JVME
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Journal of Veterinary Medical Education, Vol 35, Issue 2, 310-317
DOI: 10.3138/jvme.35.2.310
Copyright © 2008 by Association of American Veterinary Medical Colleges
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
PubMed
Right arrow PubMed Citation
Right arrow Articles by Grauer GF
Right arrow Articles by Sanderson MW

Research and Education Reports

Comparison of Student Performance after Lecture-Based and Case-Based/Problem-Based Teaching in a Large Group

Gregory F. Grauer• S. Dru Forrester• Cindy Shuman• Michael W. Sanderson


   ABSTRACT
TOP
 ABSTRACT
INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1: SAMPLE EXAMINATION...
 APPENDIX 2: STUDENT FEEDBACK...
 REFERENCES
 
The purpose of this study was to compare traditional lecture-based (LB) and case-based/problem-based (CB/PB) learning in a large group. Year 3 veterinary students at Kansas State University were asked to participate in a randomized controlled study. Students were grouped and randomly assigned to be taught by a CB/PB or a LB method. Students took identical multiple-choice examinations, one given within a week of the last class and a different one given four months later. There was no direct effect of teaching method on group scores for either examination. CB/PB students scored higher on higher-difficulty questions on the first examination (p < 0.003), but there was no effect on questions of lower and medium difficulty. There was no effect of teaching method on student performance for the second examination; however, the question difficulty category scores were all different (p < 0.017). Evaluation of examination scores suggests that the two teaching methods were of similar efficacy.

Key Words: case-based teaching • problem-based teaching • lecture-based teaching • comparison


   INTRODUCTION
TOP
 ABSTRACT
 INTRODUCTION
MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1: SAMPLE EXAMINATION...
 APPENDIX 2: STUDENT FEEDBACK...
 REFERENCES
 
The Pew National Veterinary Education Program report of the late 1980s recommended the redesign of veterinary curricula to improve students’ skills in communicating, finding and organizing information, thinking critically, analyzing, and making decisions.1 In response, many veterinary colleges incorporated some level of problem-based learning (PBL) into their curricula. PBL uses a clinical case or problem to encourage students to develop clinical reasoning skills by acquiring facts, identifying problems, generating hypotheses, and identifying additional learning needs that pertain to the pathophysiology, diagnostics, treatment, and prognosis of a case. The goal of PBL is to increase the higher-level cognitive skills of objectivity, critical thinking, interpretation, judgment, and problem solving in addition to recognition and recall. As an example, PBL techniques have been used by highly recognized teachers in veterinary medicine to teach small-animal urinary-tract physiology and disease.2,3

Since the incorporation of PBL, several studies have attempted to evaluate its effectiveness. One study observed no differences in student test scores between small-group PBL students and lecture-based (LB) veterinary students in a third-year neurosurgery course.4 LB students were exposed to more content than students in the PBL group, where the emphasis was on problem solving. Although PBL students tended to perform better than LB students on immediate and one-month post-material tests, the PBL students also tended to have lower satisfaction with their learning. Significantly more LB students agreed with the statements "good learning experience" and "learned a large amount of facts." Students in the PBL group were exposed to ill-defined real-life problems, whereas LB students were given more clear-cut information, and the authors suggest that PBL students may have been unfamiliar with the method and thus became somewhat frustrated with making judgments rather than having definitive answers.4 Other studies of small-group PBL have used student and faculty feedback and surveys to assess its effectiveness.5–9 In general, small-group PBL teaching/learning is well received by both faculty and students, although there are repeated concerns about lack of student time, lack of course time, and class size.5–9

A potential solution to the time concerns associated with small-group PBL is to use a blended cased-base/problem-based approach (CB/PB) in large groups, a methodology described for courses in veterinary clinical pathology and urinary-system physiology.10,11 In both instances, active learning with student participation in case discussions was well received by students, but examination performance was not directly compared between the CB/PB and LB methods. The purpose of the present study was to compare examination performance between third-year veterinary students taught in a large-group CB/PB setting and those taught in a large-group LB setting.


