Evaluating the Impact of a Problem-Based Learning Curriculum on Undergraduate Medical Students in Saudi Arabia

The main aim of this study was to examine in detail the benefits and problems of introducing a different method of teaching to medical education, namely the problem-based learning (pBL) method. This technique, in a number of pieces of research, has been shown to be more effective than lecture-based method in fostering better critical-thinking, problem solving, and the self-directed learning skills of students, and also to enhance the acquisition and retention of knowledge. But PBL has not been universally successful. Despite this it has being recommended by medical educators worldwide; yet it remains to be formally evaluated in Saudi Arqbia. To evaluate the impact of PBL to students in particular and to Saudi Arabia in general, a test JiUn of the method was carried out, in which four Saudi medical colleges were selected to participate. The total number of subjects was 484, comprising 232 pre-clinical students (pre-CS) and 252 clinical students (CS) ;from five courses (units/modules) in the medical curriculum. A human genetics module was used as a case subject for the test run, and both pre-clinical and clinical students were assigned randomly to either a PBL or a lecturebased curriculum (LBC) group. Data was collected using six instruments which assessed knowledge, attitude, learning styles and perceptions of students in order to test fourteen hypotheses regarding the benefits of PBL to Saudi undergraduate medical students compared to LBC. Both qualitative and quantitative methods were used to collect and analyze the data. Qualitative data included essay-type written response from students, which was analyzed using Nvivo. For the quantitative data analysis, several analytical procedures within SPSS were employed. These included descriptive and ChiSquared Statistics, Univariate analysis, One-Way and Two-Way ANOVAs and Effect Size calculations. From the randomized controlled trial undertaken on pre-clinical and clinical students, very large differences were found in the outcomes for the two groups. Within the pre-clinical students, those in the PBL group scored significantly lower than those in the LBC group on every indicator of perceived knowledge, learning or examination results. For the clinical students, those in the PBL group scored significantly higher than those in the LBC group; these positive effects of PBL did not include learning outcomes, however. Of the fourteen hypotheses stated, highlighting the benefits of the PBL approach to Saudi undergraduate medical students, none was supported with respect to pre-clinical students, while nine were supported with respect to clinical students. This brought out a large difference between Saudi Arabian pre-clinical and clinical students in response to the intervention of the PBL approach compared to the lecture-based teaching method. These quantitative findings were supported by the qualitative data. Some of the central tenets of PBL are that it enhances knowledge retention, self-directed learning skills and level of motivation. These central tenets were not supported among Pre-CS; however, they were supported by results from CS. The use of PBL was associated with a change in motivating factors from purely selfachievement to the success of the group and shared knowledge. The finding that PBL was significantly valued by CS but not by Pre-CS is discussed in relation to literature written about education and explained by drawing on the distinction between 'transitional semi-PBL' (as experienced by the Pre-CS) and 'rigorously problem-based learning' (as experienced by the CS). This discussion leads to the proposal of an experiential-based learning model (PEBL), which is described in terms of its rationale, its major features and a means for its introduction into the colleges of medicine in Saudi Arabia.EThOS - Electronic Theses Online ServiceGBUnited Kingdo