Future directions for the Bulletin

Problem-based learning (PBL) has been implemented within numerous undergraduate health curricula but less so in workforce training. Public health practice requires many of the skills that PBL aims to develop such as teamwork, selfdirected learning and the integration of multiple sources of information within problem solving. This paper summarises the historical development of PBL and the educational principles underpinning it. It hypothesises that the public health workforce would benefit from some exposure to this type of learning and highlights some of the practical issues for its implementation. Lyndal J. Trevena School of Public Health, The University of Sydney. Email: lyndalt@health.usyd.edu.au The distinguishing feature of PBL is that it begins with a problem and is followed by a student-centred enquiry process. There are no specific readings or lectures before students are presented with the problem. However, students bring previously acquired knowledge from a range of sources to what is usually a group of approximately eight randomly assigned learners and a tutor-facilitator. Students work collaboratively to define the problem, formulate enquiry plans and identify external sources for solving the problem. They also work together to analyse information and apply it. In medical education the problem often has a simulated or virtual patient, and uses a video or sometimes computer images of patient signs, symptoms, pathology and radiology results to mimic professional practice. The PBL process usually occurs over several tutorials within a week, allowing time for information to be gathered from external sources and brought back to the group process. Educational principles underpinning PBL Barrows defined four broad goals for PBL:3 (1) Motivational learning (2) Developing effective clinical reasoning (3) Developing self-learning skills (4) Structuring knowledge in clinical contexts. These goals were subsequently expanded by Schmidt,4 who defined seven steps to the PBL process (Box 1). Many variations to, and newer versions of, PBL have been developed since Barrows’work in the 1970s and Schmidt’s in the 1980s, but most educators would probably agree that the principles above are the foundation on which PBL is built. Box 1. Seven steps in problem-based learning.