FEMS Microbiology Letters Advance Access published June 13, 2016

Benefits of Using a Hybrid Problem-Based Learning Curriculum to

Improve Long-term Learning Acquisition in Undergraduate Biology
Education

Mar Carrió*, Laia Agell, Josep Eladi Baños, Elisabeth Moyano, Pilar Larramona,
Jorge Pérez

Research Group in Health Sciences Education, Universitat Pompeu Fabra, Dr.

Aiguader, 88, Barcelona-08003, Spain

* Email: mar.carrio@upf.edu

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ABSTRACT

Although problem-based learning (PBL) has been used for over 40 years, with many

studies that compare the benefits of PBL versus other educational approaches, little

attention has been paid to the effectiveness of hybrid PBL (H-PBL) curriculums. Here

we aimed to compare the learning outcomes of two groups of undergraduate biology

students working towards a bachelor degree: one group used a H-PBL approach, while

the second used a lecture-based learning (LBL) approach. Specifically, the H-PBL

group used a PBL module with interdisciplinary problems, which represented 20% of

the entire curriculum. The main outcomes of evaluation were the long-term factual

knowledge acquisition and the problem-solving skills at the end of the bachelor’s

degree. The sample included 85 students, 39 in the H-PBL group and 46 in the LBL

group. We found that an H-PBL curriculum can improve the students’ learning

outcomes such as long-term knowledge acquisition, problem solving skills and generic

competences.

KEYWORDS: Problem-based learning; hybrid methods; long-term learning; skills

development; biology

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Acknowledgments The authors are very grateful to the study participants, and

especially to the students and the teachers who helped in choosing the questions and

scoring the tests.

Author Contributions: Conceived and designed the experiments: MC, JP. Performed

the experiments: MC, JP, EM. Analyzed the data: MC, LA. Wrote the paper: MC, JEB,

LA, EM, JP.

Competing Interests: The authors have declared that no competing interests exist.

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INTRODUCTION

In the last half century, we have learned a great deal from cognitive science research

about the nature of learning. Students construct their knowledge from their prior ideas

and experiences, rather than simply taking as they have received it (Cross 1999).

Learning occurs as a social process, resulting from negotiation of meanings among

peers and teachers (Vygotsky 1978). Research also suggests that individuals learn

naturally when are engaged in solving problems that concern them (Ewell 1997). So,

learning takes place through active participation in purposeful and collaborative

activity. In this context, problem-based learning (PBL) has been used in teaching

domains like medicine, engineering, science, and economics for over 40 years (Strobel

& Van Barneveld 2009).

PBL has shown to be very useful for acquiring several generic skills needed for

scientific careers, such as cooperative working, integration of information, critical

thinking, communication skills, and self-directed learning (Dolmans et al. 2005). These

expectations are based on the intrinsic characteristics of PBL, and graduates of PBL

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curricula are expected to be better prepared for the challenges of professional practice

than those coming from lecture-based curricula (Schmidt et al. 2006).

Although several studies have been conducted to determine the effectiveness of PBL

over the traditional methods, the various methods of PBL implementation, in different

contexts and with different students’ groups, have made it difficult to gain robust

evidence in this sense. However, over the past 20 years, several meta-analyses have

investigated and quantified the effectiveness of PBL as compared to traditional

instruction (Strobel & Van Barneveld 2009; Albanese & Mitchell 1993; Kalaian et al.

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1999; Dochy et al. 2003; Newman 2003; Gijbels et al. 2005). They concluded that PBL

is significantly better than traditional instruction for training competent and skilled

practitioners, promoting long-term retention of knowledge, and improving student and

teacher satisfaction, while traditional learning approaches are more effective for short-

term retention of knowledge.

Nevertheless, the impact of hybrid curriculum on students’ outcomes is unclear (Callis

et al. 2010). Hybrid models combine PBL and traditional methods in the curricula.

