students and expert practitioners Duffy, 1996). As well, PBL has moved
(Rideout, 2001; Savin‐Baden, 2000; Tanner, beyond health care education into the
1999). The impetus for the small group, social sciences, architecture, humanities,
student‐centered initiative law, business education,
was that medical students veterinary medicine, forestry
tended to gather information and engineering. Distance
but had difficulty applying it in learning and the K‐12 sector
the clinical setting; thus, they have also been affected by
felt largely unprepared for PBL (Azer, 2001b; Baker, 2000;
their upcoming practice as Camp, 1996).
physicians (Alexander et al, McMaster University
2005; Price, 1999; Savin‐ pioneered the PBL curricula in
Baden, 2000). It was Barrows’ their School of Nursing in
desire to bridge the gap between theory 1972 (Baker, 2000; B. Brown, personal
and practice in the clinical setting and to communication, June 14, 2006). From here,
increase clinical reasoning abilities (Rideout, several schools of nursing piloted and
2001; Savin‐Baden, 2000). Barrows asserted incorporated PBL curricula as part of an
that students learned more effectively effort to better prepare graduates for
through problem situations and that the clinical practice (Alexander et al, 2002). It is
medical skills that were most important for interesting to note that while medical
treating patients were problem‐solving schools have implemented fully integrated
skills, not the memorization of facts (Savin‐ PBL curricula, schools of nursing have
Baden, 2000). implemented it primarily on a course‐by‐
Problem‐based learning became the course basis. The reason for this difference
cornerstone of the new School of Medicine is that medical education programs deliver
at McMaster University in 1969 (Johnson & a second‐degree to students already

holding an undergraduate science degree, that the subject matter was irrelevant, or
whereas the majority of nursing students material was simply forgotten or became
lack a post‐secondary or undergraduate outdated (Azer, 2001a; Johnson & Finucane;
science background (B. Brown, personal Margetson, 1998; Tanner, 1999). Students
communication, June 14, 2006). also demonstrated an inability to solve
Problem‐based learning originated problems in clinical practice (Alexander et
and continues to be adopted as a curricular al, 2002; Azer, 2001a; Baker, 2000; Hwang
approach in reaction to the issues & Kim, 2005; Margetson, 1998; Tan, 2004;
surrounding traditional educational Tanner, 1999). It was also felt that
approaches, primarily that clinicians were traditional approaches did not develop in
inadequately prepared for clinical practice students a favorable disposition towards
(Barrows, 2002). In short, it was felt that lifelong learning, a requirement of today’s
traditional methods were not equipping healthcare practitioner (Alexander et al,
students for clinical practice in today’s 2002; Azer, 2001a; Rideout, 2001; Tanner,
health care system. With an increasing body 1999).
of Philosophical Underpinnings of PBL
T
knowledge, he philosophies most closely
students associated with problem‐based
were being learning include progressivism,
overloaded, constructivism, and humanism (specifically,
particularly adult education principles). However, the
through philosophical roots of PBL go back to
lecture and Socrates, who utilized problems with his
assigned students so that through their questions he
readings could help them explore “their
(Alexander et assumptions, their values and the
al, 2005; inadequacies of their proffered solutions”
Azer, 2001a; (Savin‐Baden, 2000, p. 3). As well, Aristotle
Camp, 1996; suggested that students begin problem‐
Margetson, 1998; Rideout, 2001; Tan, 2004; solving by determining both their
Tanner, 1999). A separation of nonclinical perceptions and beliefs (Savin‐Baden,
and clinical courses led to an artificial 2000). Ancient apprenticeship models of
division between knowledge and practice learning‐by‐doing also promoted active
and thus an overall lack of integration, learning at their core.
creating a theory‐to‐practice gap (Alexander Prior to embarking on an exploration
et al, 2002; Azer, 2001a; Johnson & of the major philosophical underpinnings of
Finucane, 2000; Margetson, 1998; Tan, PBL, it is important to consider that Harold
2004; Tanner, 1999). Students often felt Barrows, who popularized the PBL concept,

