Table 2 Study details and summary of results

Hayashi et al., 2013 [30]

Comparison of tutored group with tutorless group in problem-based mixed learning sessions: a randomized cross-matched study

RCT, quantitative, cross sectional (on one PBL session)

Yr 1 (n = 202), Aichi Medical University, Japan

7–8

Daily small group discussions and short lecture regarding recurring scenario (4 discussions make a PBL session); daily report on group discussions and learning details and formative tutor feedback; written exam on the last day of each PBL session; groups are switched after one PBL session

Compared faculty-tutored and tutorless PBL. Faculty-tutored students reported a more favorable learning experience. Both groups of students performed comparably on exams, but tutorless students showed greater in-group variance on exam scores

Group dynamics in both tutored and untutored conditions were inconsistently variable

Hay & Katsikitis, 2001 [31]

The 'expert' in problem-based and case-based learning: necessary or not?

RCT, quantitative, cross sectional (on one unit)

Yr 4 (n = 144), Medical Faculty at University of Adelaide, Australia

10–12

PBL involves 3 weekly 90-min sessions— a brief initial scenario presentation (details given later), group synthesis of data and hypotheses, and identification of learning issues; CBL involves one 90-min session— full case presentation and supplementary reading provided in advance, small group presents to a larger group, more tutor feedback and assistance

Students did not especially prefer clinician or non-clinician tutors. Clinician-tutored groups performed better on a voluntary knowledge test, while the non-clinician tutor was perceived to be better at group management and communication skills

Shields et al., 2007 [32]

A faculty development program to train tutors to be discussion leaders rather than facilitators

Pretest–posttest, quantitative, cross sectional (on one course)

Yr 2 (n = 508), Harvard Medical School, USA

7–9

Three 90-min PBL tutorials per week over a 3-week course; tutors are trained in asking guiding questions, summarizing major points, and using schematics; cases and tutorial objectives are provided before tutorial; External components: 1–1 tutor–student meetings for personal feedback and identification of quiet/dominant students

Expert and non-expert tutors were rated equally favorably by students. There was little difference in academic achievement. There was little difference in academic achievement

Students enjoyed the autonomy created by tutors acting as discussion leaders (by asking question, summarizing material, and creating visual schematics), rather than facilitator. Course satisfaction improved over years of study

Davis et al., 1992 [33]

Effects of expert and non-expert facilitators on the small-group process and on student performance

Observational, mixed method, cross sectional (over one PBL session)

Yr 2 (n = 156), University of Michigan Medical School, USA

7–8

PBL involves problem identification, setting objectives, self-study followed by report of findings to the group

Students’ perception and exam grades were higher for expert than non-expert tutors

Expert and non-expert tutors did not systematically differ in facilitation style. Student self-direction was prominent in both tutor groups

Schmidt et al., 1993 [34]

Influence of tutors' subject-matter expertise on student effort and achievement in problem-based learning

Questionnaire, quantitative, cross sectional (over one unit)

Yr 1–4 health science students (n = 1120), University of Limburg, Netherlands

10

Two 120-min PBL tutorials per week over a 6-week unit; students complete a course evaluation and achievement test at end of each unit

Part 1: Results of existing studies on the effectiveness of expert versus non expert tutors are inconclusive. Some studies found a preference for student tutors over staff tutors. Part 2: Students' exam scores and self-study time was greater for expert than non-expert tutors. The effect of tutor expertise diminishes with year of study

Expert tutors were better at identifying case objectives, while non experts were more focused on group functioning. Both are important to PBL tutoring

Qin et al., 2010 [35]

Application of problem-based learning in a large class in stomatology course

Questionnaire, quantitative, cross sectional (on one unit)

Yr 4 (n = 236), China Medical University, China

7–8

Curriculum of a 30-h unit involves 12 h of lecture and 18 h of PBL (two 100-min PBL tutorials per week); both an expert and nonexpert tutor were present; groups were naturally formed and instructed to appoint a different group leader for different cases; theoretical and case analysis exam, and self- and peer-evaluations occur throughout