These are especially useful for those schools that want to benefit from the advantages of

PBL methodology but do not want a complete reform to switch to an entirely PBL-

based curriculum.

This was the case for the School of Health and Life Sciences, in Barcelona, Spain, when

PBL was introduced to the curriculum in 2004. At that time, introducing PBL to a

Spanish university was pioneering move. PBL was included in the Bachelor in Biology

program as a hybrid model, with 20% of the curriculum based on PBL and 80%, on the

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traditional method (mainly based on lectures and using a structured curriculum with

compartmentalized subjects). PBL was implemented considering the key components

defined by Barrows (2002): ill-structured problems were presented to students, who

were encouraged to generate various ideas about how to solve them; a student-centered

approach was used in which students determined what they needed to learn, defined

knowledge gaps, and acquired the missing knowledge, while tutors acted as learning

facilitators; and problems were selected based on their authenticity with professional or

“real world” practices.

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A hybrid-PBL (H-PBL) curriculum was implemented for first year students and then

was spread to the entire degree. Therefore, different cohorts of students educated by LB

and H-PBL curriculum coexisted in the School during several years. This situation

allowed performing this comparative study in its natural context. Students’ learning

outcomes from 2003 cohort (the last previous to PBL implementation) and H-PBL 2004

cohort (the first after this curricular change was introduced) were analyzed twice: When

students were at their second year and at their fifth year. Our previous study performed

when students were in their second-year degree and demonstrated that there were no

significant differences in the factual knowledge acquisition between the two cohorts

using or not H-PBL, but that PBL promoted a better development of generic and

scientific skills (Carrió et al. 2011). According to previous studies (Strobel & Van

Barneveld 2009), we would expect to see significant effect of PBL intervention when

measuring long-term learning acquisition. This was considered as the knowledge

retained after the first four years of the bachelor degree program. For this reason, the

present study was designed to test the hypothesis that an H-PBL curriculum promotes

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more effective long-term learning by students than a traditional curriculum that mainly

uses lecture-based learning (LBL).

METHODS

Study design and sample

From 1998 to 2012, the School of Health and Life Sciences (Barcelona) offered a five-

year-long Bachelor in Biology program, which then became a four-year-long program

in line with Spanish directives of implementing the European Higher Education Area

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(EHEA). In 2004, the school initiated a pilot study of adaptation to the EHEA principles

that finished in 2012. During this period, the traditional (LBL) and the experimental (H-

PBL) curricula coexisted in different cohorts of students. Data from the two consecutive

cohorts were collected in their final year of the bachelor (fifth year), and 85 students

(with 46 using LBL, and 39 using H-PBL) participated in this study. There were no

differences between the two groups of students regarding age, gender, or grades of entry

to the university (table 1).

The characteristics of the H-PBL model in the biology undergraduate curriculum

The main characteristic for the H-PBL model was that 20% of the teaching time was

devoted to PBL activities. The reason for this selection was of convenience. The

curricular change should be approved by the council of the school. Although the

members of the council recognized the value of PBL and the merit of a hybrid

curriculum, they consider that 20% was the maximum teaching time accepted to avoid

the loss of the value of more traditional activities such lectures.

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In each term, a PBL module with interdisciplinary problems that integrated learning

outcomes from different subjects of the entire curriculum was designed. This

pedagogical approach is described in detail in Table 2. All faculty members participated

in this reform. They decided the learning outcomes of their subjects that had to be

withdrawn from lectures to be taught using PBL activities. They were also involved in

writing problems and participated as tutors. The remaining teaching time (80%) was

assigned to traditional teaching methods, such as lectures, practical lab courses, and

seminars. The LBL group followed only these traditional activities without PBL

tutorials. Both groups (LBL and H-PBL) had the same learning outcomes and teachers

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and only the pedagogical method varied.

