Cognitive consequences of problem-based learning for the early development of medical expertise

Background: Problem-based learning (PBL) is used by many medical schools as either a full-time curriculum or an addition to a traditional curriculum. Purposes: The effects of PBL are examined using frameworks derived from theories of expertise and PBL's goals. Methods: Students in full-time PBL, elective PBL, and full-time traditional curricula at two schools were compared on a series of pathophysiological explanation tasks over the course of the Ist year of medical school. The students' explanations were analyzed using written protocol analysis techniques derived from cognitive science research. Results: PBL students generate explanations that are more accurate, coherent, and comprehensive than non-PBL students. They transfer the reasoning strategies that they are taught and are more likely to use science concepts in their explanations. This effect is stronger for the full-time PBL students. Conclusion: The results demonstrate strong benefits of PBL, particularly for the first-time students. Copyright (C) 1998 Lawrence Erlbaum Associates,Inc.