Problem-based learning

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This article is a bit too long, needs some reorganization and editing, also a lot text is quoted without reference (should be fixed soon) - DSchneider 19:39, 19 July 2006 (MEST)

Introduction

Problem-based learning (PBL in this article) is defined by Finkle and Torp (1995) as, “a curriculum development and instructional system that simultaneously develops both problem solving strategies and disciplinary knowledge bases and skills by placing students in the active role of problem solvers confronted with an ill-structured problem that mirrors real-world problems”.


Source : http://sll.stanford.edu/pubs/jeepark/pblsite/skipintro.htm

Students engage in authentic experiences. PBL's are inherently social and collaborative in methodology and teach students essential "soft skills" as well as domain specific content and skills. Through PBL, students learn:

  • Problem-solving skills
  • Self-directed learning skills
  • Ability to find and use appropriate resources
  • Critical thinking
  • Measurable knowledge base
  • Performance ability
  • Social and ethical skills
  • Self-sufficient and self-motivated
  • Facility with computer
  • Leadership skills
  • Ability to work on a team
  • Communication skills
  • Proactive thinking
  • Congruence with workplace skills

What is PBL?

A Little Historical Background

source: http://sll.stanford.edu/pubs/jeepark/pblsite/whatis.htm

Problem-Based Learning (PBL) has become popular because of its apparent benefits to student learning.

PBL can be thought of as a combination of cognitive and social constructivist theories, as developed by Piaget and Vygotsky, respectively. PBL is a curriculum development and delivery system that recognizes the need to develop problem solving skills as well as the necessity of helping students to acquire necessary knowledge and skills. The first application of PBL was in medical schools which rigorously test the knowledge base of graduates. Medical professionals need to keep up with new information in their field, and the skill of life-long learning is particularly important for them. Hence, PBL was thought to be well suited for this area. Many medical and professional schools, as well as undergraduate and graduate programs use PBL in some form, at varying capacities internationally.

Overview and Characteristics

(1-3 Adapted from Stepien & Gallagher 1993; Barrows, 1985 // 4 & 5 : From Problem Based Learning Initiative)

  1. Use of real world problems - problems are relevant and contextual. It is in the process of struggling with actual problems that students learn content and critical thinking skills.
  2. Reliance on problems to drive the curriculum - the problems do not test skills; they assist in development of the skills themselves.
  3. problems truly ill-structured - there is not meant to be one solution, and as new information is gathered in a reiterative process, perception of the problem, and thus the solution, changes.
  4. PBL is learner-centered - learners are progressively given more responsibility for their education and become increasingly independent of the teacher for their education.
  5. PBL produces independent, life-long learners - students continue to learn on their own in life and in their careers.


Student-centered; faculty-facilitated

source : http://edweb.sdsu.edu/clrit/learningresource/PBL/WhatisPBL.html

Pose significant, contextualized, real world situations, and providing resources, guidance, and instruction to learners as they develop content knowledge and problem-solving skills (Mayo, Donnelly, Nash, & Schwartz, 1993). In PBL, students collaborate to study the issues of a problem as they strive to create viable solutions. Teaching in PBL normally occurs within small discussion groups of students facilitated by a faculty tutor (Aspy, Aspy, & Quimby, 1993, Bridges & Hallinger, 1991).

Because the amount of direct instruction is reduced in PBL, students assume greater responsibility for their own learning (Bridges & Hallinger, 1991). The instructor's role becomes one of subject matter expert, resource guide, and task group consultant. This arrangement promotes group processing of information rather than an imparting of information by faculty (Vernon & Blake, 1993). The instructor's role is to encourage student participation, provide appropriate information to keep students on track, avoid negative feedback, and assume the role of fellow learner (Aspy et al., 1993).

Going Beyond Content

source: http://edweb.sdsu.edu/clrit/learningresource/PBL/WhatisPBL.html

The ability to solve problems is more than just accumulating knowledge and rules; it is the development of flexible, cognitive strategies that help analyze unanticipated, ill-structured situations to produce meaningful solutions.

