Problem-based learning (PBL) is a method of self-directed learning. The self-directed learning philosophy recognizes that, with some guidance and support, adult learners should be able to take responsibility for their own learning (Solomon & Baptiste, 2004). An overall goal of self-directed learning is to exercise the student’s capacity to think and discover during the process of gaining knowledge. The more active that students are in determining their own needs and learning goals, the more effective their learning is likely to be. The program expects the student—with support and guidance—to determine (1) their own learning needs; (2) how they will best set and achieve objectives to address those needs; (3) how they will select learning resources; and (4) whether their learning needs have been met. PBL is the cornerstone of our graduate program in speech-language pathology at McMaster University. Central to our mission is guiding, engaging, and challenging students to become excellent clinician-scholars who will work to maximize life participation for all people with communication and swallowing disorders.

Overview of PBL at McMaster University

Many people know of PBL from the McMaster Medical School program, which has been using PBL since 1965 (Neufeld & Barrows, 1974). Many McMaster University Health Sciences programs—including occupational therapy (OT), physiotherapy (PT), nursing, physician assistants, and midwifery—have implemented PBL since then. Indeed, we cannot imagine having built the program without the mentorship of our OT and PT colleagues, especially PBL pioneers Sue Baptiste and Patty Solomon.

“Self-directed” does not mean self-paced or unstructured. To the contrary, this approach requires an enormous amount of advanced planning by faculty and staff to ensure that we provide a range of opportunities to meet learner outcomes. Student attendance and participation in tutorials, clinical laboratories, and other courses are required; and students must demonstrate satisfactory progress via results of self, peer, and faculty evaluations. Faculty and students work together on an ongoing basis to create an effective learning environment, select appropriate learning resources, effectively facilitate and support learning, and evaluate the learning process. This formative work continues throughout student training, as new learning opportunities arise and as we adapt the curriculum based on student progress and feedback.

Key Elements and Principles of McMaster’s Graduate PBL Program

  • PBL provides an alternative to purely lecture-based, didactic instruction. Students focus on a scenario and bring to the examination of the problem all their previous knowledge and experience as well as their ability to think rationally and critically. As students begin to ask questions, certain issues become well defined and require a search for additional information. After assembling the appropriate information, students synthesize a solution that includes a reevaluation of their initial hypothesis (or hypotheses). Students learn how wrestling with any one problem opens up many other questions.
  • PBL has many advantages. PBL contributes to student motivation; enhances transfer, integration, and retention of information; and encourages curiosity and systematic thinking. Teachers can enhance the transfer of knowledge with problems that encourage students to learn content and to develop strategies to recognize core analogies or principles. Students can then transfer the newly learned strategies to new problems and contexts. As a result, students gain knowledge and simultaneously develop clinical reasoning to apply and integrate knowledge within a relevant context.
  • Problem-Based Tutorial (PBT) courses use PBL as their foundation. We use PBL principles throughout our program, but PBL is the core method for the students’ Problem-Based Tutorial (PBT) courses, which are completed in each unit of study (one unit of study is roughly equivalent to a semester). Students meet twice weekly for 2½ hours to discuss health care problems that integrate their week’s coursework. The main objective of PBT courses is to provide students with opportunities for the application of independent research and experience gained in practicum with learning from their Foundational Knowledge, Inquiry Seminar, and Clinical Skills Lab courses.
  • PBT courses are tutor facilitated. Typical PBT groups are composed of seven or eight students, and a tutor (usually, a clinician from the community)—facilitates them. The tutor functions as a facilitator of learning rather than as a disseminator of information. Transitioning from a “teacher” role to a facilitator role can be one of the greatest challenges for tutors. Tutorial group membership changes from unit to unit; therefore, students learn to interact with a variety of partners and to contribute professionally across groups with varying dynamics.
  • The PBT process consists of four main steps (detailed here). The PBT process includes brainstorming, identification of learning objectives, discussion, and feedback. For example, students might receive a health care problem that focuses on a 3-year-old child who is not speaking, and who was referred to a community health care team for assessment. There, the child received a diagnosis of developmental language disorder (DLD), and the parents are asking what “DLD” means. Students begin by brainstorming to identify key concepts and gaps in their knowledge. With the guidance of their tutor, students translate their brainstorming results into learner outcomes (e.g., identify language developmental benchmarks from ages 24–36 months, identify a community health care team, and explore the meaning of “developmental language disorder”). Learner outcomes guide the research that students complete prior to their next tutorial. At that next meeting, students share products of their research, evaluating what they have learned and learning from each other. They also provide positive and constructive feedback on group process, evidence-based practice, and clinical reasoning, including providing feedback on each member’s goals within the group (e.g., students might have personal goals such as providing succinct summaries of the literature, completing a critical review, or speaking up more or less).

Conclusion

Consistent with the PBL philosophy, our admissions process at McMaster University involves multiple mini-interviews (MMIs) in which the teacher presents students with problems, and those students must respond “in the moment”— to practice three critical components of a successful self-directed learning program: (1)  one’s ability to problem-solve; (2) conduct a self-appraisal; and (3) relate to others. Canada does not have undergraduate speech-language pathology programs, and we have relatively few prerequisites for admission. We believe that it is important to bring together students from diverse educational and work experience backgrounds so that the heterogeneity of the group itself becomes a valuable learning resource.

Although PBL requires a significant up-front time commitment from faculty and staff, the resulting outcomes are energizing for both students and faculty. We highly recommend it.

References

Neufeld, V. R., & Barrows, H. S. (1974). The “McMaster philosophy”: An approach to medical education. Journal of Medical Education, 49, 1040–1050.

Solomon, P., & Baptiste, S. (Eds.). (2004). Innovations in rehabilitation sciences education: Preparing leaders for the future. Heidelberg, Germany: Springer.