   MATERIALS AND METHODS
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
RESULTS
 DISCUSSION
 APPENDIX 1: SAMPLE EXAMINATION...
 APPENDIX 2: STUDENT FEEDBACK...
 REFERENCES
 
Course and Randomization of Students
The material used for this study was a 14-contact-hour portion of a third-year medicine course taught during the fall semester at the Kansas State University College of Veterinary Medicine (CVM). The topic area was the disorders of the small-animal urinary tract. Students (N = 110) were asked to participate in a randomized controlled teaching study, and informed consent was obtained. Students were stratified by gender and blocked into two groups according to class grade-point average (GPA). Students were randomly allocated into CB/PB and LB groups within each stratum and block.

Teaching Methods
The first group (CB/PB) was taught using a large-group CB/PB method and addressed the following problems: (1) azotemia, (2) polydipsia/polyuria, (3) proteinuria, (4) pollakiuria-dysuria-stranguria, hematuria, and (5) urine retention and urine leakage (see Table 1). The introduction to this portion of the course syllabus stated,

The format for this course is primarily problem-based learning by way of large group case discussions. Most of the class time will be devoted to discussion of clinical cases. The emphasis in these discussions will be on: 1) identification of patient problems, 2) developing differential diagnoses for these problems, 3) what approach should be taken to establish the definitive diagnosis, and 4) how to manage the problem. No formal lectures are planned for this portion of the course. In order to gain more from the case discussions, it is recommended that you study the cases ahead of time. Getting together in small groups outside of class to work on the cases is also recommended. Case discussions during class time will be improved by your input.


View this table:
[in this window]
[in a new window]

  		Table 1: Cases covered by the CB/PB group and topics covered by the LB group

 

A short introduction to each problem was provided by the instructor, and a case discussion followed. Case discussions consisted of providing history; physical examination findings; and CBC, serum biochemistry, and urinalysis results and asking the students to sequentially develop (1) a problem list, (2) a list of differential diagnoses for each problem, (3) a hypothesis diagnosis based on intersecting differential diagnoses, and (4) a list of additional diagnostic tests or treatments to prove or disprove the hypothesis. After this stepwise discussion, the case was summarized and additional questions were posed by the instructor as necessary to ensure complete coverage of the problem as well as of the pathophysiology and other learning objectives underlying the case presentation.

The second group (LB) was taught using lectures addressing various urinary topics (see Table 1). The introduction to this portion of the course syllabus stated,

This course is designed to teach the etiology, pathophysiology, clinical signs, diagnosis, differential diagnosis, and treatment of disease conditions that affect the urinary system of dogs and cats.

Material in this section was presented to students as outlined in most medical textbooks.

The CB/PB and LB groups were taught simultaneously in separate classrooms to prevent students from attending both classes. The two course instructors rotated, so that both groups had exposure to their individual teaching styles. The teaching assignments were allocated by randomly assigning one instructor to the first class period in each group, then alternating the assignments. The instructors met each day after class to ensure that there were no discrepancies in the information provided and to ensure continuity in the case presentations. The materials distributed to the two groups were different, but the overall subject material and content were similar. Any student could access either set of materials via the college intranet, and the learning objectives provided for each topic (LB) or problem (CB/PB) were the same. Access to both sets of notes and identical learning objectives were considered necessary to gain students’ acceptance and participation.

Evaluation Methods
Two multiple-choice examinations were developed with input from the Office of Educational Innovation and Evaluation (OEIE) at Kansas State University. Both examinations contained the same number of questions of lower (knowledge/factual), medium (knowledge with application), and higher (application and analysis) cognitive difficulty (see Appendix 1). The difficulty level of each question was determined by OEIE faculty based on Bloom's taxonomy,12,13 which addresses cognitive domains emphasizing the attainment, retention, and development of knowledge based on a hierarchy of six categories, from less to more complex. All students took the same examination at the end of the course. Performance on this examination determined their grade. Four months later, a different examination was given; student participation in this second examination was voluntary, but a monetary incentive was offered.

