Problem-Based Learning Vs. Traditional Teaching in Respiratory Care Education Introduction

PBL vs. Traditional

Two of the methods of pedagogy that are currently employed in respiratory therapy are Problem-Based Learning and Traditional Teaching. Both instructional methods can provide a strenuous curriculum for the student interested in comprehensive training in the field of respiratory therapy, and each method has its advantages and (of course) its disadvantages. The focus of this study will be to determine which pedagogical methodology provides the most efficient and effective results in a respiratory therapy educational setting.

To accomplish that objective, the study will administer surveys in questionnaire form to students attending two separate schools that offer training in respiratory therapy. The questionnaires will provide a quantifying response to qualitative, and quantitative, information. Each school's pedagogy will represent either problem-based or traditional teaching methods and students from each school will be asked to complete pre and post training questionnaires and surveys. Additionally, students will be tested on their knowledge of respiratory therapy training techniques, standards and requirements. Results from both schools will be analyzed and compared in order to determine if one method offers advantages over the other.

Importance of the Study

A number of recent studies have shown the importance of education and the role that instructional designs and pedagogy have in that importance. One study determined that "in recent years the transition from school to working life has acquired a new dimension for education policy and research…education at all levels are becoming empirically evident" (Scheeberger, 1999, p. 612).

This may be especially true in the medical field since it is projected as a field that will continue to grow over the next few decades. Baby boomers in America are turning 65 years of age at a rate of 10,000 per day (beginning in 2011) and will continue to do so for the next twenty years. What that means is that with an aging society there will be an increasing demand for services such as respiratory therapy. It is important to teach the individuals who are in training to understand, comprehend, and obtain the knowledge most helpful to them in their career. Not only will training help them to progress in their chosen career, it will also ensure that patients in need of help, are receiving the best possible care.

Several medical schools have implemented changes to their curriculum in order to facilitate the teaching necessary for those students seeking that knowledge. It is now estimated that more than eighty percent of medical schools in the United States have included some type of problem-based learning in their curriculum. One school that switched from traditional teaching methods to the problem-based method was the medical school at the University of Missouri-Columbia School of Medicine. A recent article extolled the fact that "MU's medical school was among the first to turn to an educational strategy called Problem-Based Learning (PBL)" (Medical News Today, 2011). According to the article, the MU's pioneering curriculum shortens by nearly 60% the amount of lecture times, teaches medicine by using clinical cases and decreases the amount of rote memorization. The teaching method used at MU also achieves outstanding results as reported in the article.

The importance of this study hinges on whether any significant differences can be determined concerning the level of achievement in the two groups of students, their overall level of knowledge, and whether that knowledge can be successfully employed in the field.

Problem-Based Learning

Problem-based learning is centered on the premise that was pioneered by such social scientists as Vygotsky, Dewey and others. Lev Vygotsky wrote "development can be classified into two levels; one is the real level of development on which children can solve problems independently, the other is the potential level of development, on which children can solve problems under the guidance of adult people or in cooperation with peers with higher capability" (Wang, 2009, p. 100). Vygotsky would likely admire the way that problem-based learning addresses the student's potential level of development with its focus on teachers as facilitators of learning, and collaborative, group environments.

Problem-based learning was first introduced as a student-centered instructional theory in the MD program at McMaster University in Canada. When it was first introduced "it heralded a major change in medical school pedagogy that has influenced the education of medical students around the world" (Neville & Norman, 2007, p. 370). According to Neville and Norman the PBL curriculum emphasized small-group tutorials, self-directed learning, a minimal number of didactic presentations and student evaluations that are based on how the student(s) perform in the tutorial (Neville & Norman, p. 370).

The PBL approach at that time (and even currently) was a dramatic change from the traditional teaching methodology, especially in the field of medical studies.Implementing PBL in the classroom meant that an entirely new approach would have to be affected.

Malcolm Knowles, a pioneer in the area of problem-based and self-directed learning once stated that "Teaching is a process of guided interaction between the teacher, the student, and the materials of instruction... Teaching, like medical practice, is mostly a matter of cooperation with nature. The function of the teacher is to guide the student into the kind of experiences that will enable him (sic) to develop his own natural potentialities" (National-Louis, 2005). Knowles presented a new way of teaching and learning that was the basis for many of today's problem-based designs.

The difference between PBL and traditional teaching likely begins with the fact that students learn from each other as well as from the instructor or teacher. The professor no longer stands in front of the class droning on and on about the intimate details of respiratory therapy. Instead the students are required to collaboratively gather data and information from the professor, their peers and the case studies. Learning via the PBL methodology would no longer require rote memorizing of phrases such as acute respiratory deterioration, collagen vascular disease, pulmonary fibrosis or even usual interstitial pneumonia. Instead students would learn by facing challenging, open-ended, ill-defined and ill-structured problems and collaborating on the diagnosis and treatment of the problems they encountered on a case by case situation.

Current literature presents data that supports the use of PBL.

One book on the subject determined that "learning in PBL is…active, deep and meaningful" (Biggs, 2003). An early study touts the fact that the theoretical assertion that PBL fosters a deep approach to learning is supported by a large amount of research especially in medical education "(Albanese & Mitchell, 1993). A book written on medical respiratory equipment with an emphasis for respiratory students states unequivocally that "an emphasis is placed on an understanding of principles involved for the various parts of the ventilator; as opposed to a rote memory approach" (Clark & Bradford, 2004).

Another study concluded that "PBL as a method and philosophy is an effective approach to fostering deeper approach to learning and improving self-directed learning abilities among nursing students" (Ali, Gameel, Sebai, Menom, 2010, p. 188). One study went into more detail as to the reasons why problem-based learning seemed to work so well in the medical field.

The study found that "the basic distinction (to learning approaches) is between a deep approach to learning, where students are aiming towards understanding, and a surface approach to learning, where they are aiming to reproduce material in a test or exam rather than actually understand it" (Allie, Armien, Bennie, Burgoyne, Case, 2007).

Other recent studies found that "self-directed learning (SDL) is a method of instruction that can be defined in terms of the amount of responsibility that the learner accepts for his or her own learning "(Fisher & King, 2010, p. 44) and that the "application of problem-based learning in pedagogy has been show to enhance the SDL ability of nursing students, and thereby develop their capacity to engage in lifelong learning" (Kocaman, Dicle, Ugur, 2009, p. 286).

Current literature certainly is available on extolling the virtues of problem-based learning, however, that does not necessarily cast traditional teaching in a bad light. Instead, traditional teaching may actually be an advantage regarding the teaching of students in the study of respiratory therapy. To discern the advantages or disadvantages of the two systems is the main focus of this study.

Traditional Teaching

Traditional teaching has been an effective teaching style for a number of decades and has been used successfully to teach respiratory therapy and other medical fields.

Depending on exactly what skills are necessary to become efficient at administering treatments in respiratory therapy scenarios, traditional teaching may be the most effective approach for medical students. One recent study found that "when tasks require extensive form acquisition components the traditional classroom environment will most likely be more effective" (McKethan, Rabinowitz, Kernodle, 2010, p. 156). Of course the study was comparing traditional teaching to virtual learning, but its premise still applies.

Another study that specifically searched for differences in learning of medical students compared problem based and traditional methods, the study determined that "no significant differences in learning outcomes were found between the two groups" (Lycke, Grottum, Stromso, 2006, p. 721). However,….....