began his educational experiment not placed “in opposition to all authoritarian
based on educational psychology or ways of arriving at knowledge” (Elias &
cognitive science but as an experiment in Merriam, 2005, p. 54); an emphasis on the
using small groups to learn through clinical consequences of actions to determine
problems to make medical education whether they are true or good; and, an
interesting and relevant to students emphasis on social reform.
(Newman, 2003). It is even more interesting Dewey promoted the notion that
then, that given the apparent lack of the “highest ideal of the progressive
psychometric and philosophical rationales movement was education for democracy”
to back his ‘experiment’, it was which Dewey defined as “people engaged in
implemented on such a wide basis, first at joint activity to solve their common
McMaster and soon after at other medical problems” (Elias & Merriam, 2005, p. 53).
schools. It seems then that Thus, there were both
a philosophical basis for individual and social goals of
PBL has been determined education, and the two
somewhat ex post facto, as could not be separated.
an explanation for acts Dewey considered that the
that lacked articulated mind and its formation was
philosophical a communal process, and
underpinnings in the first that the individual and his or
place. her society had no meaning
Progressivism apart from each other. This
Problem‐based is reflected in the PBL
learning is associated with process of group work,
a progressive philosophy (Rideout, 2001). community and collaboration which form
John Dewey (1859–1952) was the most the basis of its social context of learning
prominent promoter of progressive (Azer, 2001a; Barrows, 1998; Camp, 1996;
thought, particularly as it related to Hmelo‐Silver, 2004; Rideout, 2001; Tan,
education (Elias & Merriam, 2005). 2004).
Hallmarks of progressive education included Dewey’s early philosophy is focused
an emphasis on manual and vocational on the learner‐centered approach to
training, experiential learning, scientific education (Elias & Merriam, 2005; Prawat,
inquiry, community involvement, and 2000). He suggested that learners are not
responsiveness to social problems (Elias & passive recipients of knowledge but that
Merriam, 2005). Pragmatism is the they need to be involved in their learning,
philosophical basis of progressivism. using their experiences as a starting point.
Assumptions of pragmatism include the Learning, according to Dewey, is primarily
centrality of human experience which is an activity that students do for themselves.

Dewey adopted a more or less education” (Dewey, 1967, cited in O’Kelly et
constructivist view of teaching and learning, al, 2005). This notion supports the problem‐
in which the focus is shifted from the based approach, which combines process
teacher as controller to that of being an and content as equal aspects of learning
intellectual leader (Elias & Merriam, 2005). (Azer, 2001a; Margetson, 1998; Rideout,
The instructor’s responsibility is to 2001; Savery & Duffy, 1996). Discovery is
“organize, stimulate, instigate, and evaluate more closely aligned with the realities of
the highly complex process of education” clinical practice than knowledge
and provide a context that promotes transmission, making PBL highly relevant to
learning (Elias & Merriam, 2005, p. 68). healthcare education. Qayumi (2001)
Dewey insisted that the primary reliance in suggests that “the delivery of medical
a classroom should be upon experience and knowledge is the reverse of practical
discourse between members (Prawat, medicine” (p. 64). In other words, in clinical
2000). The PBL process promotes student‐ practice practitioners encounter problems,
centered learning by requiring students to something they are not attuned to in their
be active in the process of collaboration, knowledge‐building educational
decision‐making, and pursuing knowledge experiences. This is a problem that PBL
through a variety of sources, while the seeks to address.
teacher takes on the role of facilitator or
guide (Baker, 2000; Barrows, 1998; Camp,
1996; Hmelo‐Silver, 2004; Johnson &
Finucane, 2000; Margetson, 1998; Rideout,
2001; Wood, 2003).
Dewey viewed learning as an activity
or a process of finding out (Savin‐Baden,
2000). Dewey’s view was that knowledge is
intricately united with activity, and that we
are agents of change and not just mere Dewey’s activity‐based approach is
spectators (Baker, 2000; Rhem, 1998; supportive of the idea that when students
Rideout, 2001). Dewey asserted that true encounter a novel situation a state of
learning is established through discovery, disequilibrium is created, which provides
guided by mentoring, and that learning was the incentive for real learning to occur
not a direct outcome of knowledge (Prawat, 2000). Dewey asserted that “an
transmission. Dewey’s pragmatic position experience is educative…if it increases the
concerning knowledge is perhaps best quality of one’s interactions with important
articulated in the suggestion that there is an objects and events in the immediate
“intimate and necessary relation between environment and lays the groundwork for
the process of actual experience and even more expansive interactions in the

