The Saudi Dental Journal (2016) 28, 155161

King Saud University

The Saudi Dental Journal

www.ksu.edu.sa
www.sciencedirect.com

REVIEW ARTICLE

How eective the problem-based learning (PBL) in

dental education. A critical review
Ali Alrahlah *

Restorative Dental Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia

Received 24 April 2016; revised 7 August 2016; accepted 23 August 2016

Available online 18 October 2016

KEYWORDS Abstract The purpose of this critical review is to explore the research supporting the effectiveness
Dental education; of problem-based learning (PBL) as a teaching method in dental education. PBL was developed
Problem-based learning; more than 40 years ago in reaction to the problems and limitations of traditional teaching
Effectiveness; approaches. Here, aspects of the PBL teaching approach are reviewed, and the reasons for the sub-
Critical review stantial effect of this approach on dental education are discussed. Evidence shows that students in
PBL-based courses exhibit superior professional skills and effective learning compared with those
instructed using traditional approaches.
2016 The Author. Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an
open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Contents

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
2. Denition of PBL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
3. Effective teaching and the PBL approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
4. Education, theory, and psychology underlying PBL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
4.1. The activation-elaboration theory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
4.2. The situational interest theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
5. PBL features and process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
6. Advantages and disadvantages of PBL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
7. PBL characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
8. PBL and student motivation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

* Address: Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi
Arabia.
E-mail address: [email protected].
Peer review under responsibility of King Saud University.

Production and hosting by Elsevier

http://dx.doi.org/10.1016/j.sdentj.2016.08.003
1013-9052 2016 The Author. Production and hosting by Elsevier B.V. on behalf of King Saud University.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
156 A. Alrahlah

9. The tutors role in PBL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

10. Assessing PBL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
11. Effectiveness of PBL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
12. Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Conict of interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

1. Introduction claims made for the effectiveness of PBL as a teaching

approach are explored.
The quality and effectiveness of university education are of
major concern to university administrators (Devlin and 2. Denition of PBL
Samarawickrema, 2010). Recently, some dental schools in
Saudi Arabia have proposed the use of a new curriculum based Barrows and Tamblyn (1980) dened PBL simply as the
on a student-centered, rather than teacher-centered, approach. learning which results from the process of working toward
This curriculum is designed to promote self-learning and life- the understanding of, or resolution of a problem (Barrows
long learning. Patient cases are used in a collaborative learning and Tamblyn, 1980, p. 18). The students tutor guided them
model, such as one employing problem-based learning (PBL), to work on clinical and biomedical problems (OGrady et al.,
as a central focus to provide relevance to the topics covered in 2012).
lectures, seminars, and laboratory courses (Rahman, 2011). PBL was developed in response to the problems and limita-
Although the effectiveness of teaching is best estimated in tions of traditional teaching approaches. It is an encouraging
association with individual goals, some characteristics of way to learn, as students work with problems that are chal-
teaching are highly demanded, as demonstrated by agreement lenging and observed in their real life. Students realize that
among faculty members and evidence of student learning. A the learning needed to solve and understand existing problems
method considered to be effective in one situation may not is valuable (Barrows, 2002).
be in another. For example, a very good lecture that provides PBL has been introduced and developed into an important
the answer to a problem may be counted as an effective teaching method by which students gain the skills, knowledge,
method when the goal is solely to provide knowledge. How- and attitude, and it is an important part of many curricula.
ever, when the goal is to motivate students to develop an Three characteristics of PBL distinguish it from traditional
answer to a specic problem, then this well-designed lecture teaching approaches (Walton and Matthews, 1989). First, the
may be considered to be ineffective. Stimulating students to curriculum is organized around problems, instead of disci-
think by focusing their attention on a particular problem, plines, and the emphasis is on integrated learning, instead of
rather than confusing them, is important (Atkins and Brown, separation into basic and clinical science components. Second,
2002). it is dominated by conditions that simplify learning, such as
The various teaching methods used in medical and dental small-group teaching, a student-centered approach, active
schools include lectures, small-group teaching, and laboratory study, and independent learning. Third, it is determined by
sessions. PBL, a small-group teaching approach, requires stu- outcomes, such as improved functional knowledge, develop-
dents to use information to solve a problem, which is more ment of the skills and motivation needed for lifelong learning,
effective than learning by reading or listening. In this and the development of self-assessment skills.
approach, students are more active and thus can develop a
variety of skills, such as teamwork, problem formulation, 3. Effective teaching and the PBL approach
information nding, discussion and explanation of new infor-
mation to others, decision making, and conclusion formula-
Biggs and Tang (2011) dened effective teaching as getting
tion (Polyzois et al., 2010; Wood, 2004; Onyon, 2012). PBL
most students to use the level of cognitive processes needed
is now used in many higher-education institutes globally, and
to achieve the intended outcomes that the more academic stu-
it has been shown to be superior to more traditional methods
dents use spontaneously (Biggs and Tang, 2011, p.4). Effec-
(Dennick and Exley, 2004).
tive teaching is well known to be directed and focused on
PBL was introduced to replace traditional teaching meth-
how students learn (Devlin and Samarawickrema, 2010).
ods in health care schools. The concept was developed in the
How effectively faculty members teach depends on what
late 1960s in the School of Medicine at McMaster University
they think teaching is. Three levels of thinking about teaching
in Canada. PBL has spread throughout the world to institutes
have been recognized. The rst two levels are known as blam-
such as the University of New Mexico in the United States and
ing models, which consist of blaming the student and the tea-
University of Limburg at Maastricht in the Netherlands. The
cher, respectively. The third model incorporates learning and
implementation of PBL expanded steadily during the 1970s
teaching, and considers effective teaching to motivate students
and 1980s, and a large number of medical schools had
to use learning activities to achieve learning outcomes. Stu-
approved PBL as an essential part of their curricula by the
dents may use lower levels of cognitive learning activities than
1990s. It is currently implemented in many areas of health edu-
required to achieve outcomes, which leads to a supercial
cation, such as dentistry, pharmacy, and nursing, in universi-
approach to learning, or they can use high-level activities suit-
ties worldwide (Polyzois et al., 2010). In this review, the
able for accomplishing proposed outcomes, leading to a deep
Effectiveness of PBL in dental education 157

