Problem-Based Learning in Professional Studies from the Physiotherapy Students’ Perspective

Main Article Content

Hilkka Korpi
Liisa Peltokallio
Arja Piirainen

Abstract

The aim of the study was to investigate how physiotherapy students using a problem-based learning approach develop into experts during higher education, and answers the question: How do physiotherapy students at bachelor’s level understand the problem-based learning approach while learning to become professionals? PBL is examined using interpretative phenomenological analysis (IPA) of longitudinal data written by 15 voluntary students from two different higher education institutions and collected during 3.5 years. The main results on the new way of learning strengthen earlier conceptions of the importance of reflection in the learning process. The PBL method activates a reflection process by allowing students to participate in something that differs from their previous experiences of teaching and learning methods, which creates confusion and forces them to critically reflect on their actions. There are two dimensions of reflection in this study: self-reflection (information-seeking and creative learning processes) and reflection together (peer-group working and the teacher), in which reflection together seems to be more powerful than in earlier experiential learning theories. This study brings out the directions for and the timing of the necessary scaffolding and support for learning.

Article Details

Section
Articles

References

Barrett, T. (2006). A problem as a provoker of a space betwixt and between old and new ways of knowing. In E. Poikela & R. Nummenmaa (Eds.), Understanding problem-based learning (pp. 37–39). Tampere: Tampere University Press.

Barrows, H. (1985). How to design a problem-based curriculum for the preclinical years. New York: Springer.

Bereiter, C., & Scardamalia, M. (1987). The psychology of written composition. London: Lawrence Erlbaum Associates.

Boud, D., & Feletti, G. J. (1991). Introduction. In D. Boud & G. J. Feletti (Eds.), The challenge of problem-based learning (pp. 13–18). London: Kogan Page.

Boud, D., Keogh, R., & Walker, D. (1985). Reflection: Turning reflection into learning. New York: Kogan Page.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Cassidy, E., Reynolds, F., Naylor, S., & De Souza, L. (2011). Using interpretative phenomenological analysis to inform physiotherapy practice: An introduction with reference to the lived experience of cerebellar ataxia, Physiotherapy Theory and Practice, 27(4), 263–277. https://doi.org/10.3109/09593985.2010.488278

Cooper, H., & Spencer-Dawe, E. (2006). Involving service users in inter-professional education narrowing the gap between theory and practice. Journal of Interprofessional Care, 20(6), 603–617. https://doi.org/10.1080/13561820601029767

Cranton, P. (2006). Understanding and promoting transformative learning: A guide for educators of adults. San Francisco, CA: Jossey-Bass.

Cusack, T., & O ́Donoghue, G. (2012). The introduction of an interprofessional education module: Students’ perceptions. Quality in Primary Care, 20(3): 231–238. Retrieved from https://pdfs.semanticscholar.org/8162/e198d6aa7f48f8653ef4bbf8f413a68e8e27.pdf

Dewey, J. (1910/1991). How we think. New York: Prometheus. Dewey, J. (1938). Experience and education. New York: Collier Books.

European Higher Education Area, The Romanian Bologna Secretariat. (2017). European higher education 2010–2020. Retrieved from http://www.ehea.info

Goelen, G., De Clercq, G., Huyghens, L., & Kerckhofs, E. (2006). Measuring the effect of interprofessional problem-based learning on the attitudes of undergraduate health care students. Medical Education, 40(6), 555–561. https://doi.org/10.1111/j.1365-2929.2006.02478.x

Gunn, H., Hunter, H., & Haas, B. (2012). Problem based learning in physiotherapy education: A practice perspective. Physiotherapy, 98(4), 335–340. https://doi.org/10.1016/j.physio.2011.05.005

Holland, C., Bench, S., Brown K., Bradley, C., Johnson L., & Frisby, J. (2013). Interprofessional working in acute care. Clinical Teacher, 10(2), 107–112. https://doi.org/10.1111/tct.12002

Illeris, K. (2014). Transformative learning and identity. London, England: Routledge.

Jonassen, D. H., & Hung, W. (2015). All problems are not equal: Implications for problem-based learning. In A. Walker, H. Leary, C. Hmelo-Silver, & P. Ertmer (Eds.), Readings in problem-based learning: Exploring and extending the legacy of Howard S. Barrows (pp. 17–42). West Lafayette, IN: Purdue University Press.

Kamwendo, K., & Törnquist, K. (2001). Do occupational therapy and physiotherapy students care about research? A survey of perceptions and attitudes to research. Scandinavian Journal Caring Sciences, 15(4), 295–302. https://doi.org/10.1046/j.1471-6712.2001.00041.x

Karjalainen, A. L. (2012). Elettyä ymmärtämässä: Omaelämäkerrallinen kirjoittaminen ja teksti reflektiona sosiaalialan ammattikorkeakouluopinnoissa. [Understanding the past: Autobiographical writing and text as reflection in social studies conducted at the Diaconia University of Applied Sciences]. (A Studies 35). Helsinki, Finland: Diaconia University of Applied Sciences.