future” (Prawat, 2000, p. 806). Dewey process of social negotiation, directed by
suggested that curricula be organized the teacher, that powerful ideas get
around problems instead of subjects (Elias constructed and consensus is reached on
& Merriam, 2005). Dewey considered it how those ideas are to be tested” (Prawat,
imperative that the skills and knowledge 2000, p. 806). Dewey felt that “intellectual
that students learn be integrated into their freedom and group learning are not at
lives as persons, members of society, and loggerheads” but rather that “individual
human beings (Prawat, 2000). Dewey felt capacities are best brought out in group
that better learning was obtained, not by settings” (Prawat, 2000, p. 831). He
rote memorization of facts, but through emphasized the importance of shared
problem‐solving, critical thinking and doing. knowledge and social negotiation as the
Learning is enhanced when learners are starting point for discovery, emphasizing
actively involved in the process (Azer, that individuals exist in a social context
2001a; Rideout, 2001; Spencer, 1999). (Prawat, 2000). The problem‐based learning
Problem‐based learning uses a problem as process capitalizes on the concept of shared
the catalyst or starting point for learning. cognition, social negotiation and meaning‐
Through a process of social negotiation the making in all phases of the process as
terms of the problem are recognized and students discuss and resolve the clinical
managed, a collaborative process that problem (Rhem, 1998; Rideout, 2001).
resembles clinical practice (Alleyne et al, Constructivism
2002; Alexander et al, 2005; Azer, 2001a; Constructivist philosophy,
Barrows, 1998; Camp, 1996; Margetson, concerned with how we come to
1998; Qayumi, 2001; Savin‐Baden, 2000; understand or know, originated from
Tanner, 1999). Piaget’s research in the area of
developmental psychology (Koschmann,
1996). Constructivism suggests that learning
is a process by which the learner actively
constructs knowledge. Constructivism views
knowledge as not absolute but constructed
by the learner according to what is
previously known (Baker, 2000; Koschmann,
1996). The importance of prior knowledge
in structuring new information is a central
principle in PBL as students approach
clinical problems (Alexander et al, 2005;
Dewey supported the notion of Rideout, 2001).
socially shared cognition (Prawat, 2000). Constructivist thought also asserts
Dewey insisted that “it is through the that understanding comes from our