learning approach. Effective teaching supports suitable learn-

ing activities and does not support unsuitable ones (Biggs
and Tang, 2011).
The dominant goal of the PBL approach is to show stu-
dents the relevance of the subject matter by placing it in a suit-
able and realistic practical context. In addition, PBL is
constructed to promote numerous required learning outcomes
and goals, including: (1) helping students build a wide and ex-
ible knowledge base, (2) helping students become effective col-
laborators, (3) improving effective problem-solving skills, (4)
motivating students to learn intrinsically, and (5) developing
self-directed learning skills. PBL has been applied in many pro-
grams and elds across many levels of education worldwide; it
can be considered to be one of the few curriculum-wide edu-
cational innovations surviving since the 1960s (Loyens et al.,
2011; Bridges et al., 2012, p. 3).

4. Education, theory, and psychology underlying PBL

The performance of students taught using PBL tends to uctu-

ate slightly, according to examination scores, and some Figure 1 The PBL cycle.
researchers have claimed that the theoretical basis of PBL is
dubious. PBL usually forms part or all of health and medical
school curriculum content. Thus, tutors engagement with edu- of new knowledge into present knowledge structures
cational theory that supports this teaching method and under- (Schmidt et al., 2011).
standing of how it can help students in their future jobs are
important (Onyon, 2012). 5. PBL features and process