Kell, C., & van Deursen, R. (2003). Does a problem- solving based curriculum develop life-long learning skills in undergraduate students? Physiotherapy, 89(9), 523– 530. https://doi.org/10.1016/S0031-9406(05)60178-2

Knowles, M. S. (1980). The modern practice of adult education: From pedagogy to andragogy (2nd ed.). New York: Cambridge Books.

Kolb, D. A. (1984). Experiential learning: Experience as a source of learning and development. Englewood Cliffs, NJ: Prentice Hall.

Korpi, H., Peltokallio, L., & Piirainen, A. (2014). The story models of physiotherapy students’ professional development. Narrative research. European Journal of Physiotherapy, 16(4), 219–229. https://doi.org/10.3109/21679169.2014.934279

Korpi, H., Peltokallio, L. & Piirainen, A. (2017). Practical work in physiotherapy students’ professional development. Reflective Practice, 18(6), 821–836. https://doi.org/10.1080/14623943.2017.1361920

Kurunsaari, M., Tynjälä, P., & Piirainen, A. (2016). Students` experiences of reflective writing as a tool for learning in physiotherapy education. In G. Ortoleva, M. Betrancourt, & S. Billett (Eds.), Writing for professional development (pp. 129–151). Leiden, Netherlands: Koninklijke Brill.

Kurunsaari, M., Tynjälä, P., & Piirainen, A. (2018). Graduating physiotherapy students ́ conceptions of their own competence. Vocation and learning, 11(1), 1–18. https://doi.org/10.1007/s12186-017-9177-8

Lähteenmäki, M-L. (2006). Asiantuntijuuden kehittyminen ongelmaperustaisessa fysioterapeuttikoulutuksessa. [Development for expertise in PBL-based physiotherapy education] (Doctoral thesis). Available from TamPub Database (Record No. 1197, https://tampub.uta.fi/bitstream/handle/10024/67665/951-44-6795-7.pdf?sequence=1&isAllowed=y).

Loh, J. (2013). Inquiry into issues of trustworthiness and quality in narrative studies: A perspective. Qualitative Report, 18(65), 1–15. Retrieved from http://www.nova.edu/ssss/QR/QR18/loh65.pdf

Loyens, S. M. (2015). Foreword. In A. Walker, H. Leary, C. Hmelo-Silver, & P. Ertmer (Eds.), Readings in problem- based learning: Exploring and extending the legacy of Howard S. Barrows (pp. V–VIII). West Lafayette, IN: Purdue University Press.

Lu, J., & Chan, L. K. (2015). Differ in socio-cognitive processes? Some comparisons between paper and video triggered PBL. Interdisciplinary Journal of Problem-Based Learning, 9(2). https://doi.org/10.7771/1541-5015.1495

Malinen, A. (2000). Towards the essence of adult experimental learning. Laukaa, Finland: ER-paino.

Margetson, D. (1991). Why is problem-based learning a chal- lenge? In D. Bound & G. Feletti (Eds.), The challenge of problem-based learning (pp. 42–50). London: Kogan Page.

McAllister, A., Aanstoat, J., Hammarström, I. L., Samuelsson, C., Johannesson, E., Sandström, K., & Berglind, U. (2014). Learning in the tutorial group: A balance between individual freedom and institutional control. Clinical Linguis- tics & Phonetics, 28(1–2), 28–40. https://doi.org/10.3109/02699206.2013.809148

Merriam, S. B., Caffarella, R. S., & Baumgartner, L. M. (2007). Learning in adulthood. San Francisco, CA: Jossey-Bass. Mezirow, J. (1990). How critical reflection triggers transformative learning. In J. Mezirow & Associates (Eds.), Fostering critical reflection in adulthood. A guide to transformative and emancipatory learning (pp. 4–5). San Francisco, CA: Jossey-Bass.

Ministry of Culture and Education, Finland. (2016). Eurooppalainen tutkintojen viitekehys [European Qualification Framework]. Retrieved from http://www.minedu.fi/OPM/Koulutus/artikkelit/ammatillisen_koulutuksen_koeoepenhamina-prosessi/Eurooppalainen_tutkintojen_ja_osaamisen_viitekehys_xEQFx.html

O’Donoghue, G., McMahon, S., Doody, C., Smith, K., & Cusack, T. (2011). Problem-based learning in professional entry-level therapy education: A review of controlled evaluation studies. Interdisciplinary Journal of Problem-Based Learning, 5(1), 54–73. https://doi .org/10.7771/1541-5015.1218

Pekkinen, T. (2014). PBL-kortit—tutortyöskentelyn oppi- misen tukena [PBL cards—as supports for learning in tutor work]. In J. Tuomi (Ed.), Sitkeästi reilut 10 vuotta ongelmaperustaista oppimista hoitotyön koulutusohjel- massa [Roughly over 10 years of problem-based learning in a nursery education program] (Tampereen ammatti- korkeakoulun julkaisusarja. Sarja B. Raportteja 76) (pp. 19–24). Tampere, Finland: Tampere University Press.