Students enjoyed experts and non-experts for content learning and guiding group dynamics, respectively. Students with less PBL experience preferred expert tutors. Students enjoyed PBL and performed equally well on exams regardless of previous PBL experience

Groves et al., 2005 [36]

Tutoring in problem-based learning medical curricula: the influence of tutor background and style on effectiveness

Questionnaire, quantitative, cross sectional (over one semester)

Yr 1 students (n-270) and tutors (n = 50), University of Queensland, Australia

10

Three 11-week terms in a school year; groups remained consistent for the year

Clinician tutors were rated higher than non-clinicians on cognitive congruence, focus on summative tests, degree of authority, role congruence, and encouragement of group dynamics. Staff tutors were higher than non-staff tutors on the same. Older tutors were higher on all but role congruence. However, overall tutor ratings did not vary significantly

Kassab et al., 2005 [37]

Student-led tutorials in problem-based learning: educational outcomes and students' perceptions

RCT, quantitative, cross sectional (on one unit)

Yr 3 (n = 91), College of Medicine and Medical Science Arabian Gulf University, Bahrain

///

unspecified

Student tutors bonded better with students and faculty tutors were rated as better at problem discussion, but tutor identity had no impact on knowledge acquisition

Kassab et al., 2005 [38]

Gender-related differences in learning in student-led PBL tutorials

RCT, quantitative, cross sectional (on one unit)

Yr 3 (n = 91), College of Medicine and Medical Science Arabian Gulf University, Bahrain

///

2 PBL tutorials per week in a pre-clinical curriculum; different students are elected as peer-tutor each week; students undergo a 1-day workshop on tutoring skills

Female student tutors were rated as better at displaying professional behavior and giving feedback than male student tutors, but student tutors struggled with problem discussion and analysis regardless of gender. Tutor gender also had no impact on knowledge acquisition

Ten Cate et al., 2012 [39]

Academic achievement of students tutored by near-peers

Questionnaire, quantitative, cross sectional (over one course)

Yr 1–3 (n = 9923), University Medical Center Utrecht’s Medical School, Netherlands

14 avg

2 PBL tutorials per week for each 4–6-week course

Student course grades did not differ significantly for near-peer versus faculty tutor groups

Widyahening et al., 2019 [40]

Evaluation of the role of near-peer teaching in critical appraisal skills learning: a randomized crossover trial

RCT, quantitative, cross sectional (on one module)

Yr 4 (n = 241), Faculty of Medicine Universitas Indonesia

10–11

Curriculum involves 4-week modules with lectures, 120-min PBL sessions, presentations on study design/conduct, and computer labs (data search/analysis); PBL follows lectures and involves appraising journal articles on diagnosis, therapy, prognosis etc

Near-peer and faculty tutored students were comparable for content knowledge, critical appraisal ability, attitudes towards PBL, and confidence in their own skills. Near-peers were more readily accepted by students

Chng et al., 2015 [41]

To what extent do tutor-related behaviours influence student learning in PBL?

Questionnaire, quantitative, longitudinal (over one PBL session)—two studies reported

Study 1: Yr 2 (n = 77) / Study 2: unspecified year of study (n = 637), Singapore Polytechnic Faculty of Science, Singapore

 ≥ 5

PBL cycle was completed within 1 day; phase 1 = 1 h problem analysis, phase 2 = 4 h self-directed learning w minor tutor guidance, phase 3 = 2 h reporting and peer eval; *tutors were selected based on previous congruence ratings for this study

Study 1: Tutor ratings were higher for high-congruence tutors, but student recall ability was higher for low congruence tutors. Study 2: Students with high-congruence tutors had higher module scores. This effect was consistent for high, mid, and low performance students

Cianciolo et al., 2016 [42]

Observational analysis of near-peer and faculty tutoring in problem-based learning groups

Observational, qualitative, cross sectional (on three units)

Yr 2 (n = 46), Southern Illinois University School of Medicine, USA

6

2 PBL sessions per week over 9 weeks; Multiple-choice test and standardised patient exam administered on the last week; *PBL groups are stratified by demographic characteristics and academic achievement

All tutors exhibit a degree of professional congruence to students. Student tutors were particularly valued for their social congruence and empathy for learner needs

Tutor identity (Year 4 student, clinical faculty, basic science faculty) showed no significant differences in the observable nature of student behavior and group interaction. Facilitation practices have greater variation within tutor types than between

Schmidt, 1994 [43]

Resolving inconsistencies in tutor expertise research: does lack of structure cause students to seek tutor guidance?