4.1. The activation-elaboration theory Several features of PBL are key in attaining set goals: the
inclusive PBL tutorial process, facilitation, the problems used,
The activation-elaboration theory has three features: activa- self-directed learning, collaboration, and post-problem reec-
tion of prior knowledge, elaboration and context matching tion. A PBL tutorial session begins with the provision of infor-
to enhance memory, and information recall. Prior knowledge mation about a complex problem to a group of students.
determines what can be learned about a problem. Its activation Students must gain further information about the problem;
helps new learners by simulating links between new and old they may collect evidence by performing experiments or doing
information (Onyon, 2012; Schmidt, 1993). A problem involv- other research. At some stage in the investigation of the prob-
ing the underlying physiology and pathology of medical condi- lem, students normally suspend what they are doing to review
tion can facilitate the retention of new knowledge by building and think about the information they have gathered in their
on previously acquired relevant basic knowledge. Problem initial search; they then try to generate questions about that
solving in the context of small-group teaching has been shown information, and make assumptions about primary cause that
to activate prior knowledge, thereby facilitating the handling may help to explain the problem. Thereafter, students can for-
of new information (Onyon, 2012). mulate ideas or concepts, which requires additional learning
with the purpose of solving the problem. After considering
4.2. The situational interest theory the problem with their gathered knowledge, the students divide
up and independently research the problems they have identi-
The situational interest theory underlying PBL holds that ed. They then regroup to share what they have learned, and
problem solving makes students willing to grasp additional to review their assumptions or generate new assumptions to
information about a given topic, increasing their focus and gain new knowledge. At the end of the PBL session, students
willingness to learn. Situational interest refers to stimulation go through the problem reection or feedback stage to summa-
by a captivating or attractive problem in a given situation. rize the lessons being taught and consider their performance in
The psychological processes underlying the need to learn can collaborative problem solving and self-directed learning.
be explained by inconsistency theory, proposed by investiga- Finally, the students assess their understanding of the problem
tors of epistemic curiosity. People seem to have a natural afn- and their progress toward a solution (Bridges et al., 2012). The
ity to learn about the world when they face something that PBL cycle is shown in Fig. 1.
they do not know about or that lies beyond their expectations. In an ideal PBL process, students start by identifying the
Thus, they experience situational interest, which allows them nature of the problem; they must then expand their knowledge
to realize the knowledge gap between previous knowledge about it and work toward nding an effective solution. This
and what they currently want to know. This situation has been process requires a structured and systematic approach; stu-
referred to as a cognitively induced experience of lack of dents are, therefore, motivated to present the problem in a pos-
knowledge. It initiates knowledge-seeking behavior, which itive systematic way. The ideal PBL process consists of the
aims to identify the knowledge gap through the integration following ve steps (Campbell and Norton, 2009).
158 A. Alrahlah

communication, teamwork, and self-directed learning; and

Table 1 Advantages and disadvantages of PBL (Wood, 2003).
improved motivation and enjoyment of working together on
Advantages of PBL Disadvantages of PBL a problem. For example, for tutors in health education, this
Student centered PBL: It fosters Tutors who cannot teach: integrated approach gains when linking clinical cases with
active learning, improved Tutors enjoy passing on their basic science, by preparing students to solve clinical problems
understanding, and retention own knowledge and based on basic principles and previous knowledge. Further-
and development of lifelong understanding so may nd PBL more, skills learned and experienced in the process of PBL,
learning skills facilitation dicult and such as teamwork, delegation, and the use of relevant litera-
frustrating ture to solve a clinical problem, are important for professional
Generic competencies: PBL Human resources: More sta
work after graduation (Onyon, 2012).
allows students to develop have to take part in the tutoring
generic skills and attitudes process
Learning to work in the PBL group is another important
desirable in their future practice life skill. Group learning also provides chances for students
Integration: PBL facilitates an Other resources: Large numbers to network, exchange ideas and knowledge, and respect differ-
integrated core curriculum. of students need to access the ent views. Students may learn best by teaching each other, and
same library and computer working in groups provides them with the chance to polish
resources simultaneously their knowledge and obtain it in other ways. Furthermore,
Motivation: PBL is fun for Role models: Students may be learners gain more knowledge in groups than in other teaching
students and tutors, and the deprived access to a particular settings, perhaps because they are more engaged and involved
process requires all students to inspirational teacher who in a in the learning process (Savin-Baden and Major, 2004). Table 1
be engaged in the learning traditional curriculum would
summarizes the advantages and disadvantages of PBL.
process deliver lectures to a large group
Deep learning: PBL fosters Information overload: Students
deep learning (students interact may be unsure about self- 7. PBL characteristics
with the learning materials, directed study
relate concepts to everyday Traditional teaching approaches often follow a linear path,
activities, and improve their
whereby the tutor orders what is to be done. S/he presents
understanding).Constructivist
detailed information about a particular topic, and students
approach: Students activate
prior knowledge and build upon then solve the given problem. In PBL, the problem is presented
rst and students then work in small groups to solve it.
PBL has been developed and applied in a wide range of dis-
ciplines. The core model of PBL (Barrows, 1996) is composed
of the following six characteristics.