Faculty at OEIE designed different student feedback forms for the two groups. There were 23 common questions and two questions specific to each group (see Appendix 2). Two sections on the form used five-point Likert scales ranging from "strongly disagree" to "strongly agree"; the other sections contained multiple-choice or short-answer items.

Statistical Analysis
Categorizing the class into two groups of 55 students provided 80% power to detect a method effect of approximately 7% difference in mean test score. The question difficulty category–specific score for each student was calculated by dividing the number of correct responses by the number of questions in the specific question difficulty category. The question difficulty category–specific score was used as the outcome for an analysis of variance (ANOVA) for each examination. A full model was developed for each examination controlling for the effect of individual student, group, question difficulty category, and the interaction of group by question difficulty category. For analysis of differences between the two examinations, the difference between scores in each question difficulty category was calculated for each student. A within-subject ANOVA was performed on the question difficulty category–specific differences, including group and the interaction of group by question difficulty category. Overall error rate was controlled for post-hoc hypothesis testing by applying the Bonferroni correction to adjust critical p-values. The critical p-value used for the three comparisons was p < 0.017.

In order to compare the results of the CB/PB group and the LB group, mean scores were computed for the self-assessment items on the student feedback form (Questions 1–12). For comparison of the overall results between groups, a Welch t-test was used. This analysis was conducted because statistically significant differences were found in variance and standard deviations between the groups. For the open-ended questions, student responses were coded and analyzed to identify themes, both in the aggregate and by group.


   RESULTS
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
DISCUSSION
 APPENDIX 1: SAMPLE EXAMINATION...
 APPENDIX 2: STUDENT FEEDBACK...
 REFERENCES
 
There was no difference in gender or veterinary school GPA between the groups, and all students completed both examinations (the male:female student ratio for both groups was 15:40, and mean GPAs were 3.24 and 3.26 for the CB/PB and LB groups, respectively). There was no direct effect of teaching method on the overall score for either examination. For the first examination, the effects of question difficulty category and of the interaction of teaching method by question difficulty category were significantly associated with the examination score (see Table 2). Post-hoc examination of teaching method by question difficulty category differences indicated that CB/PB students had significantly higher scores than LB students on higher-difficulty questions (p < 0.003), but there was no effect of teaching method for lower- and medium-difficulty questions.


View this table:
[in this window]
[in a new window]

  		Table 2: Mean scores for the first examination, by teaching method and question difficulty

 
For the second examination, the effect of question difficulty category was significant, but the interaction of teaching method by question difficulty category was not (p < 0.09; see Table 3). Question difficulty category scores were all different (p < 0.017): scores for medium-difficulty question were the lowest and scores for higher-difficulty questions the highest. No significant effect of teaching method or of the interaction of question difficulty category by teaching method was found when score differences between tests were compared. Differences in scores between tests were different within question difficulty categories (see Table 4). The difference in scores between tests was significantly less for higher-difficulty questions than for lower- and medium-difficulty questions; that is, the combined scores for the higher-difficulty questions varied less between tests than the combined scores for the lower- and medium-difficulty questions in both teaching groups.


View this table:
[in this window]
[in a new window]

  		Table 3: Mean scores on the second examination, by teaching method and question difficulty category

 

View this table:
[in this window]
[in a new window]

  		Table 4: Class average by difficulty category and change from the first to second examination

 
Feedback forms were completed by 108 of 110 students (98.2%); 54 from each teaching group participated (see Table 5). Students in the CB/PB group believed that their experience increased their ability to solve real-world problems (4.07 ± 0.75) (mean ± SD) more than LB students did (3.57 ± 0.72). Students reported that expectations for the course were expressed better in the LB group (3.83 ± 1.02) than in the CB/PB group (3.11 ± 0.96); 59% of LB students indicated that lecturing was an effective method for instruction, while 48% of the CB/PB group that said CB/PB instruction was effective (see Table 6). Although fewer CB/PB students described their instruction as effective, many reported having a better understanding of the material through this type of teaching.