interactions with our environment (Baker, accommodation arises (Savery & Duffy,
2000; Camp, 1996; Savery & Duffy, 1996). 1996).
This implies that what is learned cannot be This gives the learner purpose,
separated from how it is learned. Savery determines to what the learner attends,
and Duffy (1996) state that “what we considers prior experience in constructing
understand is a function of the content, the understanding, and determines what
context, the activity of the learner, and, understanding is then constructed (Savery
perhaps most importantly, the goals of the & Duffy, 1996). Therefore, the likelihood
learner” (p. 3). Because both learning and that learning will be transferred is increased
life itself occur in contexts, it naturally when the problems resemble real‐world
follows that knowledge acquisition should situations. In problem‐based learning, it is
also be context based (Hmelo‐Silver, 2004; the problem that is the impetus that, acting
Savin‐Baden, 2000; Schmidt, Vermeulen & as a catalyst, initiates learning (O’Kelly et al,
van der Molen, 2006). PBL reflects this 2005). As such, PBL curricular organization
constructivist proposition in its situating of is based around problems rather than
knowledge in clinical problems. Students disciplines (Newman, 2003). PBL is based on
acquire knowledge through the assumption that learning
the process of exploring becomes relevant and
clinical cases and building on meaningful when applied to
what is already known (Camp, real‐world problems, and that
1996; Johnson & Finucane, new learning must be related
2000; Walsh, 2005). The to what is already known (Azer,
premise that students need to 2001a; Baker, 2000; Camp,
be actively involved in the 1996; Margetson, 1998;
learning process is a Rideout, 2001).
foundational tenet of PBL Lastly, according to
(Rideout, 2001). constructivist thought,
Another constructivist knowledge evolves in a social
premise is that cognitive context, through social
conflict is the stimulus for negotiation and through the
learning (Baker, 2000; Camp, 1996; Prawat, evaluation of the individual understandings
2000; Savery & Duffy, 1996). Dewey (Baker, 2000; Camp, 1996; Prawat, 2000;
suggested that the problem is the impetus Savery & Duffy, 1996). This emphasizes the
for learning and determines the importance of the social environment in the
organization of what is learned (Prawat, development of knowledge and testing our
2000; Savery & Duffy, 1996). Piaget put understanding. Vygotsky contributed to the
forth that when experiences do not fit into communal social construction of learning,
the existing schema, the need for stating that “knowledge is ‘constructed’ by

the learner’s cognitive activity in continuous builds on their previous experiences and is
interaction with participation in the social participatory, problem focused, designed to
community of which the learner is a increase personal responsibility for learning,
member” (Rideout, 2001, p. 26). Retention immediately applied in practice, and based
of knowledge is enhanced through on mutual trust and respect (Spencer,
discussion, questioning and critique (Azer, 1999). Features of PBL directly consistent
2001a; Camp, 1996; Margetson, 1998; with adult education include emphasizing
Rideout, 2001). This is modeled in PBL, as student autonomy; building on previous
learning is placed in a social context. knowledge and experience; building in
Furthermore, the role of tutors is not to relevance; providing the opportunity for
dominate but to assist in the learning immediate application; creating a learning
process (Rideout). Peer interaction is environment that is comfortable; exhibiting
viewed as pivotal for cognitive development mutual trust and respect; accepting
(Koschmann, 1996). differences; promoting freedom of
In summary, constructivism gives expression; aligning goals with the learners’
rise to instructional design principles that needs; encouraging students to set their
contribute to the PBL environment. These own learning goals; sharing responsibility
principles are: (1) anchor learning activities for planning, decision‐making, and
to a larger purpose or problem; (2) support executing learning experiences;
the learner in developing ownership of the demonstrating commitment; and
problem; (3) design an authentic task with encouraging active participation (Camp,
which the learner can engage; (4) design 1996; Rideout, 2001).
the problem and environment to reflect Criticisms of PBL
T
real‐world complexity; (5) give the learner he following criticisms of PBL are not
ownership of the process of developing a intended to oppose the methodology
solution; (6) design the environment to in principle or practice but instead
support and challenge learners’ thinking; (8) highlight the need for acknowledgment and
promote the testing of ideas against further research. Criticisms of PBL center on
alternate views; and (9) promote reflection four areas: resources, the student
on old content and process (Rideout, 2001; experience, adulterated forms of PBL, and
Savery & Duffy, 1996). the question of efficacy.
Humanism and Adult Education Principles PBL is resource‐intensive in terms of
Problem‐based learning models the faculty time, space (tutorial rooms),
adult educational principles that are rooted teaching materials, and library resources
in the work of Malcolm Knowles (Azer, (Azer, 2001b; Johnson & Finucane, 2000;
2001a; Camp, 1996; Morrison, 2004; Morrison, 2004; Moust, van Berkel &
Rideout, 2001). Adults are motivated by Schmidt, 2005; Walsh, 2005; Wood, 2003;).
learning what is perceived as relevant, The development of suitable cases is time‐

