BACKGROUND:

Most of the students retains and use little of what they memorize in classroom situation, unfortunately memorization is a common occurrence in traditional programme. PBL attempts to break this focus by engaging students in structuring solution to real life relevant, contextualized problems. By replacing lectures with discussion forums, faculty monitoring and collaborative research students become actively engaged in meaningful learning.

Problem-based learning (PBL) is a student-centered instructional strategy in which students collaboratively solve problems and reflect on their experiences.

The ‘PBL strategy’ encouraged students to become active and independent, to take more responsibility for their own learning process in clinical practice. They should engage in reflective practice and evaluation among themselves, peers and groups, and use exploratory ways to make sense of new ideas and experiences within the learning process so deep learning will occur.

Therefore PBL is a discovery method of teaching which is originated in the late 1960s at McMaster University in Ontario, Canada (Alexander, McDaniel, Baldwin, and Money, 2002). It has become widely used in medicine and related professions teaching since the mid 1990’s (Fry, Ketteridge, Marshall, 1999).

Howard Barrows, the founder of this educational methodology, developed the self-directed model to improve education in the medical school³. Nurses should have the capacity of exploring options, asking questions, articulating explanations, and developing appropriate nursing care plans based on reflective decisions. They must continue to value learning throughout their careers to maintain their expertise (Heliker D, 1994). Schwartz (2004) endorses this approach as graduates from PBL courses are prepared for a lifetime of learning and discovery, and are more motivated and satisfied with their education.

Problem-based learning is a process that concentrates on formal and informal learning (Chaves, Baker, Chaves, and Fisher, 2006). According to Celia and Gordon (2001), “the method has five primary components: problem-based, student-centered, reiterative, small group and facilitation”

A real clinical nursing practice scenario is presented to the group of learners to discuss, identify their existing knowledge base, identify what they need to know, and invent a plan to congregate their learning objectives (Williams, 2001).

PURPOSE:

Problem-based learning is an approach that develops students’ ability to critically apply the cumulative knowledge to actual clinical problems which reinforces motivation to learn, develops clinical reasoning skills, and enhance self-directed and life-long learning.

Three recent evaluation studies of problem based learning reported, Rideout et al. (2002) conducted, a robust evaluation in which nursing students in a conventional programme were compared to those in a problem based curriculum students perform on RN examinations did not differ significantly, however the students in problem based learning groups were more satisfied with their learning and their relationships with instructors.

Result of a qualitative research study in which PBL was evaluated for its effectiveness in nursing education in HongKong demonstrated that PBL was effective in terms of facilitating critical reflection and debate, self directed learning and comparative learning (Lee, Wong and Mok, 2004).

PBL is a problem oriented, students-directed strategy design to provide learner with opportunities to build on existing knowledge, acquire information literacy skills, learn from each other, practice clinical decision making and acquire cognitive cues to guide future clinical decision making in real world situation (Rideout, 2001; Schnidt, 1993; Woods 1994).

Cannon and Newble (2000) suggest that PBL also requires students to develop the skills of learning effectively, including information skills, team working, and communication and, most importantly, high order cognitive skills for professional development in nursing practice.

PBL develop the bridge between classroom learning and professional practice in such profession like Nursing, Medical Education, accounts and business.

Advantages and Disadvantages of Problem-Based Instruction:

Advantages:

· Active process

· The way we make decisions anyway

· Increases tolerance of uncertainty

· Stimulates self-learning naturally

· Positively aids modelling

· Trainee-directed/trainer-monitored

· Increases motivation

· Encourages "experience" > "intuition"

Disadvantages:

· Other teaching methods are useful too!

· Need good tutorial skills

· Takes longer

· Needs planning

The use of PBL in nursing has revealed both advantages and disadvantages. Plenty studies have reported the effectiveness of Problem Based Learning in Nursing and Health Professional Education, according to Beers(2005), “one of the strongest arguments in favour of PBL is that it provides a more enjoyable and stimulating learning environment for both students and faculty”(p. 511). This study also shown that students attitude’s, clinical reasoning abilities, problem solving skills, critical thinking skills, effects on learning styles, and retention of information are increased by using Problem Based Learning.

Process/ method in PBL:

Active learning by problem based learning will be applied as the teaching instructional method in nursing. In this method, four different case scenario will be given to all class students in small groups. All groups will be given the time to debate, critique, analyze and conclude the different case scenario. According to Celia and Gordon (2001), problem scenarios are designed to challenge the learners to meet the curriculums objectives. Learners are presented with a real clinical situation or issue about which they must engage in collaborative learning. This integrative group approach to learning develops interpersonal skills, teamwork, and personal growth for the participant (Celia and Gordon, 2001).