Step 1: Groups are formed. Students are initiated into the (1) Learning is student-centered. Despite the tutors super-
fundamentals of this instructional approach and its meaning vision, students must take all responsibility for their
to them individually. They start to identify differences between own learning, recognition of their need for better under-
traditional teaching methods and PBL. Then, the role of the standing, and handling of the search for information
tutor/facilitator is claried. The groups agree on fundamental and sources, such as books, journals, and online
rules of behavior within the group and manage their roles. The resources.
importance of the leader and scribe are specically (2) Learning occurs in small student groups. In most early
emphasized. PBL sessions, these groups consist of ve to nine stu-
Step 2: Groups start on their rst task by trying to under- dents. At the end of each course of study, the students
stand the problem. They argue from the perspective of their are assigned randomly to new groups with new tutors.
present knowledge and experience: what is known? What is This approach gives them more practice in studying
not known? Students agree on a common view of the problem, effectively with different groups of students.
identify gaps in their knowledge, and decide what needs to be (3) Tutors are facilitators or guides. The role is better
explored and who will do which part of the research. understood with regard to metacognitive communica-
Step 3: Students independently report the results of their tion. The tutor asks her/his students different sorts of
research to the group. This report must be a clear summary question that they are supposed to be asking themselves
and be linked to the groups understanding of what the prob- to enhance their understanding and enable them to han-
lem is. dle problems more efciently. Ultimately, the students
Step 4: Students review their new knowledge and reect on take on this role, stimulating each other. The non-
what it means in terms of their perception of the problem. New expert tutor concept, which holds that tutors should lead
gaps in their knowledge are identied. Other research needs are units in which they are not experts, was introduced to
also identied and met by one member of each group. prevent tutors from returning to the old teaching
Step 5: The process continues until the students are able to method of giving students direct information and guid-
formulate a suitable answer to the problem. ance. Tutors should, however, be experts in the difcult
role of teaching.
6. Advantages and disadvantages of PBL (4) Problems form the organizing focus and stimulus for
learning. In PBL for health and medical education,
patient and public health problems are presented in var-
Advantages of PBL over traditional approaches include
ious formats, such as written case scenarios, simulated
improved integration of basic and clinical skills; improved
Effectiveness of PBL in dental education 159