consuming and requires staff development, Another criticism centers on the
current clinical practice and partnerships student experience. Students experience
between educational and health care stress and feel overloaded until they are
institutions (Johnson & Finucane, 2000; Tan, familiar with the PBL process (Azer, 2001b;
2004). As well, staff orientation is required Johnson & Finucane, 2000; Tan, 2004;
to pre‐empt difficulties in integration of a Wood, 2003). Other criticisms include the
PBL curricula (Azer, 2001b; noticeable lack of a
Butler, Inman & Lobb, 2005; classroom role model as
Johnson & Finucane, 2000; seen in traditional lecture
Tan, 2004; Walsh, 2005). based programs; Wood
Some colleges have found (2003) suggests such role
that due to fiscal and other models can be very
resource limitations PBL is inspirational for students. As
not sustainable. Lack of staff well, the learning quality in a
resources may cause small PBL context is somewhat
groups to burgeon to up to dependent on having a high
30 students, causing a functioning group (Azer,
significant degradation of the process. In 2001b; Walsh, 2005). Also, it is commonly
consulting with McMaster University’s heard students disparaging that they are
School of Nursing, I discovered that their paying tuition to teach themselves (B.
program is structured to incorporate 240 Brown, personal communication, June 14,
clinical teaching staff (over and above 2006). Finally, as with any teaching method,
faculty) who are contracted on an hourly it may not meet everyone's needs (Tan,
contract of 39 hours per year to teach 2004). I often hear students express
tutorial groups (B. Brown, personal frustration that they feel they “aren’t
communication, June 14, 2006). If a nursing learning anything” and are paying tuition to
program only uses faculty, they will have teach themselves. Some students, however,
insufficient numbers to manage a large say they are benefiting from the PBL
number of tutorial groups. Colleges may approach. Overall, PBL receives mixed
also have space limitations and students reviews from students.
may have limited access to library and The third area of criticism centers on
computer resources. If a PBL program is the myriad adulterated forms of PBL.
fiscally unable to maintain the high staffing Almost forty years after the inception of
ratios required (and because staff are problem‐based learning, we are noticing
difficult to find in a time of global nursing that there exists a wide understanding of
shortage) the nursing program may decide the nature of PBL in its pure form, and that
to revert to a more traditional curricular a range of adulterated forms of PBL exist
approach which is more sustainable. (Baker, 2000; Butler et al, 2005; Camp,

1996; Tanner, 1999). As well, the 1999). In addition, variables are often
implementation of PBL is influenced by confounded because PBL is accompanied
pedagogies that underpin both curricula with other major curriculum revisions, such
and the staff that implement it, which also as staff development, and it cannot be
contributes to modifying its essence (Savin‐ determined if the results can be attributed
Baden, 2000). There is also the perception to the use of PBL (Johnson & Finucane,
that PBL constitutes a relatively inefficient 2000).
way to learn and that not as much content Quantitatively, PBL is difficult to
is covered as in traditional curricula, which evaluate for several reasons. There are
also leads individual instructors to issues centered on the difficulty of
significantly modify the PBL process (Azer, evaluating a process‐based approach with
2001b; Johnson & Finucane, 2000; Moust et content‐driven evaluative methods
al., 2005). PBL might not be fully integrated, (Newman, 2003). Wood (2003) suggests
occurring instead on a course‐ that “if assessment methods rely
by‐course basis, with each solely on factual recall then PBL
instructor modifying the is unlikely to succeed in the
process to compensate for its curriculum” (p. 330); other
perceived deficiencies. It is factors need to be considered.
difficult to tell exactly what Other issues surrounding the
occurs behind closed classroom quantitative evaluation of the
doors and how individual effectiveness of PBL is that
instructors are modifying the examination results and clinical
process to suit their skills evaluations, while
understanding of it. frequently cited as measures of
The fourth and most the effectiveness of PBL, do not
significant category of criticism address understanding (Butler et
concerns the question of efficacy of PBL as al, 2005). As well, there are no standardized
an instructional and curricular elements that can be replicated, measured
methodology. Problems inherent in and compared (Baker, 2000). What the
reviewing existing literature regarding the research has indicated is that licensure
effectiveness of PBL as an educational exam scores remain consistently high and
method can be reduced to the fact that high comparable to traditional delivery
quality evidence is simply lacking (Newman, counterparts (Alexander et al, 2005; B.
2003). Much of the literature does not Brown, personal communication, June 14,
contain enough information regarding 2006). Individual studies, however,
experimental and control cohorts and to demonstrate mixed results overall, ranging
the type of PBL being used or evaluated from PBL exceeding traditional methods in
(Camp, 1996; Newman, 2003; Tanner, test scores to the opposite being