Real-life problems seldom parallel well-structured problems; hence, the ability to solve traditional school-based problems does little to increase relevant, critical thinking skills students need to interact with life beyond classroom walls. Real-life problems present an ever-changing variety of goals, contexts, contents, obstacles, and unknowns which influence how each problem should be approached. To be successful, students need practice solving ill-structured problems that reflect life beyond the classroom. This skill is the goal of PBL.

This is probably why over 80% of medical schools use the PBL methodology to teach students about clinical cases, either real or hypothetical (Vernon & Blake, 1993, Bridges & Hallinger, 1991).

Versions of PBL

There are many problem-based learning models. E.g. Edwin Bridges (1992) suggests that there are two versions of PBL that have been implemented in the classroom, problem-stimulated PBL and Student Centered PBL.

Problem Stimulated PBL (PS PBL)

PS PBL uses role relevant problems in order to introduce and learn new knowledge. The Prospective Principals Program at Stanford University's School of Education employs PS PBL in its curriculum.

PS PBL emphasizes 3 major goals:

  1. development of domain-specific skills
  2. development of problem-solving skills
  3. acquisition of domain-specific knowledge
The PS PBL Process
  1. Students receive the following learning materials:
    1. the problem ;
    2. a list of objectives that the student is expected to master while working on the problem ;
    3. a reference list of materials that pertain to the basic objectives ;
    4. questions that focus on important concepts and applications of the knowledge base.
  2. Students work in teams to complete the project, resolve the problem, and accomplish the learning objectives.
    1. each student has a particular role in the team - leader, facilitator, recorder, or team member
    2. time allotted to each project is fixed
    3. the team schedules its own activities and decides how to use the allotted time
  3. Student performance is evaluated by instructors, peers, and self using questionnaires, interviews, observation, and other assessment methods.

Throughout the process, instructors serve as resources to the teams and provide guidance and direction if the team asks for it or becomes stymied in the project.

Student Centered PBL (SC PBL)

SC PBL is similar to PS PBL in some aspects. SC PBL has the same goals as PS PBL, but includes one more: fostering life-long learning skills. Physicians are one group of professionals who are required to stay current with new developments in their fields. The skills of a life-long learner are particularly important for this group. Hence, several medical schools employ student centered PBL.

The SC PBL Process
  1. Students receive the problem situation.
  2. Students work on the problem in project teams.
  3. Students are evaluated in multiple ways by instructors, peers, and self.

The process appears to be similar to that of PS PBL, but there are significant differences in each step, which are driven by the goal of fostering life-long learning skills. The major differences are in student responsibilities. In SC PBL:

  • students identify the learning issues they wish to explore;
  • students determine the content to be mastered;
  • students determine and locate the resources to be used.

In short, students have self-defined learning issues. As is the case with PS PBL, students decide how to appropriately use the newly acquired information and knowledge in order to solve the problem at hand.

Case-based PBL

See learning by design.

The Advantages of PBL

source : http://edweb.sdsu.edu/clrit/learningresource/PBL/PBLadvantages.html Les "Goals and Objectives" sont tirés de...Summary of Psychological Basis of PBL source: ??? (un tableau si je me rappelle bien...)

  • Emphasis on Meaning, Not Facts
  • Increased Self Directed learning
  • Higher Comprehension and Better Skill Development
  • Interpersonal Skills and Teamwork
  • Self-Motivated Attitude
  • Goals and Objectives of PBL : Foster problem-solving skills in students.
  • Goals and Objectives of PBL : Enhance acquisition, retention, and use of knowledge.
  • Goals and Objectives of PBL : Transfer of Principles and Concepts.
  • Level of Learning

Why is there an increase in scores resulting in PBL? Information theory links 3 conditions to subsequent improved retrieval and use. Bridges & Hallinger (1991) report that students improve their comprehension because they:

  1. are better at activating prior knowledge,
  2. learn in a context resembling their future context, and
  3. elaborate more fully on the information presented.

Increased elaboration promotes mental processing, understanding, and recall. Because content is learned in context, definitions, information, theories, correlations, and principles are learned and integrated with one another (Mandin, Harasym, & Watanabe, 1995).

See also the learning level article.