Questionnaire, quantitative, cross sectional (over one unit)

Unspecified health science students (n = 1800) and tutors (n = 320), University of Limburg, Netherlands

10

Two 120-min PBL tutorials per week over a 6-week unit

Tutor expertise impacted student achievement primarily in modules where students had low prior knowledge and in poorly structured modules. Student tutors produced consistent achievement scores regardless of prior knowledge and course structure

Vasan et al., 2009 [44]

A survey of student perceptions of team-based learning in anatomy curriculum: favorable views unrelated to grades

Questionnaire, quantitative, cross sectional (on one course)

Yr 1 (n = 317), New Jersey Medical School, USA

8

TBL involves assigned pre-class readings, identification of learning issues, individual testing, 90-min group discussion, group testing, and peer evaluation; tutors float between groups during tutorial; curricular context involves presentations and dissection labs but no basic knowledge lectures

Perception of PBL was generally favorable, but increased with higher anticipated grades, while perception of groupwork was not significantly impacted by anticipated grades

Gallagher, 2009 [45]

Collaborative essay testing: group work that counts

Questionnaire, mixed method, cross sectional (on one course)

Junior level nursing students (n = 163), Saint Xavier University of Chicago, USA

3–4

Groups are engaged in case studies, scenario reviews, etc. and present to a larger group under guidance of a faculty facilitator; 3 closed-book exams with group and individual components throughout semester; *groups are assigned

Perception of learning was irrelevant to grades

Students acknowledged the professional need for collaborative skills and perceived good group dynamics overall. Students felt more motivated to study and more confident in their knowledge in group settings

Students were in favor of group testing

Wahid et al., 2015 [46]

Students’ characteristics related to their performances in problem-based learning

Questionnaire, quantitative, cross sectional (over one module)

Yr 1–3 (n = 539), Faculty of Medicine Universitas Indonesia, Indonesia

///

Two 120–180 min PBL sessions per week, involving 4–5 cases over each 6-week module; PBL is supplemented by lectures, labs, conferences, etc.); module grades incorporate knowledge tests and learning process evaluation scores; *tutors are physicians or faculty with biomedical backgrounds

Academic performance did not vary by gender and geography. Performance increased with years of study and varied by admission method. Talent-scouted students (based on grades and extracurriculars) were highest performing, while students admitted based on standard exams were lowest performing

Wimmers & Lee, 2015 [47]

Identifying longitudinal growth trajectories of learning domains in problem-based learning: a latent growth curve modeling approach using SEM

Questionnaire, quantitative, longitudinal (over two years)

Yr 1–2 (n = 296), UCLA School of Medicine, USA

8

2 PBL sessions a week over nine 5–8-week blocks in a school year; PBL is supplemented by lectures, labs, and clinical skills workshops

Students’ skills and abilities were highly variable. Professionalism was the most stable trait over time. Individual differences in ability persisted over the two-year study period

Kamp et al., 2013 [48]

The effect of midterm peer feedback on student functioning in problem-based tutorials

Pretest–posttest, mixed methods, cross sectional (on one course)

Yr 2 health science students (n = 74), University of Maastricht, Netherlands

 ≤ 10

One 120-min PBL tutorials per week over 8-week courses; PBL involves case discussion, identification of learning issues, synthesis of findings; peer feedback given mid-way of course; all students received training giving peer feedback; *tutors switched each tutorial

Peer feedback was more effective in low-achievers than high-achievers for improving the quality of student contribution

Students suggested feedback would be more effective if given verbally and received in the context of well-defined group and individual goals

Ganguly et al., 2019 [49]

Association of group composition diversity and performance outcomes in a pre-clerkship team-based learning program

Questionnaire, quantitative, cross sectional (on one PBL session)

Yr 1 (n = 238), University of Texas Southwestern Medical School, USA

5–7

1–2 TBL sessions per course; TBL groups were stratified based on DISC personality assessment, science background, and gender balance

