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      Does blended problem-based learning make Asian medical students active learners?: a prospective comparative study

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          Abstract

          Background

          Asian educators have struggled to implement problem-based learning (PBL) because students rarely discuss their work actively and are not sufficiently engaged in self-directed learning. Supplementing PBL with additional e-learning, i.e. ‘blended’ PBL (bPBL), could stimulate students’ learning process.

          Methods

          We investigated the effects of bPBL on tutorial group functioning (discussion, self-efficacy, self-directed learning, active participation, and tutor’s perceived authority) and students’ level of acceptance of the e-learning elements. We compared PBL and bPBL in a medical university in Japan. In the bPBL condition, the tutor’s instructions were replaced with online materials and short quizzes. After the course, a 13-item questionnaire using a 5-point Likert scale was distributed regarding the tutorial group functioning of the tutorial group (influence of discussion, self-efficacy, self-directed learning, active participation, and tutors’ authority). The mean scores of subscales were compared with analysis of covariance. Knowledge levels were measured using a pre-test post-test design. A multiple regression analysis was performed to explore the association between e-learning acceptance and the subscales related to PBL.

          Results

          Ninety-six students participated in the study (PBL: n = 24, bPBL: n = 72). Self-efficacy and motivation for learning triggered by group discussions was significantly higher for students in bPBL ( p = 0.032 and 0.007, respectively). Knowledge gain in test scores was also significantly better in the bPBL condition ( p = 0.026), and self-directed learning related positively to the acceptance of blended learning ( p = 0.044).

          Conclusions

          bPBL seemed more effective in promoting active learning and improving knowledge, without affecting tutors’ authority. Implementing e-learning into PBL is suggested to be an effective strategy in the Asian context.

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          Most cited references48

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          What drives a successful e-Learning? An empirical investigation of the critical factors influencing learner satisfaction

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            Motivational and self-regulated learning components of classroom academic performance.

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

              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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                Author and article information

                Contributors
                +81 263-37-3359 , ishimizu@shinshu-u.ac.jp
                +81 263-37-2634 , hnaka@shinshu-u.ac.jp
                +81 263-37-2686 , ysato@shinshu-u.ac.jp
                +31(0)43 3885726 , i.wolfhagen@maastrichtuniversity.nl
                +31(0)43 3885728 , kd.konings@maastrichtuniversity.nl
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                15 May 2019
                15 May 2019
                2019
                : 19
                : 147
                Affiliations
                [1 ]ISNI 0000 0001 1507 4692, GRID grid.263518.b, Center for Medical Education and Clinical Training, , Shinshu University, ; 3-1-1 Asahi, Matsumoto, 3908621 Japan
                [2 ]ISNI 0000 0001 1507 4692, GRID grid.263518.b, Department of Internal Medicine II, , Shinshu University, ; 3-1-1 Asahi, Matsumoto, 3908621 Japan
                [3 ]ISNI 0000 0001 1507 4692, GRID grid.263518.b, Department of Internal Medicine IV, , Shinshu University, ; 3-1-1 Asahi, Matsumoto, 3908621 Japan
                [4 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, Department of Educational Development and Research, Faculty of Health, Medicine & Life Sciences, , Maastricht University, ; Universiteitssingel 60, 6229 ER Maastricht, The Netherlands
                Author information
                http://orcid.org/0000-0002-6731-7104
                Article
                1575
                10.1186/s12909-019-1575-1
                6521359
                31092243
                a51e8cd6-91b1-47d4-99da-0538e5833876
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 December 2018
                : 24 April 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;
                Award ID: #15K19145
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Education
                blended learning,health professions education,problem-based learning,quiz,self-directed learning

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