Barriers and disadvantages

The Barriers to PBL

source : http://edweb.sdsu.edu/clrit/learningresource/PBL/PBLBarriers.html

  1. Changing the Curriculum
  2. The transition is difficult
  3. More Time to Teach Same Content
  4. PBL Costs More
  5. Faculty lack extrinsic rewards for PBL teaching
  6. Faculty lack facilitator skills.
Disadvantages of PBL

source: http://edweb.sdsu.edu/clrit/learningresource/PBL/DisPBL.html

  1. Academic achievement : Few academicians doubt the ability of students schooled in PBL to exhibit strong reasoning and team building skills.
  2. Time demands.
  3. Role of the student : Because of the orientation towards the subject-matter expertise of their instructor and the traditional memorization of facts required of students, many students appear to have lost the ability to "simply wonder about something" (Reithlingshoefer, 1992).
  4. Role of the teacher : In PBL, the instructor acts more as a facilitator than disseminator of information.
  5. Appropriate problems : Without problems that encompass both a large goal and specific objectives which students must find on their way to reaching the goal's solution, there is a good chance that important information will not be studied.
  6. Student assessment : PBL differs from traditional instruction in a variety of ways, and therefore student knowledge and achievement may be better measured with alternate assessment methods.
How to Overcome Barriers and Implement PBL

source: http://edweb.sdsu.edu/clrit/learningresource/PBL/PBLimplementing.html

  1. Overcoming Resistance : Show faculty members examples of success and to explain how it works. Provide them with training. Engage them in activities such as observing facilitators.
  2. Rewarding Faculty for PBL Participation.
  3. Finding Time and Money.
  4. Training teachers to use PBL.
  5. Strategy : Faculty should read about PBL and how to facilitate small group discussions. Faculty should envision the situation from the student's view. Faculty should create a forum for facilitators to discuss PBL issues as they arise. Faculty should promote seek feedback from students.


How to Structure PBL

source: http://edweb.sdsu.edu/clrit/learningresource/PBL/PBLStructure.html

Design Considerations
  1. How should PBL be incorporated into the curriculum?
  2. What problems should be used and how should they be presented?
  3. What are the instructional goals?
  4. How should small groups be formed?
  5. How much should each problem be prestructured?
  6. How to evaluate the program and the students?
  7. What resources should be available?
  8. How to prepare students and faculty for PBL? (Bridges, 1992).
Getting Started
  • Anticipate and manage anxiety (Bernstein, Tipping, Bercovitz, & Skinner, 1995).
  • Explain to all involved what is happening and why.
  • Tutors should receive training (Foley, Levy, Russinof, & Lemon, 1993).
  • Students should be oriented to PBL.
  • State the PBL goals.
  • Randomly assign students to PBL (Mennin Friedman, Skipper, Kalishman, & Snyder, 1993).
Creating An Appropriate Problem
  • PBL problems should be created with (Bridges, 1992):
  1. introduction,
  2. content,
  3. learning objectives,
  4. resources,
  5. expected outcome,
  6. guiding questions,
  7. assessment exercises,
  8. and time frame .
  • Relevancy
    • focus problems on current events, student lives, or relationships to actual occurrences at the local, national, or international level.
    • maintain motivation
    • Content reasonable for the time allotted.
    • ability of students to transfer their acquired skills and knowledge to life outside the classroom, and their ability to solve real world problems.
  • Coverage: to help ensure your problem will guide students to appropriate information :
    • Identify the big picture, major concept, or main idea
    • Identify the basic facts and concepts students have to uncover as they solve the problem.
    • Create a problem that not only focuses students on the large problem but also takes them through the objectives.
    • Make sure resources are available for students to reference during their problem analysis and solution.
  • Complexity
    • Helps ensure that there is no "one right" answer. Having multiple correct answers that approach the problem from various perspectives and solutions can springboard to class discussions that stimulate student higher level thinking.
    • Often allow for the integration of interdisciplinary solutions; a common occurrence in solving real world problems.
    • Complex problems usually require learners to exhibit management, research, and thinking skills that help distinguish less expert from more expert performers (Albanese & Mitchell, 1993). This differentiation can help serve as a grading standards in the class.
Guidelines for Problems
  1. common situation to serve as a prototype for other situations,
  2. significant,
  3. prevention is possible,
  4. interdisciplinary,
  5. cover objectives,
  6. task oriented,
  7. and complex enough to incorporate prior knowledge (Albanese & Mitchell, 1993).

