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Purpose: The purpose of this study was to assess changes in expectations and perceptions among physician assistant (PA) program matriculants regarding small group problem-based learning (PBL) from the beginning to the end of the first didactic year. Some of the stress experienced by students entering health science professional programs using PBL may be due to lack of awareness of the goals and norms of PBL which differ from those of traditional lecture-based curricula. A change in student expectations as a result of participation in PBL would indicate that these goals and norms can be learned through participation. Methods: The authors developed the PBL Readiness Questionnaire, a 71-item 10-point Likert scale regarding student expectations of the PBL experience regarding self, others and the facilitator. Questionnaire items were developed using data from a student survey as well as literature on characteristics associated with successful performance in a PBL setting. The questionnaire was administered to 60 PA students at the beginning of the first year fall semester and again at the end of the first year spring semester. Results: Analysis revealed a significant change from pre to posttest on total score as well as on the subscales of Expectations of Self and Expectations of Facilitators. The subscale of Expectations of Others approached significance. Conclusions: The change in Expectations of Facilitator may reflect the different role of facilitator vs. lecturer. Facilitators challenge physician assistant students with questions rather than providing information. The change in Expectations of Self could indicate that physician assistant students do not have accurate expectations of their own role in this type of group setting, and the experience of participating in PBL may positively affect their expectations. An area for future study would be a psychometric analysis of the questionnaire items in order to refine the tool and ascertain the reliability and validity of items and subscales. INTRODUCTION Students entering health science programs that utilize small group problem-based learning (PBL) encounter an environment that is novel and stressful to them.1 Some of the stress results from a lack of awareness of the goals and norms of PBL. The goals of PBL are to provide a framework for acquiring clinical knowledge, to develop clinical reasoning and self-directed learning, and to promote an atmosphere that motivates learning.2 A survey of medical students at the University of Sydney identified three concepts that characterize PBL: 1) peer collaboration to develop clinical knowledge and reasoning; 2) independent learning; and 3) problemsolving.3 As a result of the structure and process of PBL, students have multiple roles. In addition to the traditional role of student, they are teachers to their peers, researchers of learning issues developed by the group, and providers of social support to other group members.4 Research advocates socialization of students to these goals and roles as a means to promote increased understanding and active engagement in the PBL process.1,3,5 Students find the perceived lack of explicitly defined content and assignments of the PBL process to be stressful. Determining the breadth and depth of material to be studied through self-directed learning and overlooking or missing important topics are common concerns.6 Students have identified three factors that promote learning in PBL: 1) tutor/facilitator, 2) group, and 3) self-directed Effect of Two Semesters of Small Group Problem-Based Learning (PBL) On Expectations of Physician Assistant Students Regarding Self, Others, and Facilitator Using the PBL Readiness Questionnaire 2 © The Internet Journal of Allied Health Sciences and Practice, 2016 learning.7 According to focus groups and surveys of PBL students, an effective faculty facilitator is a guide rather than a teacher, one who creates a safe learning environment in which every member of the group is encouraged to participate. The effective facilitator intervenes appropriately to promote problem solving and metacognition, but does not lecture, interrupt with their own agenda, or dominate the group.6,8,9 Medical students noted that a good PBL group member is one who is self-motivated, wellprepared, actively participates, and is not rude, competitive, or domineering.6,9 Focus groups of medical students at McGill university described an effective small group as one that is non-threatening, adheres to the group’s goals, encourages teamwork and individual participation, has an effective facilitator, and fosters problem-solving.9 To facilitate the transition from a traditional lecture-based setting to a small group PBL learning environment, physician assistant (PA) studies programs have incorporated opportunities to learn about PBL in their admissions process.10,11 Medical and nursing programs have utilized the Self-directed Learning Readiness Scale for Nursing Education (SDLRSNE) to assess students’ likelihood of success with adult level independent learning environments.12,13 However, the SDLRSNE was not found to be useful in differentiating readiness for PBL when administered to applicants of a graduate PA program.14 Part of the reason for this may be that the SDLRSNE does not contain items that assess important qualities of learning in a small group PBL setting. To rectify this area of concern, one group of educators developed pilot items pertaining to student expectations of the facilitator, expectations of self as related to the group, and expectations of others as related to the group. They found that these pilot items significantly changed on a pre-post questionnaire that was administered to PA applicants on the same occasion as the SDLRSNE.10,14 Therefore, it was determined that there is a need to develop a readiness questionnaire and scale specifically applicable to small group PBL education. The items in the questionnaire should include expectations about self-directed learning and small group process that reflect perceptions of PBL students regarding expectations of self, others, and the facilitator. The PBL readiness questionnaire used in this study was developed not only to assess applicant readiness, but also to assess changes in expectations and perceptions among PA program matriculants from the beginning to the end of the first didactic year. These changes reflect the students’ process of incorporating goals and norms of PBL into their learning styles. It is hypothesized that graduate level PA students will incorporate attributes of small group PBL as they become proficient in the process and thus demonstrate significant change in their expectations of themselves, others, and the facilitator. |