PBL tutorials were carried out in groups of eight to ten students during the full

academic year (nine months). The students spent three weeks on solving each problem,

accounting for nine different problems per year (Table 2). They had two working

sessions per week, one with the tutor and one with the group alone. At the end of each

problem, students prepared a final report to explain the process they followed to solve

the problem, including assignment of tasks in the group, identification of the relevant

knowledge acquired, working hypotheses, identified research topics, conclusions, and

critical use of the information sources. The topics taught through PBL were also

assessed by the traditional exams. PBL modules were included in the first four years of

the program.

The evaluation instrument and data collection

The two groups were compared using the same instrument prepared for this purpose.

Students were evaluated in their final (fifth) year on a day that was not previously

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known to them. Evaluation was carried out during one of their regular lectures, in a

period time they did not have any close assessment. Participation was anonymous and

voluntary. All students attending on the evaluation day participated; 88% of the LBL

cohort, and 72% from the H-PBL cohort, were in the classroom on the day that their

cohort was evaluated. The LBL cohort carried out the exercises in November 2008, and

the H-PBL cohort, in November 2009. Questionnaires were handed out to the

participants after having obtained their verbal informed consent. Answers were stored

and analyzed when results from both cohorts were available. The reviewers were blind

to which cohort the evaluation exercise corresponded to.

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The instrument was a questionnaire with two parts: part 1 assessed factual knowledge,

and part 2 problem-solving skills. Part 1 comprised 35 multiple choice questions (MCQ)

that included topics from all the subjects of the previous four academic years such as

genetics, cell biology, histology, bioinformatics, anthropology, and chemistry, among

others. MCQ were chosen among those with the lowest difficulty index of each subject,

obtained from previous exams, but which had not been used to evaluate the participants

of the current study. The chosen questions (4 for each subject) were sent to the

corresponding teachers, who choose the two most relevant. The MCQ were identical for

both cohorts. Some examples are included as supplementary data.

Part 2 included an example of a PBL problem. It was contextualized as scientific news

that explained “the discovery of a gene mutation that could be involved in the anorexia

nervosa development”. Students were asked to define learning objectives, formulate a

hypothesis, describe which knowledge areas should be investigated to better understand

the issue, and plan a solving strategy. A rubric was developed to correct this part of the

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test, and a double-blind review was performed. Assessment of the results of parts 1 and

2 were scored separately using the numeric range 0–10 (with 10 as the best score).

Data analysis

All the answers to part 1 were analyzed quantitatively, using the SPSS Statistics 19

software. Means and standard deviations were calculated. A t-test was used to compare

the mean scores of both groups. Data were also compared considering the number of

students that failed or passed the exam (pass threshold: 5/10) using the 2 test. In all

cases, values were considered statistically significant if p < 0.05.

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Questionnaire to assess students’ and tutors’ perceptions about the development of

skills during PBL

At the end of the H-PBL cohort’s fourth year, students and teachers were surveyed to

find out their perception of the skills development by PBL. Filling in the questionnaire

was voluntary and anonymous. Students answered the questionnaire during their time in

the classroom. For teachers, the questionnaire was sent and collected by email. The

questionnaire asked the participants to rate the acquisition of a list of generic skills

developed in PBL from 0 (not acquired) to 10 (fully acquired). The skills were

identification of research questions, hypothesis formulation, data analysis, synthesis of

data, argumentation, oral and written communication, cooperative work, informational

skills and time management.

Ethics Statement

The study protocol was approved by the Academic Coordination and Assessment Office

(OCAA) of the School of Health and Life Sciences of our university. The protocol

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stated that participants were informed of the objective and the methods of the survey

and this information included that their participation was voluntary and anonymous, that

there is no way of knowing who participated and who did not, and that no consequences

followed their decision in any way. Later, they gave their oral consent to be included as

participants and accepted to follow study requirements. Since participation was

voluntary and all data collected were anonymous, the need of written informed consent

was not considered necessary. The OCAA board approved this consent procedure as

IRB did not consider a formal approval of the study.