View this table:
[in this window]
[in a new window]

  		Table 5: Mean student feedback scores

 

View this table:
[in this window]
[in a new window]

  		Table 6: Students’ assessments of the effectiveness of CB/CB and LB instruction

 
Both CB/PB and LB students faced positive and challenging experiences in their respective groups (see Appendix 2). Students were more familiar with the LB format and felt more comfortable with this method of pedagogy, classroom organization, and expectations. While some CB/PB students worried that they were missing out on information that was shared with the LB group, many felt they had a better understanding of the material, given the real-world applications that were presented to them. CB/PB students were more likely to access the lecture material online than LB students were to access the case material online (see Table 7), but there was no difference in the amount of time they spent studying. Students from both groups indicated that the most ideal learning environment would include both LB and CB/PB applications.


View this table:
[in this window]
[in a new window]

  		Table 7: Students’ study activity outside of class

 

   DISCUSSION
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
APPENDIX 1: SAMPLE EXAMINATION...
 APPENDIX 2: STUDENT FEEDBACK...
 REFERENCES
 
The results of this study indicate that the use of a large-group CB/PB teaching method did not affect overall student academic performance, a result similar to those previously reported from medical schools.14–16 The rationale for the use of CB/PB was threefold: (1) to provide exposure to methods of clinical reasoning, (2) to provide a framework for the organization of knowledge, and (3) to foster self-directed learning and cooperative learning skills.17,18 The instructors wanted students to learn the material in the context of its use in the clinical setting and to learn from one another. We anticipated that students who were struggling to understand portions of the material would be more likely than their instructors to identify the sources of misunderstanding.19

The stated objectives were partially achieved in the present study. Compared with LB students, the CB/PB students scored significantly higher on the application and analysis questions on the first examination and had a higher self-assessment of their problem-solving skills. In addition, a higher percentage of the CB/PB students accessed online material. Although differences in examination scores have been difficult to identify, outcomes assessment of PBL in medical school curricula has demonstrated improved scores on licensing examinations and improved performance in clinical rotations.20,21

Overall scores on both examinations were lower than expected, but the examinations developed for the study were intentionally made difficult, in an attempt to identify differences between groups. The instructors expected LB students to perform better on the first examination, especially on the lower- and medium-difficulty questions, and CB/PB students to perform better on the second examination, especially on the higher-difficulty questions, but the results of the two groups were similar. Students gain acceptance into veterinary school largely by excelling in LB educational systems; thus, it might be anticipated that a subset of this group taught using CB/PB would not outperform another subset. In addition, it was common for the CB/PB students, at least initially, to feel stressed about the new teaching strategies and whether they might be misdirected or inefficient.

The CB/PB students spent more time online accessing LB materials than LB students spent accessing CB/PB materials, perhaps because the CB/LB students were concerned about missing factual material or because they lacked experience with the CB/PB format. The LB students reported a greater level of comfort with their course expectations than the CB/PB students did; conversely, the CB/PB students reported an increased ability to solve real-world problems, and on the first examination the CB/PB students outperformed the LB students on the higher-difficulty questions.

Scores on the lower- and medium-difficulty questions decreased between the first examination and the second. Both groups improved their scores on the higher-difficulty questions, and scores increased to a greater extent in the LB group than the CB/PB group. This result may be due to the subsequent exposure of both groups to CB/PB teaching in later sections of the parent course and in other courses.

This study has several limitations. First, the study period was short (14 class periods). Second, neither the CB/PB group nor the LB group used one model exclusively: case examples were presented to the LB group, without discussion, and brief topic reviews were presented in the CB/PB group. The latter was considered necessary based on a previous study in which 96% of students stated that the PBL format would be improved by a brief introduction to the topic prior to discussion of the material.11 Third, the level of student/faculty and student/student interaction associated with the CB/PB method would likely have been different if the entire class of 110 had been involved; in this study, the LB students met in their regular large classroom, while the CB/PB students met in a smaller room that may have facilitated the discussion process. Finally, contamination across groups occurred, because students communicated across groups and all students could access all materials. Although this cross-fertilization likely enhanced the learning experience for both groups, it also probably made detecting differences in performance between groups more difficult.