Students perceived gender as the most important aspect of diversity, but diversity in race/ethnicity most influenced academic performance. More racially diverse groups perceived diversity as more important for learning outcome when compared to less diverse groups

Thompson et al., 2015 [50]

Team cohesiveness, team size and team performance in team-based learning teams

Questionnaire, quantitative, cross sectional (over one rotation)

Yr 3 (n = 975), across four university medical schools, USA

5–7

4 TBL sessions per 6-week clerkship rotation; course grades incorporate individual and group exam scores

Group exam scores increased with larger group size (5–7) and correlated with individual exam scores. Gender composition of groups was irrelevant

Mpofu et al., 1998 [51]

Perceptions of group dynamics in problem-based learning sessions: a time to reflect on group issues ^b

Questionnaire, mixed method, longitudinal (over one module)

Yr 1 (n = 46), FMHS United Arab Emirates University, UAE

7–8

One 2 h PBL session per week over a 140-h module; the role of group leader and scribe is rotated amongst members; PBL is supplemented by practical skills workshops, lectures, and self-study); *students separated by gender due to cultural reasons

Student perceptions differed significantly by gender. Females prioritized maximizing academic learning outcomes and males valued the opportunity to participate autonomously

Students rated communication and participation among the most important aspects of PBL, and dysfunctional group behavior and power imbalance among the least important. Dysfunctional group behavior was frequently ignored. The perceived importance of a leader role decreased over time

Das Carlo et al., 2003 [52]

Medical student perceptions of factors affecting productivity of problem-based learning tutorial groups: does culture influence the outcome? ^b

Questionnaire, quantitative, cross sectional (over one module)

Yr 1 (n = 115), FMHS United Arab Emirates University, UAE

8–10

Students undergo a 2-week orientation program to PBL processes and goals; PBL tutorials are 2 h long; tutors are rotated for each of 4 themes in a module; *students separated by gender due to cultural reasons

Female groups scored higher in motivation and productivity. Male groups displayed more disruptive behavior such as lateness and absenteeism

Motivation contributed to group productivity

Burgess et. al., 2014 [53]

Medical students as peer tutors: a systematic review

Systematic review

n/a

n/a

n/a

Students who participated in PBL as peer tutors reported favorable experiences and immediate behavioral outcomes, though academic benefits were variable

Favorable experiences centered around recurrent themes of confidence and autonomy

Koufogiannakis et al., 2005 [54]

Impact of librarians in first-year medical and dental student problem-based learning (PBL) groups: a controlled study

RCT, quantitative, cross sectional (on one block)

Yr 1 medical and dental students (n = 164), University of Alberta, Canada

9

4 PBL sessions per week over 6 week unites; all students undergo a 2 h library lab session at the start of the term; *tutors are physicians; *groups are stratified by demographic representation

The presence of a librarian facilitator during PBL made no difference in students’ attitudes, confidence in library skills, and exam performance

Iqbal et al., 2016 [55]

Differential impact of student behaviours on group interaction and collaborative learning: medical students' and tutors' perspectives

Semi-structured interview, qualitative, retrospective on overall experience

Yr 1–2 students (n = 22) and tutors (n = 8), University of New South Wales Medical School, Australia

///

2 h weekly tutorials on scenario-based collaborative learning activities; grades incorporate individual and group assessments

Student behaviors may positively or negatively impact group cohesion (associated to students' experience of the group), group learning, or both. Timidness was viewed unfavorably while assertiveness was viewed favorably. Cohesion and learning may occur independently of each other

Feedback was thought to be important to both cohesion and learning

Van Berkel & Dolmans, 2006 [56]

The influence of tutoring competencies on problems, group functioning and student achievement in problem-based learning

Questionnaire, quantitative, cross sectional (on one module)

Yr 1–2 (n = 352 groups), University of Maastricht Medical School, Netherlands

9–10

2 PBL sessions per week

Regular feedback and evaluation correlated to group functioning

Tutors’ ability to stimulate self-directed learning correlated to perceived PBL case quality and group performance