Novice learners require more structure and cues while more experienced students are self-directed learners. The best format for problems is unorganized, unsynthesized, and open-ended because this allows for student processing (Albanese & Mitchell, 1993). Students are motivated to use their reasoning skills and relate the content to their own context and previous knowledge (Albanese & Mitchell, 1993). Software can be used in the PBL curriculum, but avoid telling students when the solution is reached. This stops the learning process. Point out inappropriate strategies.

Evaluation

Evaluation is an iterative process. Be prepared to make changes along the way based on experience (Bernstein, Tipping, Bercovitz, & Skinner, 1995).

The Library

Ensure resources and time are available for self-study. "If students are to be genuinely empowered with their own learning, it is important to provide them with the necessary infrastructure." (Rangagachari, 1991). PBL students study in the library more than conventional students and study more during the day than the evening. Increasing the time spent instructing students, decreases the time students spend in self-study (Williams, Saarinen-Rahikka, & Norman, 1995). Limit instructional time to promote self-study by students. If students must learn basic science or similar material for national standardized examinations, increase student access to self-assessment, provide practice examinations, allow additional examination preparation time (Mennin et al., 1993).

Example & Facilitation of PBL

Real life problems are inherently interdisciplinary and all disciplines can tailor the exampled approach that follows. Learning in the problem-based curriculum is initiated with the presentation of an ill-structured problem. Programs that focus on "neat" well-defined problems do not seem to have an effect on the way students approach real problems in the career path they choose (Gallagher, Stepien, & Rosenthal, 1992). To set the stage and orchestrate a PBL format, presented here are points an instructor may incorporate to achieve such a course, with a medical school example case in point.

See an example: Medicine Blends Computers and PBL

PBL according to the Stanford Center for Innovations in Learning

Problem-based learning

PBL in the classroom

There are several models of how PBL works in the classroom. All of them agree that in a PBL curriculum,

  1. students work through a series of problems designed to:
    • be authentic (i.e. address real-world concerns)
    • target defined areas of the curriculum
    • be "ill-structured" - they must be defined and analyzed through inquiry from a minimum of presenting information
    • approximate the real world, so that students find themselves actually engaged in the problem and not just observers of it;
  2. the role of the instructor changes from a "sage on the stage" to a "guide on the side";
  3. students work collaboratively in small groups toward the problem's resolution.

Barrows (1985) proposes the following model of the PBL process :

Process Purpose
Students read and address problem, without background preparation.
  • Teaches students to encode and organize information in useful ways.
  • Allows students to find what they know and what they don¹t know. Misconceptions can be corrected in discussion of the problem.
  • Mimics the real life context they will face as doctors.
Students discuss and analyze problem using prior knowledge and resources available.

Tutor poses questions: ie. Do you need more information? Are you sure of the facts or will a review be helpful? Do you think more information on this area would be helpful?

Tutors encourage hypotheses are grounded in science.
  • Development of cognitive skills for problem-solving process
  • Development of self-monitoring skills to identify the learning needs
  • Development of habitual student-initiated questioning
Students decide what they need to know and where they might best find the information. They decide which resources to use (people, published papers, etc.).
  • Self-directed study
Students revisit problem with new information and knowledge acquired during self-study.

Students critique learning resources used.

Group decides appropriate hypotheses and critiques prior performance.
  • New organization of information to problem-solve.
  • Self-assessment
  • Peer-assessment
Students should think about how what they learned has added to their understanding
  • Reflection
  • Self-assessment

Schmidt and Moust describe the main frame of the process of PBL as iterative and cyclical in nature.

  1. Students approach the problem, without any prior background research.
  2. In the small group tutorial, they analyze the problem based on prior-knowledge, elaborate on the knowledge through discussion, develop new knowledge structures and formulate their own learning objectives.
  3. Students proceed to a period of self-directed study. This helps them to develop, fine-tune, and restructure the existing knowledge structure.
  4. Students then return to the small group tutorial, where they integrate and apply the knowledge they gained during self-directed study in order to problem-solve.