patients, computer simulations, and video clips. This should be only a facilitator of learning (Davis et al., 1992;
approach challenges students in practice, underscores Schmidt et al., 1993). In one study, students tutored by staff
the importance of learning, and motivates them to learn; members usually performed better on nal examinations than
they try to understand the problem from the perspective did those taught by peers, although the differences were small.
of other subjects, such as basic sciences. Thus, the prob- Another study showed that student tutors performed differ-
lem requires them to focus on integrating knowledge ently from staff tutors, in that they showed a better under-
from many disciplines to obtain particular information. standing of the nature of the problems that students face
(5) Problems are a vehicle for the development of problem- when trying to learn about a particular problem. Moreover,
solving skills. For example, in health education, a student tutors show more special interest in their students.
patient problem is introduced in the same way as in real Staff tutors show more overuse of their expertise in the subject
life. The layout of the problem should allow the students of a problem. In terms of the skills needed for small-group
to ask questions of the patient, perform physical exam- teaching, one study showed that students and staff members
inations, and request laboratory tests. Students should gave similar importance to the use of a teaching style that lets
obtain the results of these investigations as they work students deal with the tutorial discussion process. Both groups
through the problem. of students felt that tutors should perform as role models in
(6) New information is attained through self-directed learn- terms of motivating critical thinking and reection (Schmidt,
ing. Students are likely to learn and gather expertise 1995). Students mainly highlighted the importance of tutors
through their own studying and research, as profession- expertise in the topic of the problem (Schmidt, 1995).
als do. Students work together, discussing, reviewing, The role of the tutor changes from information presenter to
comparing, and debating what they have learned in problem-solving session facilitator. Tutors monitor students
the course of this self-directed learning (Barrows, 1996). by supervising discussion and asking questions that lead accu-
racy, relevance, prompting students to search for information
to analyze the problem, and encourage participation of the
8. PBL and student motivation whole group. Thus, tutors guide students to learn key con-
cepts, facts, and processes linked to the course unit. PBL tutors
Many supporters of PBL presume that this teaching method is must nd or create suitable and helpful problems based on
very motivating for students. Particular features of PBL, such clear learning outcomes (Allen et al., 2011).
as working on real-life problems as an individual in a small The successful implementation of PBL depends on the
group under intermittent supervision, likely encourage student tutors framing of active student learning and building on
motivation and learning. Motivation operationalizes students knowledge. For instance, PBL tutors can prepare mini-
circumstantial interest, which is interest prompted by environ- lectures to help students nd missing information or useful
mental stimuli, such as the problem or the facilitators discus- resources, to dig deeper into particular topics. Tutors can also
sion of an interesting fact (OGrady et al., 2012). join discussions by listening and asking questions (Hmelo-
Few empirical studies have explored how PBL affects stu- Silver et al., 2007).
dents motivation to learn. Intrinsic interest was the motiva-
tional factor that can be measured for the given topic. For 10. Assessing PBL
example, Schmidt and Moust (1995) were the rst researchers
to test a path model in investigating associations among PBL The assessment of PBL is challenging, as students are given
features, such as the quality of problems and tutors, group autonomy to set learning goals that may or may not meet
functioning, intrinsic interest, and time spent on self-study. the tutors expectations. In a previous study, progress testing
Group functioning refers to the ways in which students inter- theory was used for PBL assessment (Schmidt, 1995). Progress
act with others in their PBL groups, including the level of tests were administered to all students in a particular course,
teamwork and whether group discussions are interesting. The and the researchers then tried to evaluate knowledge gained
outcomes, in terms of motivation students by their tutor, were over a long period of time, instead of that acquired in a short
linked positively to intrinsic interest in the topic (Schmidt and period of time before an examination. A memorization-
Moust, 1995). These results have been conrmed in other stud- oriented learning style was correlated negatively with meaning-
ies, which have found a strong association between group ful learning, while the accomplishment on progress tested was
functioning and intrinsic interest in the topic. These ndings correlated positively with meaningful learning (Schmidt, 1995).
indicate that the way students work together in groups, such One difculty in evaluating PBL is that the process used to
as by creating learning objectives, playing around with ideas solve a problem and the solution reached are equally impor-
and assumptions that may clarify the facts introduced in the tant. In addition, social interactions in a PBL group are com-
problem, helping group members, and giving explanations, plex; they unfold in sequence over time. Evaluation of the
has a positive effect on students perceived interest in a topic acquisition of such skills is quite difcult. For instance, knowl-
(OGrady et al., 2012). edge evaluations have been used to assess students in PBL
courses, but this approach does not effectively capture the
9. The tutors role in PBL acquisition of collaboration skills during PBL. Assessment
by facilitators might be better, but it could affect group har-
The role of the tutor in PBL has been a matter of heated mony. Moreover, the issue can be even more complicated
debate; some scholars argue that the tutor must be an expert when students have worked as facilitators or co-facilitators
in the subject taught, whereas others believe that the tutor (Albanese and Dast, 2014).
160 A. Alrahlah