PBL case quality correlated to group performance and individual test scores

Alizadeh et al., 2017 [57]

Uncover it, students would learn leadership from Team-Based Learning (TBL): The effect of guided reflection and feedback

Pretest–posttest, quantitative, cross sectional (on one block)

Yr 1 (n = 223), Tehran University Medical School, Iran

4–7

Preclinical curriculum is lecture predominant, supplemented by lab exercises, case-based discussions, and TBL

Role reflection may be important to the appreciation of group-based learning. Reflective capacity was promoted by feedback

Guided reflection and feedback had no effect on leadership behavior or team decision quality but did increase students’ acceptance of leadership and self-awareness for group roles

Kingsbury & Lymn, 2008 [58]

Problem-based learning and larger student groups: mutually exclusive or compatible concepts—a pilot study

Questionnaire, quantitative, cross sectional (on one module)

Yr 2 students (n = 111) and tutors (n = 8), University of Nottingham Medical School, UK

20–21

Different weekly topics explored over a 5-week summer module; cluster PBL methodology (7 cases distributed to smaller groups of 2–3 students for self-directed research, and finding are presented to the large group at the end of the week) followed by summary lecture to debrief clinical relevance of the case

Students and tutors generally reported a positive PBL experience, with minimal conflict in group dynamics. Tutors lacking in facilitation experience or training had worse perception of PBL

Tutors and students liked the use of a subgroup PBL format in a large class, with no comparator. Case difficulty impacted tutors’ but not students’ perception of learning effectiveness

Dolmans et al., 2001 [59]

Relationship of tutors' group-dynamics skills to their performance ratings in problem-based learning

Questionnaire, quantitative, cross sectional (study period unspecified)

Yr 1–4 (n = 75 groups), University of Maastricht Medical School, Netherlands

5–10

unspecified

Overall group dynamics were favorable, and groups' ratings of sponging behaviors were low. However, groups' ratings of the tutors' ability to facilitate group dynamics and reduce problematic behavior were also low

Dolmans & Schmidt, 2006 [60]

What do we know about cognitive and motivational effects of small group tutorials in problem-based learning?

Scoping review

n/a

n/a

n/a

Group processes in PBL are driven by cognitive (reasoning, cognitive conflicts, collaborative knowledge construction) and motivational factors (intrinsic interest), which are beneficial to academic outcomes. The effects of group discussion are greater in those with less prior knowledge, and students who did not contribute in group discussions did equally well on tests

Hendry et al., 2003 [61]

Group problems in problem-based learning

Questionnaire, mixed method, cross sectional (retrospective on general experience)

Yr 1–2 students (n = 143) and tutors (n = 76), University of Sydney Medical School, Australia

8–9

3 PBL tutorials per week (new case each week); tutors change per block over 9 blocks; PBL is supplemented by lectures

Quiet and dominant students, lateness, and absenteeism were perceived as frequent PBL issues by students and tutors. Poorly organized tutorials, superficial case problems, and dominant students were considered the most hindering for learning. Tutors felt prepared to deal with curriculum-related dysfunction, but neither tutors nor students are effective at resolving issues caused by student behavior. Students also identified dominant and uninterested tutors as problematic

ODoherty et al., 2018 [62]

What can we learn from problem-based learning tutors at a graduate entry medical school? A mixed method approach

Questionnaire & focus group, mixed methods, cross sectional (on one course)

Yr 1–2 tutors (n = 33), University of Limerick School of Medicine, Ireland

///

*All tutors are clinicians

First year students were more likely to rely on tutors more as knowledge experts, compared to second year students. Tutors perceived dominant and timid students as a major challenge for facilitation. Experienced tutors were more confident in engaging in autonomous facilitation styles. The facilitation process is not standardized and is complicated by external factors

Van Mook et al., 2007 [63]

Factors inhibiting assessment of students' professional behaviour in the tutorial group during problem-based learning

Questionnaire, quantitative, cross sectional (on overall experience)

Yr 2–4 (n = 393), University of Maastricht Medical School, Netherlands

///

unspecified

Lack of effective feedback, lack of effort to find solutions to group conflicts, and lack of motivation were perceived to be the main barriers to assessing professional behaviour. These may be left unaddressed without having negative repercussions to students' academic performances. Unprepared tutors were additionally identified as a concern