Students will then return to the first step and continue to cycle until the problem is fully addressed.

Groups in PBL
  • Teams are responsible for
    • scheduling their own activities
    • deciding how to use their time to solve the problem
    • master the learning objectives.
  • Groups usually consist of 5 to 7 students. Four roles are possible:
    • project leader - proposes meeting agendas, suggests division of labor, and develops the overall project plan.
    • facilitator - describes the process to be followed during the steps of the project plan, determines appropriate time to proceed in plan, and suggests adjustments to the plan as needed.
    • recorder - takes group notes of each meeting.
    • team member - takes individual notes, participates in discussion, and reviews resource materials.
  • Other PBL models include a mentor or tutor in the group (often a faculty member, or another student).
The individual student in PBL
  • active role in learning.
  • students have responsibility for their own learning by identifying their learning issues and needs.

According to Schmidt and Moust (1989), the student progresses through a series of steps, "The Seven Jump", during the PBL process.

  1. Clarify unknown terms and concepts in the problem description.
  2. Define the problem(s). List the phenomena or events to be explained.
  3. Analyze the problem(s). Step 1. Brainstorm. Try to produce as many different explanations for the phenomena as you think of. Use prior knowledge and common sense.
    • student outcomes:activation of prior knowledge, elaboration, restructuring of information, organization of information, intrinsic motivation]
  4. Analyze the problem(s). Step 2. Discuss. Criticize the explanations proposed and try to produce a coherent description of the processes that, according to what you think, underlie the phenomena or events.
  5. Formulate learning issues for self-directed learning.
  6. Fill in gaps in your knowledge through self-study.
  7. Share your findings with your group and try to integrate the knowledge acquired into a comprehensive explanation for the phenomena or events. Check whether you know enough now.
    • student outcomes: restructuring, applying, problem solving]
The instructor in PBL
  • serves as a resource to the student teams.
  • is frequently acts as a mentor or tutor to the group.
  • is most active in planning the PBL the content and sequence of projects, providing immediate feedback on student work and discussion, and evaluating students.
  • acts as metacognitive coach, serving as model, thinking aloud with students and practicing behavior he wants his students to use (Stepien and Gallagher, 1993).
  • coaxes and prompts students to use questions such as "What is going on here? What do we need to know more about? What did we do during the problem that was effective?" and take on responsibility for the problem.
  • is aware of the progress and conversations within the groups so that students continue on fruitful paths.
How to do PBL

The Teacher Pages of NASA's Classroom of the Future provides an informative and practical way to use PBL in the classroom. Savery and Duffy (In Press), discuss issues for instructional design in constructivist environments:

  • Anchor all learning activities to a larger task or problem.
  • Support the learner in developing ownership for the overall problem or task.
  • Design an authentic task.
  • Design the task and the learning environment to reflect the complexity of the environment students should be able to function in at the end of learning.
  • Give the learner ownership of the process used to develop a solution.
  • Design the learning environment to support and challenge learners' thinking.
  • Encourage testing ideas against alternative views and alternative contexts.
  • Provide opportunity for support and reflection on both the content learned and the learning process.

Barrows (How to Design a Problem Based Curriculum for the Pre-Clinical Year, 1985) also provides a suggested list of objectives for a course and recommends that both faculty and students are provided with the list at the start of the course. Although Barrows specialized in the application of PBL in medical education, his ideas can be generalized to other laboratory sciences. Here are his suggested objectives: By the end of the course, the student should be able to demonstrate capabilities in the following areas:

Analytical Reasoning Skills

  • Generate several hypotheses
  • Appropriate use of hypothesis-oriented inquiry-strategy
  • Problem synthesis
  • New hypothesis or new inquiry approach
  • Protocol-oriented or routine inquiry
  • Appropriate laboratory or diagnostic tests
  • Final working hypothesis
  • Management plan to correct the problem

Clinical or Laboratory skills Self-assessment and self-study skills

  • Assess adequacy of knowledge and reasoning skills in evaluating problems presented
  • List information that needs to be reviewed or learned

Knowledge

  • List of knowledge that needs to be learned and appropriately applied in analysis of problems

Assessment of PBL

source:http://edweb.sdsu.edu/clrit/learningresource/PBL/webassess/studentNclasses.html

Because instruction and learning is different in problem based settings than traditional instruction, many instructors find student evaluation difficult. PBL encourages development of meta-cognitive skills like group learning or research and communication skills and aims transferring knowledge to novel situations. With such multiple purposes for PBL, it is important to consider a variety of evaluation techniques.

