Implementing problem‐based learning within a lecture‐dominated curriculum: Results and process

In 1972, the School of Medicine at the University of Troms⊘, Norway, started a highly integrated, community‐oriented, and organ‐course‐based undergraduate program. The teaching, however, is conventional: mainly lecture based and teacher directed. In 1989, the organ course on the skeletomuscular system, placed early in the curriculum, was transformed into a problem‐based format. A comparison of the students’ knowledge and attitudes was made between two classes: the one using problem‐based learning (PBL) and the class of the previous year who had the conventional format (control group). We found no difference between the two classes in knowledge, but there were many differences in the students’ attitudes toward what they had learned and the learning conditions—all in favor of the problem‐based format. For instance, 69% (vs. 4% for controls) thought that the course had stimulated independent thinking, 72% (vs. 26%) became stimulated to read medical literature instead of merely notes and handbooks, and 87% (vs. 0%) thought that the course trained them to a great extent in problem solving. In toto, the costs measured in number of teacher hours increased by 24% in the problem‐based course (due to added tutorials), but for the students decreased by 3% their prescheduled hours. Two conclusions are that this change was a small (only one course in an entire curriculum) but important step to be taken in the Troms⊘ medical school and that it is possible to implement considerable changes even in a conventional learning environment.