11. Effectiveness of PBL had acquired the same information in traditional learning set-
tings, such as lectures. Some researchers have proposed that
The claims made for PBL indicate improvement in higher- students in PBL courses develop greater clinical competencies.
education outcomes (Gijbels et al., 2005). The results of studies Moreover, one study showed a signicant difference in perfor-
exploring the inuences of PBL are conclusive about the abil- mance on an ethics PBL task in Harvard medical students
ity of students to solve problems (Gijbels et al., 2005). (Savin-Baden and Major, 2004). Another study conducted in
An understanding of effective teaching is necessary to the context of a dietetics and nutrition course showed that stu-
ensure the quality of dental education. This understanding dents in PBL groups developed greater thinking ability and
must incorporate the skills and practices of effective teaching problem-solving skills than did those instructed using tradi-
staff and the ways in which teaching is practiced in overlapping tional methods (Savin-Baden and Major, 2004).
and various contexts (Devlin and Samarawickrema, 2010). Data on the inuences of PBL are affected by the way in
Allen et al. (2011) argued that PBL methods improve the which students skills and knowledge are assessed. The effec-
effectiveness of student learning, enhance student performance tiveness of PBL will likely be more apparent when adequate
in challenging tasks, and promote better knowledge retention. assessment methods are used (Dochy et al., 2003). When
PBL appears to have strong effects on learning and accom- assessment depends only on factual recall, the success of
plishment compared with other approaches in which learning PBL as part of a curriculum appears to be questionable.
is not based on problem solving. Students taught using PBL Assessment should obey the basic rules of testing students in
have shown superior learning acquisition compared with those association with curriculum outcomes, and should incorporate
taught under control conditions, in which problems were not a suitable variety of methods (Wood, 2003).
the focus of attention and students were not encouraged to PBL may be used as the backbone of an entire curriculum
use their prior knowledge (Schmidt et al., 2011). or as the chosen approach for some courses. A course can be
The PBL process can initially appear discouraging to those designed to involve mixed teaching methods (including PBL)
exposed only to traditional teaching methods. In the begin- to attain learning outcomes, including students skills, knowl-
ning, students in groups have contradictory views about the edge, and attitudes. Complementary lectures may be appropri-
problem and its meaning. These perspectives must be investi- ate to introduce new topics or to deliver overviews of
gated further to reach a shared understanding of the problem challenging topical material in combination with PBL prob-
under discussion. This stage is difcult for students who are lems. Furthermore, adequate time should be given each week
new to this approach, as they are not used to stating their for students to work on self-directed learning (Wood, 2003).
views and may be unwilling to argue with other group mem- Although no single approach to dental education can be
bers. On the other hand, students who are not stimulated to deemed to be optimal, the PBL approach has been found to
clarify their understanding and attitudes from the beginning be highly successful, mainly in the elds of health and medi-
will suffer at a later stage (Campbell and Norton, 2009). cine. This success is due to the development of students cogni-
Several studies have examined the learning outcomes asso- tive and research skills, and underlies the increasing popularity
ciated with the traditional lecture-based approach. The results of PBL throughout the world. It has also become common in
demonstrate that this method can effectively provide students other disciplines, such as engineering, agriculture, law, busi-
with required knowledge; other methods, however, may be ness, and computing. Many consider PBL to stimulate the
more effective. Moreover, in comparison with other methods, development of a deeper learning approach, which remains
traditional lectures are not ideal for teaching skills or changing with students throughout their lives (Campbell and Norton,
students attitudes (Jeffries, 2014). These results point to the 2009).
benet of reducing the number of lecture hours in health and
medical curricula, replacing them with more effective teaching 12. Summary
methods, such as PBL (Jeffries, 2014).
PBL students and facilitators affect and challenge each In conclusion, evidence clearly supports the effectiveness of
other in different ways, related to aspects such as their opin- PBL in dental education. Through PBL, students learn to
ions about what is considered to be knowledge, the content become associates in the teaching and learning processes; they
and process of interaction, and dealing with conict within take responsibility for their learning, successfully work as part
the group. Most groups try to achieve the learning objectives of a team, cope with new and changing circumstances, and
of the topic as a minimum, due to the students dynamics acquire lifelong learning skills. Therefore, PBL can improve
and the facilitators academic position (Savin-Baden and the critical thinking of dental students, teaching them to ana-
Major, 2004). lyze and solve real problems, which prepares them for their
Several studies have compared the effectiveness of PBL and future careers. This remarkable development in teaching
traditional teaching methods in improving lifelong learning approaches has improved the effectiveness of teaching in den-
skills. Some of these studies, particularly those focusing on tal education institutes.
medical education, have explored clinical performance skills;
they have shown that students in PBL courses perform better Conict of interest
than those in traditional learning settings in most cases. Fur-
thermore, students who had acquired knowledge to solve prob- The author declares that he has no conict of interest associ-
lems were found to be more prone to use their knowledge ated with the material used in the current article and no nan-
spontaneously to solve new problems than were those who cial interest as well.
Effectiveness of PBL in dental education 161

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