San Diego State University's Technology Initiative Web Site) suggests the following ideas for assessment:

  • Written examinations : should be designed to ensure transference of skills to similar problems or subject domains.
  • Practical examinations : used to ensure that students are able to apply skills learned during the course.
  • Concept maps : Much of the learning that goes on during PBL is more than just a compilation of facts. As such, written examinations may not be an adequate measure of student growth. Requiring students to generate concept maps, in which they depict their knowledge through the creation of identified nodes and links, may present another option to determine their cognitive growth.
  • Peer assessment : Because life outside the classroom usually requires working with others, peer assessment is a viable option to measure student growth. Providing students with an evaluation rubric often helps guide the peer evaluation process. This process also emphasizes the cooperative nature of the PBL environment.
  • Self assessment : An important element of PBL is to help students identify gaps in their knowledge base in order for more meaningful learning to result. Self assessment allows students to think more carefully about what they know, what they do not know, and what they need to know to accomplish certain tasks.
  • Facilitators/tutor assessment : The feedback provided by tutors should encourage the students to explore different ideas. It is important that facilitators not dominate the group, facilitate learning and exploration. Tutor assessment may consist of how successful individuals interacted with their group and their cognitive growth.
  • Oral Presentations : Because so much of work life revolves around presenting ideas and results to peers, oral presentation in PBL provide students an opportunity to practice their communication skills. Presenting findings to their group, the class, or even a real-life audience can help strengthen these skills.
  • Reports : Written communication is another skill important for students. Requiring written reports allows students to practice this form of communication.
Assessing the value of a PBL curriculum

source: http://edweb.sdsu.edu/clrit/learningresource/PBL/webassess/curriculum.html

When determining the value of PBL curriculum, the literature has focused on 4 components : (a) attitudes, (b) basic knowledge, (c) problem solving ability, and (d) study habits.

Attitudes: Students enrolled in PBL courses appear to have a more favorable attitude toward their course than students schooled in traditional instruction. Improved attitudes contribute to a variety of factors including increased course enrollment, enhanced interest in major course of study, and positive feedback from faculty and employers (Pincus, 1995); a reduced dropout rate (Bridges & Hallinger, 1991; Pincus, 1995); and an increase in student comments concerning the advantages of PBL after their learning experience (Bernstein, Tipping, Bercovitz, & Skinner, 1995). Schmidt, Henny, and de Vries (1992) conclude that "problem based curricula do appear to provide a friendlier and more inviting educational climate."

Basic knowledge: Test results seem split on basic knowledge comprehension. In the medical field, although it was sometimes found that students schooled with PBL performed worse on standardized tests, they performed better on clinical tests and equal on essay tests to conventionally-schooled students (Albanese, 1993). Not all studies are favorable to PBL, but Albanese found that PBL knowledge is more deeply ingrained and less likely to be as easily forgotten.

Reasoning and problem solving skills: The evidence appears supportive in finding PBL students better than conventional students in analyzing atypical medical cases (Albanese, 1993), and in having stronger problem solving skills (Gallagher, Stepien, & Rosenthal, 1992).

Team work Most PBL is done in small groups. Therefore it is not surprising to find that students who learn in this context tend to be more oriented toward collaborative learning.

Examples and links

University level
  • Teacher Training in Science: Sherman Rosenfeld and Yehuda Ben-Hur, PBL in Science and Technology: A Case Study of Professional Development, Department of Science Teaching, Wizmann Institute of Science, [1]
High School Level
Commercial PBL example cases
links

References

Albanese, M., & Mitchell, S. (1993). Problem-based learning: A review of the literature on its outcomes and implementation issues. Academic Medicine. 68(1), 52-81.