determined, and several studies reported compared with expert practitioners who
no difference between cohorts (Alleyne et engage in forward reasoning (p. 535).
al, 2002; Baker, 2000; Distlehorst, Dawson, Anecdotal evidence from colleagues
Robbs & Barrows, 2005; Enarson & Cariaga‐ involved in clinical teaching is conflicting
Lo, 2001; Hmelo‐Silver, 2004; Hwang and and varies widely among instructors and
Kim, 2005; Iputo & Kwizera, 2005; Miller, settings. Finally, it has been suggested that
2003; Morrison, 2004; Newman, 2003; there may be some subjects in which
Schmidt et al, 2006; Smits, Verbeek & de foundational knowledge is best
Buisonje, 2002).
Qualitatively, the literature revealed
that students and instructors reported
increased enjoyment and satisfaction with
the educational process of PBL (Antepohl,
2003; Hwang & Kim, 2005; Johnson &
Finucane, 2000; Miller, 2003; Morrison,
2004; Savin‐Baden, 2000; Smits et al, 2002),
although this has not been my observation,
disseminated first (Tan, 2004). One study
particularly regarding students. Another
found that students with a solid basic
issue is that little information is available
science foundation did better academically
regarding clinical performance of former
than students who did not, regardless of
PBL students (Antepohl, 2003). Areas in
the type of curriculum (Enarson & Cariaga‐
which graduates felt particularly prepared
Lo, 2001), suggesting that there may be
were in the areas of communication,
some domains that require essential prior
collaboration and critical thinking. As well,
knowledge (Tan, 2004). Overall, it is clear
students noted increased retention of their
that more research is needed concerning
learning (Tanner, 1999).
the efficacy of problem‐based learning
Research has not confirmed whether
(Morrison, 2004; Moust et al, 2005;
PBL fosters application and integration of
Newman, 2003; Savin‐Baden, 2000). In
knowledge, builds on previous learning,
short, the findings of the literature
develops clinical reasoning and cognitive
concerning the efficacy of PBL are
abilities similar to that of expert
inconclusive and at times contradictory.
practitioners or brings relevance to future
On a closing note, McMaster
clinical practice (Azer, 2001b; Morrison,
University’s School of Medicine has recently
2004; Walsh, 2005). Furthermore, Patel
undergone a curricular modification,
(cited in Tanner, 1999) found that PBL
changing from a PBL program to a
students “utilize more ‘backward reasoning’
“Compass” program, which is PBL at its
than conventional students”, a
heart but is more structured and delivers
characteristic of novice practitioners, as
more content (B. Brown, personal

communication, June 14, 2006). Brown learning is not a panacea for the problems
assures me, however, that PBL is alive and in adult education. However, it is an
well at McMaster University. instructional tool to create practitioners
Conclusion that are responsive and engaged with the
P
roblem‐based learning is considered realities of today's healthcare environment.
to be one of the most significant Perhaps we should consider that
innovations in adult education. Its educational methods go through phases, of
curricular aim is to better prepare which PBL is the most recent. As well, we
practitioners for clinical practice in a rapidly might consider that there may be yet other
changing world. In the absence of hard and ways to meet the needs of students that
fast evidence of its effectiveness, given the uphold the principles of adult education and
implementation issues PBL presents, and create the kind of practitioner we need in
given that the student experience is mixed today’s healthcare practice.
at best, I suggest that problem‐based

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