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RESULTS

Comparison of long-term factual knowledge acquisition between the LBL and H-PBL

students

The data analysis revealed that students from the H-PBL group obtained higher scores

than students from LBL group (Table 3). The mean score of H-PBL students was 0.47

points higher than LBL students, and this difference was statistically significant.

The majority of the H-PBL students passed the MCQ test. Only 2.5 % of them failed,

while 13% of the LBL students did. Although these differences were not statistically

significant, the results indicated a trend for students educated with the H-PBL curricula

to be more likely to pass the MCQ test than those from the LBL group (table 4).

Comparison of problem-solving skills between LBL and H-PBL students

The results showed that the mean score of the H-PBL students was 0.8 higher than that

of the LBL students in this assessment. This difference was not statistically significant,

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as both average scores had high values of standard deviation, with the LBL cohort 0.62

points higher than the H-PBL cohort (3.35 and 2.73, respectively) (Table 3).

Comparing students of each cohort that reached the threshold score in this exercise

demonstrated that H-PBL students were more likely to pass (76.9%) than LBL students

(58.6%). Nonetheless, again these differences were not statistically significant (Table

4).

Development of students’ skills in PBL activities

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As shown in Figure 2, the students’ and teachers’ perception of the level of skills

acquisition was between 6.4 and 8.1 out of 10, respectively. Students rated cooperative

work and informational skills as the best reinforced skills, while the teachers

highlighted informational skills and time management. Students scored most

competences higher than teachers. The exceptions were communication skills and time

management.

Discussion

We found that the H-PBL curriculum implemented in our school improved factual

knowledge acquisition of students in the long-term.

By comparing these results with those of our previous study performed with the same

students in their second year of the program (Carrió et al. 2011), we determined that the

H-PBL cohort had a higher increase of factual knowledge acquisition. Thus, the mean

test score for the H-PBL cohort increased 1.4 points from the second to the fifth years,

while that of the LBL cohort increased 0.8 (Fig. 1).

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On the other hand, the fact that our previous study (Carrió et al. 2011) did not show

significant differences between the two cohorts in the second year, while our present

study performed 3 years later showed a significantly better performance of H-PBL

students, suggests that knowledge acquired through PBL is better retained. No

differences were seen in the final grades between the students of the four cohorts that

graduate before the H-PBL started and the four of the students that followed this new

curriculum.

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Our current result agrees with previous literature reports that have indicated the

advantages of PBL over the traditional methods, especially in long-term learning

(Abraham et al. 2008; Chou & Chin 2009; Mahdizadeh et al. 2008; Pourshanazari et al.

2013). This could be explained by the nature of the PBL methodology, which fosters a

better understanding of the matter and consequently may favor long-term information

retention. Contrary to what happens in the traditional learning method, PBL students

focus on meaning rather than on pure knowledge (Berkson 1993). From the

constructivist analysis, PBL may promote more effective learning because it encourages

students to build new knowledge in a contextual scenario, connecting their own prior

knowledge with the new challenges presented by the problem and through a social

interaction, either with other students or with the tutor.

On the other hand, the hybrid model implemented in our school, in which a PBL

module with interdisciplinary problems is present in the entire curriculum, favors the

review of basic science knowledge, since students connect the presented scenarios with

prior knowledge learned through different subjects. Moreover, through PBL, students

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learn to think critically, which can facilitate learning in subsequent lectures (Derting &

Ebert-May, 2010). Thereby, our results suggest that the PBL module has reinforced the

students’ learning that was acquired through the traditional learning methods.

PBL is expected to improve students’ problem-solving skills, as they learn by analyzing

complex problems, identifying what they need to learn in order to solve a problem,

engaging in self-directed learning, applying their new knowledge to the problem, and

reflecting on what they learned and the effectiveness of the strategies they employed.

