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      The efficacy of self-directed learning versus problem-based learning for teaching and learning ophthalmology: a comparative study

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          Abstract

          Introduction

          Self-directed learning (SDL) and problem-based learning (PBL) are fundamental tools to achieve lifelong learning in an integrated medical curriculum. However, the efficacy of SDL in some clinical courses is debated.

          Aim

          The aim of the study was to measure the effectiveness of SDL for an ophthalmology course in comparison with PBL.

          Methods

          A cross-sectional study was conducted with fifth-year medical students enrolled in an ophthalmology course. SDL comprised four case-based scenarios guided by several questions. PBL comprised three sessions. An ear, nose, and throat (ENT) course was selected for comparison as a control. At the end of the course, 30 multiple-choice questions (MCQs) for both SDL and PBL were assessed and analyzed against their counterparts in the ENT course by an independent t-test.

          Results

          For the SDL component of the ophthalmology course, the number and percentages of students attaining high (n = 6/60, 10%) and moderate (n = 15/60, 28.3%) scores on an MCQs written exam were evaluated. For the PBL component, high scores were seen for 23.3% (n = 14/60), and moderate scores for 33.3% (n = 20/60) of the participants. For the SDL component of the ENT course, the number and percentages of students attaining high (n = 14/60, 23.3%) and moderate (n = 17/60, 28.3%) scores were recorded. For the PBL component, high (16/60, 26.6%) and moderate (17/60, 28%) scores were recorded. Significant p-values were obtained between the results for SDL and PBL in the ophthalmology course ( p = 0.009), as well as between SDL results for both courses ( p = 0.0308). Moreover, differences between the SDL results of ophthalmology and the PBL results of ENT ( p = 0.0372) were significant.

          Conclusion

          SDL appears to be less valuable for promotion of self-readiness. Periodic discussions in small groups or by panel discussion are strongly recommended for students to enhance readiness with SDL.

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          Problem-based learning: future challenges for educational practice and research.

          Diana Dolmans, Ineke H. A. P. Wolfhagen, W Grave … (2005)
          Problem-based learning (PBL) is widely used in higher education. There is evidence available that students and faculty are highly satisfied with PBL. Nevertheless, in educational practice problems are often encountered, such as tutors who are too directive, problems that are too well-structured, and dysfunctional tutorial groups. The aim of this paper is to demonstrate that PBL has the potential to prepare students more effectively for future learning because it is based on four modern insights into learning: constructive, self-directed, collaborative and contextual. These four learning principles are described and it is explained how they apply to PBL. In addition, available research is reviewed and the current debate in research on PBL is described. It is argued that problems encountered in educational practice usually stem from poor implementation of PBL. In many cases the way in which PBL is implemented is not consistent with the current insights on learning. Furthermore, it is argued that research on PBL should contribute towards a better understanding of why and how the concepts of constructive, self-directed, collaborative and contextual learning work or do not work and under what circumstances. Examples of studies are given to illustrate this issue.
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            Problem based learning.

            Natasha Wood (2003)
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              A controlled trial of active versus passive learning strategies in a large group setting.

              Reginald Morgan, Paul Haidet, Meghan Moran … (2003)
              To compare the effects of active and didactic teaching strategies on learning- and process-oriented outcomes. Controlled trial. After-hours residents' teaching session. Family and Community Medicine, Internal Medicine, and Pediatrics residents at two academic medical institutions. We randomly assigned residents to two groups. One group received a didactic lecture on effective use of diagnostic tests; during this session, the teacher spent a full hour delivering content. The other group received the same content in a session structured to foster resident-to-resident interactions. In the latter session, the teacher spent only 30 minutes directly delivering content to residents. We measured residents' knowledge about and attitudes toward the session content before, immediately after, and one month after each session. We measured residents' perceptions of engagement and session value immediately after each session. We employed blinded observers who used a structured instrument to observe residents' activities during each session. Both teaching methods led to improvements in residents' scores on both knowledge and attitude assessments. The amount of improvement was not statistically different between groups. Residents in the active learning session perceived themselves, and were observed to be, more engaged with the session content and each other than residents in the didactic session. Residents in the didactic session perceived greater educational value from the session compared to residents in the active session. We reduced the amount of time spent in teacher-driven content delivery by 50 percent and covered the same amount of content with no detrimental effects on knowledge acquisition or attitude enhancement. Teaching strategies that foster learner-to-learner interactions will lead to more active engagement among learners, however, these learners may value the session less. Further research is needed to explore learner perceptions of the teaching process and other outcomes of active learning in medical education.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Adv Med Educ Pract
                Journal ID (iso-abbrev): Adv Med Educ Pract
                Journal ID (publisher-id): Advances in Medical Education and Practice
                Title: Advances in Medical Education and Practice
                Publisher: Dove Medical Press
                ISSN (Electronic): 1179-7258
                Publication date Collection: 2018
                Publication date (Electronic): 04 September 2018
                Volume: 9
                Pages: 623-630
                Affiliations
                [1 ]Pathology Department, Faculty of Medicine, Assuit Branch, Al-Azhar University, Cairo, Egypt, Ihab.bassyouny@ 123456azhar.edu.eg
                [2 ]Pathology Department, Faculty of Medicine, Albaha University, Albaha, Saudi Arabia, Ihab.bassyouny@ 123456azhar.edu.eg
                [3 ]Department of Surgery, Faculty of Medicine, Albaha University, Albaha, Saudi Arabia
                Author notes
                Correspondence: Ihab Shafek Atta, Pathology Department, Faculty of Medicine, (Assuit Branch), Al-Azhar University, Assiut, 71524, Egypt, Tel +20 10 0155 6079, Email Ihab.bassyouny@ 123456azhar.edu.eg
                Article
                Publisher ID: amep-9-623
                DOI: 10.2147/AMEP.S171328
                PMC ID: 6129018
                PubMed ID: 30233269
                SO-VID: a31be333-d304-490d-9b02-06fa19af253b
                Copyright © © 2018 Atta and Alghamdi. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Subject: Original Research

                Keywords: sdl,pbl,ophthalmology,ent,lifelong learning,teaching tools
                Data availability:
                Keywords: sdl, pbl, ophthalmology, ent, lifelong learning, teaching tools

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