Several potential advantages for students' learning are claimed for problem-based learning (PBL). Students in PBL curricula may be more highly motivated; they may be better problem solvers and self-directed learners; they may be better able to learn and recall information; and they may be better able to integrate basic science knowledge into the solutions of clinical problems. Although some of these claims find theoretical support from the literature on the psychology of learning, to date there has been no review of the experimental evidence supporting the possible differences in students' learning that can be attributed to PBL. In this review article, the authors examine each claim critically in light of that evidence. They conclude that (1) there is no evidence that PBL curricula result in any improvement in general, content-free problem-solving skills; (2) learning in a PBL format may initially reduce levels of learning but may foster, over periods up to several years, increased retention of knowledge; (3) some preliminary evidence suggests that PBL curricula may enhance both transfer of concepts to new problems and integration of basic science concepts into clinical problems; (4) PBL enhances intrinsic interest in the subject matter; and (5) PBL appears to enhance self-directed learning skills, and this enhancement may be maintained.
A new theory of the development of expertise in medicine is outlined. Contrary to existing views, this theory assumes that expertise is not so much a matter of superior reasoning skills or in-depth knowledge of pathophysiological states as it is based on cognitive structures that describe the features of prototypical or even actual patients. These cognitive structures, referred to as "illness scripts," contain relatively little knowledge about pathophysiological causes of symptoms and complaints but a wealth of clinically relevant information about disease, its consequences, and the context under which illness develops. By contrast, intermediate-level students without clinical experience typically use pathophysiological, causal models of disease when solving problems. The authors review evidence supporting the theory and discuss its implications for the understanding of five phenomena extensively documented in the clinical-reasoning literature: (1) content specificity in diagnostic performance; (2) typical differences in data-gathering techniques between medical students and physicians; (3) difficulties involved in setting standards; (4) a decline in performance on certain measures of clinical reasoning with increasing expertise; and (5) a paradoxical association between errors and longer response times in visual diagnosis.
Summary Problem‐based learning is an instructional method that is said to provide students with knowledge suitable for problem solving. In order to test this assertion the process of problem‐based learning is described and measured against three principles of learning: activation of prior knowledge, elaboration and encoding specificity. Some empirical evidence regarding the approach is presented.
The present study was conducted to provide future researchers and dental educators with an overview of stress amongst undergraduate dental students reported in the literature. This overview is needed for the development of a new questionnaire measuring the level of stressors including students, staff and process of dental education. In addition, the review can be used to modify dental curricula to decrease such stress and produce better dentists. Our study consisted of a systematic review of 49 peer-reviewed articles published between 1966 till October 2008 in English, discussing different aspects of stress amongst undergraduate dental students. These aspects are demographic variables of stress, sources of stress, impact of stress, indicators of stress, instruments measuring stress level and management of stress. Major sources of reported stress were related to examinations, clinical requirements and dental supervisors. Studies suggest using signs and symptoms for early detection of stress and proper intervention.
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