Aspy, D.N., Aspy, C. B., & Quimby, P.M. (1993). What doctors can teach teachers about problem-based learning. Educational Leadership, 50(7), 22-24.

Barrows, H.S. (1985). How to Design a Problem-based Curriculum for the Preclinical Years. New-York : Springer

Bernstein, P., Tipping, J., Bercovitz, K., & Skinner, H.A. (1995). Shifting students and faculty to a PBL curriculum: Attitudes changed and lessons learned. Academic Medicine, 70(3), 245-247.

Blumberg, P., Solomon, P., & Shehata, A. (1994, April). Age as a contextual cue in problem-based learning. Paper presented at the meeting of the American Educational Research Association, New Orleans, LA.

Bridges, E. M. (1992). Problem based learning for administrators. Eugene, OR: ERIC Clearinghouse on Educational Management. (ERIC Document Reproduction Service No. ED 347 617)

Bridges, E. M., & Hallinger, P. (1991, September). Problem-based learning in medical and managerial education. Paper presented for the Cognition and School Leadership Conference of the National Center for Educational Leadership and the Ontario Institute for Studies in Education, Nashville, TN.

Delafuente, J. C., Munyer, T. O., Angaran, D. M., & Doering, P. L. (1994). A problem solving active learning course in pharmacotherapy. American Journal of Pharmaceutical Education. 58(1), 61-64.

Dolmans, D. H., Gijselaers, W. H. & Schmidt, H. G. (1992, April). Do students learn what their teachers intend they learn? Guiding processes in problem-based learning. Paper presented at the meeting of the American Educational Research Association, San Francisco, CA.

Engel, C. (Ed.). (1992). Annals of Community-Oriented Education Volume 5. Network Community-Oriented Educational Institutions for Health Sciences. (pp. 193-198). Maastricht, The Netherlands: University of Limburg.

Farnsworth, C. C. (1994). Using computer simulations in problem-based learning. In M. Orey (Ed.), Proceedings of the Thirty-fifth ADCIS Conference (pp. 137-140). Nashville, TN: Omni Press.

Foley, R. P., Levy, J., Russinof, H. J., & Lemon, M. R. (1993 ). Planning and implementing a problem-based learning rotation for residents. Teaching and Learning in Medicine, 5(2), 102-106.

Gallagher, S. A., Stepien, W. J., & Rosenthal, H. (1992). The effects of problem-based learning on problem solving. Gifted Child Quarterly. 36(4), 195-200.

Greening T. (1998). “Scaffolding for success in PBL”. Medical Education Online. Vol III.

Harden, R. M. & Margery H. Davis, (1998) The continuum of problem-based learning, Medical Teacher, Vol. 20, No. 4.

http://edweb.sdsu.edu/clrit/learningresource/PBL/WhatisPBL.html

http://sll.stanford.edu/pubs/jeepark/pblsite

Mandin, H., Harasym, P., & Watanabe, M. (1995). Developing a "clinical presentation" curriculum at the University of Calgary. Academic Medicine, 70(3), 186-193.

Mayo, P., Donnelly, M. B., Nash, P. P., & Schwartz, R. W. (1993). Student Perceptions of Tutor Effectiveness in problem based surgery clerkship. Teaching and Learning in Medicine. 5(4), 227-233.

Mennin, S. P., Friedman, M, Skipper, B, Kalishman, S., & Snyder, J. (1993). Performances on the NBME I, II, and III by medical students in the problem-based learning and conventional tracks at the University of New Mexico. Academic Medicine, 68(8), 616-624.

Ostwald, M. J., Chen, S. E., Varnam, B., & McGeorge, W. D. (1992, November). The application of problem-based learning to distance education. Paper presented at the world conference of the International Council for Distance Education, Bangkok, Thailand.

Pincus, K. V. (1995). Introductory Accounting: Changing the First Course. New Directions for Teaching and Learning, 61, 88-98.

Problem Based Learning Initiative at Southern Illinois Institute : http://www.pbli.org/pbl/pbl1.htm

Problem Based Learning: http://www.mcli.dist.maricopa.edu/pbl/sources.html (46 web and 16 print references)

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