Visschers-Pliejers et al., 2005 [64]

Student perspectives on learning-oriented interactions in the tutorial group

Questionnaire, quantitative, cross sectional (over one course)

Yr 2 (n = 175), University of Maastricht Medical School, Netherlands

9

unspecified

Students rated the desirability of learning-oriented interactions (questioning and reasoning) higher than their frequency of occurrence in PBL. Contrastingly, handling conflict was deemed less desirable than its frequency of occurrence

Papinczak, 2009 [65]

Conducting the symphony: a qualitative study of facilitation in problem-based learning tutorials

Questionnaire, qualitative, cross sectional (on one year)

Yr 1–2 (n = 295), University of Queensland Medical School, Australia

8–11

5 h PBL tutorial per week over 36-week school year; PBL involves case analysis, hypotheses formation, and self-directed learning

Students were critical of overly directive or lax tutors, and of tutors who interjected too often or not often enough. Students perceived a greater need for tutors to interject in process-related aspects, such as handling conflict and intervening with dominating personalities. Tutors were viewed as professional role models

Park et al., 2020 [66]

Shining a light into the black box of group learning: medical students' experiences and perceptions of small groups

Semi-structured interview, qualitative, retrospective on one year

Yr 1 (n = 9), UBC Faculty of Medicine, Canada

8

Three 120-min PBL tutorials per week (new case each week) over 6-week units; curriculum is lecture predominant, supplemented by PBL, dissection labs, formal skills training, and portfolio-based mentoring experience; *PBL groups are reassigned every 6 weeks; *tutors are clinicians or health professional or teaching experts

Students understand the intention of PBL to train teamwork skills but preferred self-learning over group learning. Tutors were perceived to be responsible for managing group dynamics, and dysfunctional group behaviour was ignored so long as marks were not impacted. Perception of tutors as an assessor of performance reduced "risk-taking behavior" such as leadership and conflict resolution

Poskiparta et al., 2003 [67]

Students' and teachers' experiences of a problem-based learning method in health promotion in a Finnish polytechnic

Semi-structured interview, qualitative, retrospective (on one year)

Yr 1–2 nursing students (n = 9) and tutors (n = 10), unspecified polytechnic, Finland

///

Unspecified, newly implemented PBL curriculum

Students become more favorable of PBL as they become more familiar with the format and more confident with self-direction

Varga-Atkins et al., 2010 [68]

Developing professionalism through the use of wikis: A study with first-year undergraduate medical students

Questionnaire & focus group, qualitative, cross sectional (on two modules)

Yr 1 (n = 32), University of Liverpool School of Medicine, UK

8

Semesters are divided into 2-week modules around PBL cases (week 1 = set learning objectives, then independent study (including wiki use), week 2 = share learning with group)

Good group dynamics and confidence in content knowledge increased likelihood of posting to a shared wiki page. Lack of motivation and fear of making poor-quality contributions decreased engagement. Students were more likely to post to an already active wiki than to start a new one

Engagement with the wiki allowed students to reflect on their identities as knowledge experts and increased their confidence with the material

Hommes et al., 2014 [69]

Understanding the effects of time on collaborative learning processes in problem-based learning: a mixed methods study

Observational, mixed method, longitudinal (over 18 months)

Yr 1–2 (n = 173–204), University of Maastricht Medical School, Netherlands

8–12

6–10-week modules; *tutorial groups and tutors are randomly reassigned each module

Groups cohered better over time as students became more familiar with group formation processes. Speed of group coherence was greatly influenced by external factors (e.g., approaching exams)

Zgheib et al., 2016 [70]

The long-term impact of team-based learning on medical students’ team performance scores and on their peer evaluation scores

Questionnaire, quantitative, longitudinal (over two years)

Yr 1–2 (n = 102), American University of Beirut Faculty of Medicine, Lebanon

5–6

Curriculum is half lecture and half non-lecture (TBL, cases, panels, labs); TBL activities include lecture preparation, assigned readings, or a mix of both; TBL learning objectives are given ahead of time; *TBL groups are switched half-way in Yr 1 and again for Yr 2; *students undergo an initial workshop on TBL philosophy and goals

