A theory-driven approach to assessing the cognitive effects of PBL

Medical schools are increasingly looking to case-based formats such as problem-based learning (PBL) for their medical students. However, the effects of PBL have not been adequately assessed for an informed decision. An approach to assessment should consider not just the knowledge outcomes expected of all students, but should be tailored to the theoretical goals of PBL: clinical reasoning, integration of scientific and clinical knowledge, and lifelong learning skills. This means that problem-solving processes as well as products need to be measured. In addition, cognitive measures associated with expert performance can be used to assess the extent to which PBL affects the development of expertise. In this study, students taking an elective in PBL were compared with students taking other electives on a realistic pathophysiological explanation task. The problem-solving protocols were examined for coherence, use of science concepts, strategy use, and self-directed learning. The results indicate that cognitive measures can be used to distinguish students who have participated in PBL from their counterparts in terms of knowledge, reasoning, and learning strategies. This suggests that such measures may play a meaningful role in assessment of student learning.