Successful Use of Problem-Based Learning in a Third-Year Pediatric Clerkship

Objective.— To determine the effect of changing from lectures to a problem-based learning (PBL) curriculum on student knowledge accrual and satisfaction with the didactic portion of a clerkship. Design.— Study of cohorts before and after PBL introduction and in comparison with unchanged medicine clerkship. Setting.— Third-year pediatric clerkship at 5 clinical sites. Participants.— The PBL curriculum was introduced in the 1996 academic year. The 2 classes before the intervention served as historic controls (n = 319), whereas the 2 classes after PBL served as the intervention group (n = 320). Intervention.— Small groups of students worked through 6 PBL cases representing common pediatric illnesses. Main Outcome Measures.— Knowledge was assessed with the pediatric and internal medicine subject examination of the National Board of Medical Examiners (NBME); student satisfaction was assessed by an anonymous end-of-rotation questionnaire. Results.— Scores on the pediatric subject examination improved significantly from means of 69.2 and 70.0 in the historic control group to 73.6 and 74.2 in the PBL cohort ( P P Conclusion.— Use of PBL in a clinical clerkship was associated with higher scores on the NBME subject examination and increased student satisfaction. These results should encourage the use of PBL during the clinical years.