Communication, professionalism, and personal development improved over time. Speed of improvement in teamwork skills also increased with experience

Perceptions of tutorials were generally positive. Students preferred and performed better in tutorials involving lecture preparation as compared to readings-based sessions

Nieminen et al., 2006 [71]

On the relationship between group functioning and study success in problem-based learning

Questionnaire, quantitative, cross sectional (on one PBL session)

Yr 1 medical and dental students (n = 116), University of Helsinki, Finland

8–11

Two 90-min PBL tutorials per week over 5-week courses; PBL is supplemented by lectures, clinical sessions, labs, and self-study; students are assessed by an end-of-course test with 3 opportunities to retest

Tutor performance and students’ self-perception of contribution influenced overall experience of group processes

Case quality influenced course grade

Schmidt & Moust, 1995 [72]

What makes a tutor effective? A structural-equations modeling approach to learning in problem-based curricula

Questionnaire, quantitative, cross sectional (over one course)

Yr 1–4 health science students (n = 1452), University of Limburg, Netherlands

///

Two 120-min PBL sessions per week over 6-week courses; *PBL groups are randomly assigned

Effective tutors require a combination of content knowledge, the ability to engage with students authentically, and the ability to communicate in accessible language

Matthew-Maich et al., 2016 [73]

Nursing students' perceptions of effective problem-based learning tutors

Questionnaire, qualitative, cross sectional (on one year)

Yr 1–4 nursing students (n = 511), Mohawk College & McMaster University, Canada

10–12

PBL tutorial involves introduction of case scenario, hypothesis formation, identifying learning issues, information gathering and independent study, knowledge debate within group, knowledge application, and reflection of learning process; curricular context is unspecified

Effective tutors were knowledgeable and enthusiastic and inspired motivation to learn in students. In contrast, ineffective tutors were powerful demotivators

Dolmans et al., 1999 [74]

Is tutor performance dependent on the tutorial group's productivity?: Toward further resolving of inconsistencies in tutor performance

Questionnaire, quantitative, cross sectional (over one module)

Yr 1–4 (n = 363 groups), University of Maastricht Medical School, Netherlands

10–12

6-week units

Ratings for tutors with stable performance across tutorials did not vary based on group productivity. Ratings for tutors whose performance was discrepant across tutorials correlated with group productivity

Ju et al., 2017 [75]

Do medical students generate sound arguments during small group discussions in problem-based learning?: an analysis of preclinical medical students' argumentation according to a framework of hypothetico-deductive reasoning

Observational, quantitative, longitudinal (over one unit)

Yr 1 (n = 15), Inje University College of Medicine, Korea

7–8

Three 120-min PBL sessions over first week, followed by 3–4 weeks of lecture per organ block; standardized patients are used in first PBL session

Students were generally poor at providing justification for argumentation during PBL. Most arguments made, regardless of the phase of PBL, were unbacked claims. Fewer claims were backed by data from the case scenario, and even fewer claims were backed by warranted justification

Rotgans et al., 2018 [76]

How cognitive engagement fluctuates during a team-based learning session and how it predicts academic achievement

Questionnaire, quantitative, longitudinal (over one PBL session)

Yr 1–2 (n = 175), Lee Kong Chian School of Medicine Singapore, Singapore

5–6

2 TBL sessions per week; both a content expert and a process expert are present; *students are exposed to 3 orientation TBL sessions prior to this study

Regardless of year of study, cognitive engagement was highest during phases of PBL requiring small group interaction and lowest in preparation and class discussion phases

MacLeod, 2011 [77]

Caring, competence and professional identities in medical education

Semi-structured interview, qualitative, retrospective on overall experience

Yr 2 students (n = 12) and tutors (n = 10), Dalhousie Medical School, Canada

7

unspecified

Various PBL processes allowed students to understand the importance of and display both competence-related (confidence, capability, suitability) and caring-related (benevolence, humbleness) aspects of professional behavior. Gaps in PBL were filled via individual extracurricular engagements