Although this approach is student centered, the facilitators or tutors are equally important to the process. “The facilitator maintains the focus on learning, guides the process, meets the challenge, and provides appropriate feedback to each student and the whole group” (Celia and Gordon, 2001, p.13). It is also important to examine the facilitation role to promote effective learning through the use of PBL (Haith-Cooper 2000). Because the role of the educator today is to explore student thinking toward conceptual understanding, to increase depth of subject knowledge, to provide student learning opportunities and by encouraging the articulation and contrasting of different points of view, to allow the emergence of common understandings (Heliker D, 1994). So, the teacher will act as a facilitator for student’s active learning and discuss the different cases in small groups and will analyze the case, identify their own needs for information, and then solve real problems which occur in everyday life. Students will assume an active role in seeking and acquiring new knowledge rather than being passive recipients of knowledge.

David Merrill’s first principles of instructions will be applied in PBL. So, as a result PBL will be used for active learning as a teaching module in nursing to develop the skills of learning effectively, team working, and communication and most importantly high order cognitive skills in nursing Practice.

According to Siu et al. PBL is suitable for nursing education because of it explores students' self-directed learning practice and develops essential professional competencies that requires information search, management skills and verbal and non-verbal communication skills. This may be contributed to that PBL uses real-life contexts to capitalize on students' prior knowledge and reinforce important management concept.

Challenges in PBL:

However, in PBL tutorials, students may face a number of challenges, including poor interaction, spending more time on peripheral issues, lack of focus, difficulties in progressing to the case discussion, superficial learning, poor time management, poor contribution, or dominance of some members in the group discussion. Other challenges that may occur in PBL tutorials include; students not addressing the issues raised in the PBL case in enough depth; students not clearly defining their learning issues and failing to target the key concepts raised in the case.

Anticipated Implication:

PBL is a method that allows the nursing students to explore real problem situations with an emphasis on problem-solving. PBL is a learner-centered method of teaching and it helps student to become more effective in identifying, seeking out and assimilating knowledge in nursing. Problem-based learning provides a practical clinical teaching methodology to facilitate the application of theory to practice and guide students in the acquisition of critical reasoning and practical skills. PBL approach for active learning will also help them to retain the knowledge for long term and perform better in their examination. So, the current planning accreditation document stresses the need to educate nursing students to become problem solver. Therefore, Nursing Board continues to encourage the adoption of PBL in the nursing curriculum.

CONCLUSION:

Now it is concluded that the active learning in problem-based learning promotes self directed. Because PBL is a student-centered learning process where students learns about a subject in the context of complex, multifaceted, and realistic problems.PBL are to help the students develop flexible knowledge, effective problem solving skills, self-directed learning, effective collaboration skills and intrinsic motivation. Working in groups, students identify what they already know, what they need to know, and how and where to access new information that may lead to resolution of the problem.

BIBLIOGRAPHY:

1. Alexander JG, McDaniel GS, Baldwin MS, Money BJ Promoting, applying, and evaluating problem-based learning in the undergraduate nursing curriculum. Nurs Educ Perspect. 2002 Sep-Oct; 23(5):248-53.

2. Fry. H, Ketteridge. S, Marshall. S, (1999), A Handbook for teaching and lecturing in Higher Education, Kogan Page Ltd, Glasgow.

3. Rideout, E. (2001). Transforming nursing education through problem-based learning. Sudbury, MA: Jones and Bartlett Publishers.

4. Heliker, D. 1994 Meeting the challenge of the curriculum revolution: Problem based learning in nurse education Journal of Nursing Education 33 : 45-47.

5. Schwartz S (2004) Time to bid goodbye to the psychology lecture, Personal Space, The Psychologist, 17, (1).

6. Chaves, J. F., Baker, C. M., Chaves, J. A., and Fisher, M. L. (2006). Self, peer, and tutor assessments of MSN competencies using the PBL-evaluator. Journal of Nursing Education, 45(1), 25-31.

7. Celia, L. M., and Gordon, P. R. (2001). Using problem-based learning to promote critical thinking in an orientation program for novice nurses. Journal for Nurses in Staff Development, 17(1), 12-19.

8. Williams, B. (2001). Developing critical reflection for professional practice through problem based learning. Journal of Advanced Nursing, 34(1), 27-34.

9. Rideout, E. (2001). Transforming nursing education through problem-based learning. Sudbury, MA: Jones and Bartlett Publishers.

10. Lee, W.M., Wong, K.Y. and Mok, E. (2004). Problem-based learning: Ancient Chinese educational philosophy reflected in a modern educational methodology. Nurse Education Today, 24, 136-144.

11. Cannon, R. and Newble, D. (2000) A Handbook for Teachers in Universities and Colleges (4th edn.). London: Kogan Page.

12. Beers, G. W. (2005b). The effect of teaching method on long-term knowledge retention. Journal of Nursing Education, 44(11), 511-514.

13. Haith-Cooper M. An exploration of tutors' experiences of facilitating problem-based learning. Part 1--an educational research methodology combining innovation and philosophical tradition. Nurse Educ Today. 2003 Jan;23(1):58-64.

14. Siu, H. M., Laschinger, H. K., and Vingilis, E. (2005). The effect of problem-based learning on nursing students, perceptions of empowerment. Journal of Nursing Education, 44(10), 459Y469.

Received on 10.01.2014 Modified on 20.02.2014

Int. J. Nur. Edu. and Research 2(1): Jan.-March, 2014; Page 16-18