Many studies demonstrated the impact of PBL in obtaining problem-solving skills

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(Albanese & Mitchell 1993; Kalaian et al. 1999; Reynolds et al. 2010). In our study, a

similar trend was revealed, since students educated with H-PBL performed better in

problem-solving exercises than those educated with traditional approaches. As these

differences were not statistically significant, we cannot firmly corroborate these results

in our groups. However, more homogenous results were also seen in the H-PBL than in

LBL-cohort, as the comparison of standard deviations showed. We speculate that this

could be an indicator of the problem-solving skills acquired in the H-PBL students.

The choice of the 20% of PBL teaching time in the hybrid curriculum deserves further

comments. The introduction of such innovation in a traditional curriculum is not

welcomed with enthusiasm by all teachers. To avoid such resistance that may difficult

or even makes impossible, the implementation of the PBL we agree that the use of this

method will only suppose a fifth of the total teaching time. This means a reduction of

the lectures in a similar percentage. Given this agreement, all teachers accepted to

participate in the pilot program, assist to the training courses and follow all the changes

that the hybrid PBL curriculum implied. It could be speculate that increasing the PBL

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time (i.e. to 25% or 50%) had allowed better academic results, but our main goal was to

permit that teachers had a direct experience with the method and to prove its feasibility

and pedagogical value. We consider that our results are consistent with this aim.

Our study has several limitations. The most important is related to its own

characteristics. The aim of the study was to assess the effect of the introduction of H-

PBL curriculum. It was performed in a naturalistic academic environment and no

experimental intervention was carried out. For this reason, we compared the last cohort

of the old curriculum (e.g. LBL group) to first new cohort of the new curriculum (e.g.

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H-PBL cohort). In this non-interventional design, only two groups of students could be

compared and hence the size of the study groups was small. Given the lack of evidences

in the literature about the effect of H-PBL curriculum in students learning outcomes, we

consider that our data are of interest, especially if the results showed statistically

significant differences. The effect of other confounding factors between the groups that

could explain our results cannot be discarded. However, we believe that the differences

observed can be mostly explained by the introduction of PBL, as both cohorts were

consecutive, with similar demographic characteristics and no explicit changes were

included in the curricula during that time.

The value of our results may be also limited by the lack of statistical significance in

most of the evaluation tools in spite of the higher values in the hybrid PBL group. This

may be due to the sample size but also to the actual lack of differences of the learning

between both groups of students. However, before the study was started, teachers of our

school felt that students would learn less factual knowledge with hybrid PBL than with

the traditional curriculum. Our study showed that this was not the case as differences

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were not shown. We consider that this may be an important point as those teachers

interested in introducing PBL in their schools may use these data to counteract the

belief of ‘losing content knowledge’ that some colleagues may feel. Moreover, students

and tutors felt that generic competences were clearly improved through PBL sessions.

Because the evaluation instrument used to assess problem-solving skills was designed to

be answered in one hour, an additional limitation was that it only measured the ability to

analyze a problem and plan a solving strategy. It did not assess other skills extensively

developed during PBL activities, such as the ability to find, evaluate, and use

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appropriate learning resources, to work cooperatively, and to demonstrate effective

communication skills. However, data obtained from a survey of H-PBL students and

teachers showed that their perception of the acquisition of these skills was very positive

(Fig.2).

In summary, this study provides initial evidences that a hybrid PBL curriculum may

favor long-term knowledge acquisition and tends to improve problem-solving skills as

well as generic competences. The few existing reports in literature about using hybrid

PBL curricula in health science education suggested an improved performance of

students who have learned with PBL as compared with traditional methods, but they did

not assess the impact on long-term learning (Callis et al. 2010; Lian & He 2013). Our

results show that better performances are persistent over a long time period, which make

the improvement gained with PBL even more relevant. This thus suggests that the

implementation of hybrid models that combines PBL with traditional approaches may

favor students learning. The most relevant contribution of our study is the finding that

even a hybrid curriculum, with 20% of the students’ time devoted to PBL activities, is

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enough to significantly improve knowledge acquisition. While this finding is novel and

important, recent research has now provided solid evidence that active learning

methodologies confer a deeper understanding of science than standard lectures

(Waldrop 2015). However, the limited evidence of our study needs to be substantiated

with other empirical studies comparing hybrid PBL curriculum with those mainly based

in lecture-based approach.

