Implementation, students' perceptions and students' performance in problem-based learning and traditional paediatric clerkships

The purpose of this study was to examine the implementation of problem-based learning (PBL) in an undergraduate paediatric clerkship and to compare students' perceptions and performance in an objective structured clinical examination (OSCE), following PBL and traditional didactic clerkships (TDC). Fourth year students in a five-year curriculum were randomly allocated to PBL or TDC. Both clerkships were of eight weeks duration and offered the same in-patient, out-patient and on-call experiences. PBL included student-centred learning in small groups facilitated by a tutor, provided essential content through appropriately designed paper problems and encouraged independent study to pursue specific learning goals. It was feasible to implement PBL in the paediatric clerkship for students whose previous education was predominantly traditional. PBL contributed to the students' satisfaction about the clerkship and for acquiring theoretical knowledge. Although PBL did not have a detrimental effect on students' patient contact opportunities, the paper problems of PBL would not replace real patient experiences nor the practice and supervision that students need for acquiring clinical skills. These findings are discussed with the theoretical conception of PBL and learning in clerkships.