Sustaining Problem-Based Learning (PBL) in medical programs: insights from two continents

Background Problem-based learning (PBL) is a well-established approach in health-professions education, valued for promoting self-directed collaborative learning, but its implementation varies widely across contexts. Linköping University and Moi University have adopted PBL for decades despite facing challenges such as limited resources. This was a comparative study aiming to explore experience of first-year medical students and tutors regarding PBL in two universities in different continents. Methods Four focus groups were conducted with tutors and students respectively, from Moi University and Linköping University. In total, 24 participants were included. Data was analyzed using thematic analysis. Results A prominent main theme was identified: system support for upholding the principles of PBL. Within this theme, five subthemes were developed unravelling various understandings of the core principles of PBL, as well as practices of PBL. The role of tutors was considered crucial, although their prerequisites and systemic support were not always sufficient. The findings highlight how clarity of procedures requires solid and committed leadership on various levels for a successful PBL process. Conclusions PBL supports active, collaborative learning, but its sustainability depends on having adequate institutional support. Without clear leadership, adequate resources, and ongoing competence development, the PBL principles risk being diluted over time.