Learning from the problems of problem-based learning

Analysis of the literature indicates that the recent rapid rise of PBL has closely paralleled the timing of the information explosion. The growing dominance of PBL could thus worsen the problems of information management in medical education via several mechanisms: first, by creating the impression that a defined spectrum of core factual knowledge suffices for clinical competence despite ongoing knowledge expansion (quality cost); second, by dissuading teachers from refining the educational utility of didactic modalities (improvement cost); and third, by reducing faculty time for developing reusable resources to impart factual knowledge more efficiently (opportunity cost).These costs of PBL imply a need for strengthening the knowledge base of 21st-century medical graduates. New initiatives towards this end could include the development of more integrated cognitive techniques for facilitating the comprehension of complex data; the design of differentiated medical curricula for producing graduates with defined high-priority skill sets; and the encouragement of more cost-effective faculty teaching activities focused on the prototyping and testing of innovative commercializable educational tools.Many doctors have commented that their medical education began in earnest on the first day that they entered the hospital wards as a hands-on practitioner. Claims of this kind support the view that the apprenticeship model of professional learning – which has been the backbone of training in the healing arts for thousands of years [1] – remains as central to medical career development today as ever [2]. A perennial complaint of the medical apprentice-in-training is that there are too few structured teaching activities within the busy world of postgraduate work [3], a concern which many institutions have addressed by developing formalised continuing education initiatives reminiscent of medical school courses [4-6]. Predictably, different complaints prevail at the pre-licensure ph