Problem-based learning has been defined in many ways. Traditional PBL involves small groups of students meeting with a facilitator who helps guide them through a problem or case. The methodology described in the present study may be best described as large-group case-based discussions facilitated by an instructor. Two of the major concerns raised about PBL concern the amount of faculty time it requires and its efficiency in disseminating large amounts of material within relatively short time frames. The results of this CB/PB teaching study may partially alleviate these concerns.


   APPENDIX 1: SAMPLE EXAMINATION QUESTIONS
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1: SAMPLE EXAMINATION...
APPENDIX 2: STUDENT FEEDBACK...
 REFERENCES
 
Lower-Level Questions
Which of the following statements is the best definition of a complicated urinary tract infection [UTI]?

  1. a UTI caused by a bacterium that is resistant to multiple antibiotics
  2. a UTI caused by two or more bacteria
  3. a UTI that recurs soon after antibiotic treatment has been discontinued
  4. a UTI that results from impaired host defense mechanisms
  5. a UTI in which multiple sites within the urinary tract are involved at the same time

Which one of the following drugs affects urinary bladder (detrusor) tone?

  1. phenylpropanolamine (alpha agonist)
  2. phenoxybenzamine (alpha antagonist)
  3. bethanecol (cholinergic)
  4. diethylstilbestrol (DES) (hormone replacement)

Higher-Level Questions
A 9-year-old spayed female domestic shorthair cat is presented for evaluation of polyuria/polydipsia (PU/PD). Physical examination reveals slightly dry mucous membranes and decreased muscle mass (body condition 2/5). The cat struggles a bit during collection of blood and urine. Results of minimum data base are shown below.
Parameter Patient Reference Range
Hematocrit 32 30–45%
Plasma protein 7.8 6–8 g/dL
BUN 28 17–25 mg/dL
Creatinine 1.5 0.5–1.4 mg/dL
Sodium 152 148–161 mmol/L
Potassium 3.2 3.3–5.2 mmol/L
Glucose 257 63–140 mg/gL
Specific gravity 1.027
Urine dipstick pH—6.5, protein—1+ (SSA—1+)
glucose—neg
Urine sediment no abnormal findings

Based on the information you have, which one of the following is the most likely mechanism for PU/PD in this cat?

  1. Osmotic diuresis secondary to diabetes mellitus
  2. Excessive thyroid hormone interfering with action of antidiuretic hormone (ADH)
  3. Damage to the urine concentrating mechanism secondary to pyelonephritis
  4. Insufficient number of nephrons secondary to chronic kidney disease
  5. None of the above are likely

Of the following diagnostic tests, which should be performed next in this cat to better define the cause of the PU/PD?

  1. Urine culture and thyroid hormone concentration
  2. ACTH response test
  3. Water deprivation test
  4. Urine protein/creatinine ratio
  5. Glucose tolerance test


   APPENDIX 2: STUDENT FEEDBACK FORM, CB/PB GROUP
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1: SAMPLE EXAMINATION...
 APPENDIX 2: STUDENT FEEDBACK...
REFERENCES
 
The feedback form for the LB group was the same except for Questions 21 and 22, where "lecture-based" was substituted for "case-based/problem-based."

Student Feedback Form: Case-Based/Problem-Based Section
The purpose of this questionnaire is to collect your feedback about the Urinary Section of Medicine II. We are interested in your perspective of how the class was structured, and any suggestions you may have on how future classes could be improved. The information you give will be entirely confidential; all of the responses will be collected and analyzed by the Office of Educational Innovation and Evaluation on campus. The aggregate responses will be reported back only after the section is completed and grades have been assigned. If you have any questions about this process, please feel free to ask Dr. Grauer or Dr. Forrester for more information. Please take a few minutes to complete the entire form.

