Internet Edition

Issue No. 1, March 1997

Problem Based Learning - A bold new approach to dental education in the Faculty of Dentistry

by Dr Kelvin Foong

Professor Stewart Mennin (fourth from right) in a discussion with staff on the PBL process

The traditional role of teaching has been one of imparting knowledge from the teacher to student. Little is required of the students except to imbibe the knowledge, and pass exams well. With the emphasis on continuing education, such a unilateral transference of knowledge is ill-equipped to produce clinicians capable of self-directed life-long learning. In addition, the classroom of the future will no longer be one with four-walls but a global, electronic storage of information.

The fine art of Problem-based learning (PBL) was taught to a handful of staff and students at the Faculty of Dentistry in May 1996. Professor Stewart Mennin, from the Medical School of the University of New Mexico led and facilitated discussion on PBL teaching. The striking difference between traditional teaching and PBL lies in the center of learning - the student or the learner. Self-motivated student learning comprise a major portion of the PBL method. Staff intervention in group discussion is limited to providing feedback and focus. Students are internally motivated to learn more, are less likely to feel bored, and much more alert in group discussion. Learning appears to be an enjoyment rather than a chore when the learning is student-centred.

Why Problem-Based Learning?

Have you ever questioned the relevance of what you studied and were taught to do during your undergraduate days? It is a common experience among practicing clinicians. To bridge the learning gap, the PBL method aims to provide relevancy in the eductional process, for "education is most effective when undertaken in the context of future tasks" (Glasser, 1982). On a similar note, internalising the relevance of a subject increases the motivation for learning. Students who perceive the relevance of working with dental problems and the challenge for solving provide a strong motivational impetus for learning.

The desirable outcomes of an educational process are plenty; students who are enthusiastic about the subject and who are interested in learning more and are more able to apply information and communicate ideas to others. Having had a solid foundation of basic knowledge, students and future clinicians will be more aware of their limitations in the process of identifying and solving clinical problems. In its entirety, problem-based, student-centred learning is designed to help students develop a wide range of knowledge and behavioral skills that will make them life-long learners.

The Learning Process

The PBL process starts with a "case". Cases provide a structure for a discussion which allows students to discover what they already know, what they don't know and what they need to learn. The learning process directs students to explore the knowledge associated with the problem, and to expand on their own knowledge boundary. Throughout the learning process students identify problems, suggest possible causes, recall their prior knowledge, explain their reasoning in terms of basic mechanism, explore the limits of their understanding and ask specific questions, incorporate new information and revise their thinking.

Critics argue that problem-based learning tends to distract students from the real issues of the problem. The learning direction may go off at a tangent if students are engrossed over an issue. The provision of a staff facilitator ensures students are not too far off track. While the expansion of knowledge borders is a definite advantage of the PBL concept, losing focus on the essentials of the problem is easy. A fine balance is needed and the role of the staff facilitator in steering the students' discussion is therefore important.

Students in a group discussion with Staff acting as facilitators

A Chinese proverb aptly sums up the PBL process : "I hear and I forget; I see and I remember; I do and I understand." With such an array of benefits to the learner, the Faculty of Dentistry has boldly embarked on a pilot project to incorporate PBL into the curriculum, to provide future clinicians the skills needed to meet the challenges of the 21st century.

(Note: The Faculty has narrowed the PBL concept to Case-based learning, concentrating on one patient's problems. This involves less time to accomplish the learning objectives).

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