References

Downloaded from http://femsle.oxfordjournals.org/ by guest on June 24, 2016

Abraham RR Vinod P Kamath MG et al. (2008) Learning approaches of undergraduate
medical students to physiology in a non-PBL and partially PBL-oriented curriculum.
Adv Physio Educ 32: 35–37.

Albanese MA & Mitchell S (1993) Problem-based learning: A review of literature on its

outcomes and implementation issues. Acad Med 68: 52-81.

Barrows HS (2002) Is it Truly Possible to Have Such a Thing as dPBL? Dist Educ; 23
(1): 119-122.

Berkson L (1993) Problem-based Learning: Have the expectations been met? Acad
Med 68 (10): S79-S88.

Callis AN McCann AL Schneiderman ED et al. (2010) Application of basic science to

clinical problems: traditional vs. hybrid problem-based learning. J Dent Educ 74 (10):
1113-24.

Carrió M Larramona P Baños JE et al. (2011) The effectiveness of the hybrid problem-
based learning approach in the teaching of biology: a comparison with lecture-based
learning. J biol educ 45: 229-235.

Chou FH & Chin CC (2009) Experience of problem-based learning in nursing education

at Kaohsiung Medical University. Kaohsiung J Med Sci 25: 258–263.

Cross KP. (1999) Learning is about making connections: the cross papers number 3.
Mission Viejo, CA: League for Innovation in the Community College and Educational
Testing Service.

Derting TL & Ebert-May D (2010) Learner-centered inquiry in undergraduate biology:

positive relationships with long-term student achievement. CBE- Life Sci Educ 9: 732-
741.

15
Dochy F Segers M Van den Bossche P et al. (2003) Effects of problem based learning:
a meta-analysis. Learn Instr 13: 533–568.

Dolmans DH De Grave WS Wolfhagen I et al. (2005) Problem-based learning: future

challenges for educational practice and research. Med Educ 39 (7): 732-741.

Ewell PT (1997) Organizing for learning: A new imperative. AAHE Bulletin 50 (4): 3-6.

Gijbels D Dochy F Van den Bossche P et al.. (2005) Effects of Problem-Based

Learning: A Meta-Analysis from the Angle of Assessment. Rev Educ Res 75 (1): 27-61.

Kalaian HA Mullan PB & Kasim RM (1999) What can studies of problem based
learning tell us? Synthesizing and modeling PBL effects on National Board of Medical
Examination performance: Hierarchical Linear Modeling meta-analytic approach. Adv
in Health Sci Educ 4: 209-221.

Lian J & He F (2013) Improved performance of students instructed in a hybrid PBL

Downloaded from http://femsle.oxfordjournals.org/ by guest on June 24, 2016

format. Biochem Mol Biol Edu 41 (1):5-10.

Mahdizadeh M Kermanian F Iravani S et al. (2008) Comparing lecture and problem-

based learning methods in teaching limb anatomy to first year medical students. Iranian
J Med Educ 2: 379–388.

Newman M (2003) Special Report 2: A pilot systematic review and meta-analysis on

the effectiveness of Problem Based Learning. ITSN Learning and Teaching Support
Network. Middlesex University, UK.

Pourshanazari A Roohbakhsh M Khazaei H et al. (2013) Comparing the long-term

retention of a physiology course for medical students with the traditional and problem-
based learning. Adv in Health Sci Educ 18: 91–97.

Reynolds M Hancock J and Dawson R (2010) Problem-Based Learning in a Higher

Education Environmental Biotechnology Course. Innov Educ and Teach Int 47 (2): 175-
186.