Please answer questions 1–12 using the following scale:

  1. This section of the course increased my ability to solve real world problems.
  2. This section of the course encouraged me to consider alternatives when solving problems.
  3. This section of the course improved my ability to identify appropriate resources for clinical purposes.
  4. I learn best when I am asked to apply concepts to real life situations.
  5. I learn best when I break concepts into smaller pieces or chunks.
  6. You need a good memory to do well in this section.
  7. I had a clear understanding of what was expected in this course.
  8. Much of what I’m studying seems random, like unrelated bits and pieces.
  9. When working on a new topic, I try to see in my own mind how all the ideas fit together.
  10. When I read text books or other resources, I try to see how they fit with the material presented in class.
  11. I learn best when I carry out investigations to test my ideas or find new information.
  12. I learn best when I memorize.

(Please circle your response Yes or No for questions 13–16)

  1. I accessed the Case-Based materials that were available online.
  2. I accessed the Lecture materials that were available online.
  3. I discussed course content with other students in my section of the course.
  4. I discussed course content with students in the other section of the course.

Please answer the following questions:

  1. Approximately how much time (in hours) did you spend outside of class working individually on the cases presented by the instructors?
  2. Did you meet in a small group outside of class specifically to discuss the cases? If so, approximately how much time (in hours) did you spend outside of class working on the cases as a group?
  3. When working in a group setting, my preferred role is the: (please circle one)
  1. recorder—take notes and document the activity of the group
  2. facilitator—guide the discussion and ensure that all members participate
  3. synthesizer—continually check accuracy of the group and clarify points
  4. discussant—contribute to all discussions, offer suggestions/feedback as appropriate

Please complete all the items by circling the number that corresponds with your view for each instructor using the SD, D, NA/D, A, or SA scale.

  1. As this section of the course was co-taught, we would like to get your perspective on the effectiveness of each instructor. The instructor:
Please answer the following questions:
  1. How effective was the case-base/problem-based instruction for you in learning the material in this section?
  2. What aspects of the case-base/problem-based instruction did you find challenging?
  3. Overall, what contributed most significantly to your learning in this course? In other words, what are the important features to retain the next time this course is taught?
  4. Overall, what made your learning in this course more difficult? In other words, what are the most important changes you would suggest for the next time this course is taught?
  5. Please use this space or the back of the page to share any other comments you have about this section.

Thank you for taking time to complete this form.


   ACKNOWLEDGMENTS
 
This study was approved as exempt by the University Institutional Review Board on research involving human subjects (IRB # 3966), Kansas State University, on July 13, 2006. The study was funded by the Mark Morris Institute and by Hill's Pet Nutrition, Inc., Topeka, KS.


   Footnotes
 
AUTHOR INFORMATION

Gregory F. Grauer, DVM, MS, is a Professor in the Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, 1800 Denison Ave., Manhattan, KS 66506 USA. E-mail: ggrauer{at}vet.ksu.edu.

S. Dru Forrester, DVM, MS, is a Scientific Spokesperson for Hill's Pet Nutrition, Inc., 400 SW 8th Ave., Topeka, KS 66603 USA.

Cindy Shuman, PhD, is an Evaluator in the Office of Educational Evaluation and Innovation, College of Education, Kansas State University, 2323 Anderson Ave., Manhattan, KS 66506 USA.

Michael W Sanderson, DVM, MS, is an Associate Professor in the Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, 1800 Denison Ave., Manhattan, KS 66506 USA.


   REFERENCES
TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 APPENDIX 1: SAMPLE EXAMINATION...
 APPENDIX 2: STUDENT FEEDBACK...
 REFERENCES
 