Schmidt HG Vermeulen L & Van der Molen HT (2006) Longterm effects of problem-
based learning: a comparison of competencies acquired by graduates of a problem-
based and a conventional medical school. Med Educ 40: 562-567.

Strobel J & Van Barneveld A (2009) When is PBL more effective? A meta-synthesis of
meta-analyses comparing PBL to conventional classrooms. I J PBL 3 (1): 44-58.

Vygotsky LS (1978) Mind in Society. Harvard Univ Press, Cambridge, MA.

Waldrop MM (2015) The science of teaching science. Nature 523: 272–274.

Table 1. Characteristics of two participant cohorts

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Cohort Age Number of Gender Grades of Number of
(average) students at entry (out of students that
first year 10) reached the
fifth year
2003 cohort (LBL) 17,8 62 14,5% male 7,42 52
85,5% female

2004 cohort (H-PBL) 17,9 63 14% male 7,32 54

86% female

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Table 2. PBL problems used in each academic trimester. Each trimester equals to a
module.

Course Trimester Problems Subjects

P1 Physics and chemistry
1 P2 Chemistry and zoology
P3 Physics and zoology
P4 Anthropology and botany
1 2 P5 Biochemistry and mathematics
P6 Biochemistry and botany
P7 Anatomy, physiology, and cytology
3 P8 Physiology and cytology
P9 Physiology and cytology
P10 Anatomy, physiology, and histology

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1 P11 Anatomy, physiology, and histology
P12 Anatomy, physiology, and histology
P13 Anatomy, physiology, and histology
2 2 P14 Biochemistry I
P15 Biochemistry II
P16 Nutrition and genetics
3 P17 Genetics and immunology
P18 Genetics and immunology
P19 Ecology
1
P20 Ecology and psychobiology
3
P21 Cellular biology and physiopathology
2
P22 Pharmacology and evolution
3 P23 Microbiology, plant physiology, and statistics
P24 Analytics chemistry, bioimaging, and developmental
1 biology
P25 Developmental biology and bioimaging
4
P26 Bioinformatics
2
P27 Biotechnology
3 P28 Toxicology, structural biology, and bioethics

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Table 3. Comparison of the scores on the multiple choice test and problem solving test
from students educated with a lecture-based learning (LBL) or a hybrid problem-based
learning (H-PBL) approach. Results are shown as means of scores out of 10. p values
are derived from t-student tests. Values were considered statistically significant if p <
0.05.

Mean scores obtained by students (out of 10)

LBL curricula H-PBL curricula
t p value
(n = 46) (n = 39)

Multiple choice test 6.13 ± 1.11 6.60 ± 0.95 2.08 0.041

Solving-problem test 5 ± 3.35 5.8 ± 2.73 1.22 0.225

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Table 4. Comparison using the 2 test of the tests scores based on pass (>5/10) or fail
(<5/10) results for the LBL and H-PBL cohorts (n = 42) in each type of exam. Values
were considered statistically significant if p < 0.05.

LBL curricula H-PBL curricula 2 p

cohort cohort
(n = 46) (n = 39)

Multiple choice test Pass 40 (86.9%) 38 (97.4%)

3.07 0.07
Fail 6 (13%) 1 (2.5%)

Problem-solving test Pass 27 (58.6%) 30 (76.9%)

3.17 0.07

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Fail 19 (41.3%) 9 (23%)

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 Downloaded from http://femsle.oxfordjournals.org/ by guest on June 24, 2016
Figure 1. Comparison of multiple choice tests scores obtained in the second and the
fifth year of the program by students in the LBL or H-PBL cohort. The second-year test
was answered by 52 students from the LBL cohort and 42 from the H-PBL cohort, and
the fifth-year test was answered by 46 students from the LBL cohort and 39 from the H-
PBL cohort.

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Figure 2. Students’ (grey bars) and tutors’ (black bars) perceptions about how generic
competences were developed through PBL. They were asked to value the level of
development from 0 to 10, being 0 not developed and 10 totally developed.

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