  1. Pritchard WR, ed. Future Directions for Veterinary Medicine. Durham, NC: Pew National Veterinary Education Program, Duke University, 1989.
  2. Brown SA. Learning basic science alongside veterinary students: creating an interactive classroom. J Vet Med Educ 31: 295–300, 2004.[Abstract/Free Full Text]
  3. Forrester SD. My journey from teaching to learning excellence. J Vet Med Educ 33: 5–9, 2006.[Abstract/Free Full Text]
  4. Bauer M, Bill R, Hullinger R, Toombs J, Teclaw R. Problem-based learning vs. lecture to teach neurosurgery to third-year veterinary students. J Vet Med Educ 19: 22–25, 1992.
  5. Herron MA, Wolf A, DiBrito W. Faculty and student attitudes toward problem solving and independent learning in the veterinary medical curriculum. J Vet Med Educ 17: 19–21, 1990.
  6. Haynes JS, Myers RK. A case-based cooperative learning approach to teaching veterinary systemic pathology. J Vet Met Educ 25(1):12–16, 1999.
  7. Bauer M, Ogilvie G. Incorporation of problem-based learning into a third-year veterinary curriculum. J Vet Med Educ 23: 43–46, 1996.
  8. Monahan CM, Yew AC. Adapting a case-based, cooperative learning strategy to a veterinary parasitology laboratory. J Vet Med Educ 29: 186–192, 2002.[Abstract/Free Full Text]
  9. Patterson JS. Increased student self-confidence in clinical reasoning skills associated with case-based learning (CBL). J Vet Med Educ 33: 426–431, 2006.[Abstract/Free Full Text]
  10. Canfield PJ. An interactive, student-centered approach to teaching large-group sessions in veterinary clinical pathology. J Vet Med Educ 29: 105–110, 2002.[Abstract/Free Full Text]
  11. Wilke WL. Use of a problem–solution method to teach basic physiology of the urinary system. J Vet Med Educ 18: 46–48, 1991.
  12. Bloom BS. Taxonomy of Educational Objectives, Handbook I: The Cognitive Domain. New York: David McKay, 1956.
  13. Koskinen H. Evaluation of the level of difficulty of patient cases for veterinary problem-solving examination: a preliminary comparison of three taxonomies of learning. J Vet Med Educ 34: 106–111, 2007.[Abstract/Free Full Text]
  14. Rich SK, Keim RG, Shuler CF. Problem-based learning versus a traditional educational methodology: a comparison of preclinical and clinical periodontics performance. J Dent Educ 69: 649–662, 2005.[Abstract/Free Full Text]
  15. Dyke P, Jamrozik K, Plant AJ. A randomized trial of a problem-based learning approach for teaching epidemiology. Acad Med 76: 373–379, 2001.[Medline]
  16. Antepohl W, Herzig S. Problem-based learning versus lecture-based learning in a course of basic pharmacology: a controlled, randomized study. Med Educ 33: 106–113, 1999.[CrossRef][Medline]
  17. Whitfield CF, Mauger EA, Zwicker J, Lehman EB. Differences between students in problem-based and lecture-based curricula measured by clerkship performance ratings at the beginning of the third year. Teach Learn Med 14: 211–217, 2002.[CrossRef][Medline]
  18. Kaufman DM, Mann KV. Achievement of students in conventional and problem-based learning curriculum. Adv Health Sci Educ 4: 245–260, 1999.[CrossRef]
  19. Albanese M. Problem-based learning: why curricula are likely to show little effect on knowledge and clinical skill. Med Educ 34: 729–738, 2000.[CrossRef][Medline]
  20. Kaufman DM, Mann KV. Comparing achievement on the Medical Council of Canada Qualifying Examination Part 1 of students in conventional and problem-based curricula. Acad Med 73: 1211–1213, 1998.[Medline]
  21. Richards BF, Ober P, Cariaga-Lo L, Camp MG, Philp J, McFarleane M, Rupp R, Zaccaro DJ. Ratings of students’ performances in a third-year internal medicine clerkship: a comparison between problem-based and lecture-based curricula. Acad Med 71: 187–189, 1996.[Medline]




This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
PubMed
Right arrow PubMed Citation
Right arrow Articles by Grauer GF
Right arrow Articles by Sanderson MW

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
AAVMC APPRECIATES THE SUPPORT OF OUR TWO PATRONS, HILL'S PET NUTRITION AND BAYER ANIMAL HEALTH, WHO IN COMBINATION ARE FULLY SUPPORTING THIS SITE.
Hill's Pet Nutrition
Upcoming Veterinary Education Meetings