Piirainen, A. (2014). The peer groups bridging the disciplines and social contexts in higher education. In B. Käpplinger, N. Lichte, E. Haberzeth, & C. Kulmus (Eds.), Changing configurations of adult education in transitional times (pp. 473–484). Berlin, Germany: ESREA Publications.

Piirainen, A., & Skaniakos, T. (2014). Pienryhmäohjaajien vertaisryhmä andragogisessa koulutuksessa. [Small group instructors’ peer group in andragogical education] Aikuiskasvatus, 34, 107–120. Retrieved from http://elektra.hel-sinki.fi/se/a/0358-6197/34/2/pienryhm.pdf

Poikela, E., & Poikela, S. (2006). Problem-based curricula— theory, development and design. In E. Poikela & R. Nummenmaa (Eds.), Understanding problem-based learning (pp. 71–81). Tampere, Finland: Tampere University Press.

Poikela, S. (2003). Ongelmaperustainen pedagogiikka ja tutorin osaaminen. [Problem-based pedagogy and the tutor’s knowing and competence] (Doctoral thesis). Available from TamPub Database, Record No. 250, http://tam- pub.uta.fi/bitstream/handle/10024/66398/951-44-5661-0.pdf?sequence=1&isAllowed=y)

Rasi, P. M., & Poikela, S. (2016). A review of video trig- gers and video production in higher education and continuing education PBL settings. Interdisciplinary Journal of Problem-Based Learning, 10(1). https://doi.org/10.7771/1541-5015.1609

Saarinen-Rahiika, H., & Binkley, J. M. (1998). Problem-based learning in physical therapy: A review of the literature and overview of the McMaster University experience. Physical Therapy, 2(78), 195–121. Retrieved from MEDLINE, http://pubmed.gov/9474111

Sahlberg, P. (2011). Finnish lessons: What can the world learn from educational change in Finland? New York: Teachers College Press.

Savery, J. R. (2006). Overview of problem-based learning: Definitions and distinctions. Interdisciplinary Journal of Problem-Based Learning, 1(1). https://doi.org/10.7771/1541-5015.1002

Savery, J. R. (2015). Overview of problem-based learning: Definitions and distinctions. In A. Walker, H. Leary, C. Hmelo-Silver, & P. Ertmer (Eds.), Readings in problem-based learning: Exploring and extending the legacy of Howard S. Barrows (pp. 5–15). West Lafayette, IN: Purdue University Press.

Savin-Baden, M. (2016). The impact of transdisciplinary threshold concepts on student engagement in problem- based learning: A conceptual synthesis. Interdisciplinary Journal of Problem-Based Learning, 10(2). https://doi.org/10.7771/1541-5015.1588

Savin-Baden, M., & Major, C. H. (2004). Foundations of problem-based learning. Bodmin, England: MPG Book Ltd. Schmidt, H. G. (1983). Problem-based learning: Rationale and description. Medical Education, 17(1), 11–16.

Schön, D. A. (1987). Education: The reflective practitioner. San Francisco, CA: Jossey Bass.

Smith, J. A. (2004). Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qualitative Research in Psychology, 1(1), 39–54. Retrieved from http://www.tandfonline.com/doi/abs/10.1191/1478088704qp004oa

Smith, J. A. (2011). Evaluating the contribution of interpretative phenomenological analysis. Health Psychology Review, 5(1), 9–27. https://doi.org/10.1080/17437199.2010.510659

Smith, J. A. (2017). Interpretative phenomenological analysis: Getting at lived experience. Journal of Positive Psychol- ogy, 12(3), 303–304. https://doi.org/10.1080/17439760.2016.1262622

Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. London: Sage.

Smith, J. A., & Osborn, M. (2008). Interpretative phenom- enological analysis. In J. A. Smith (Ed.), Qualitative psychology: A practical guide to research methods (pp. 53–80). London: Sage.

Smith, J. A., Spiers, J., Simpson, P., & Nicholls, A. R. (2017). The psychological challenges of living with an ileostomy: An interpretative phenomenological analysis. Health Psychol- ogy, 36(2), 143–151. https://doi.org/10.1037/hea0000427

Sockalingam, N., & Schmidt, H. G. (2011). Characteristics of problems for problem-based learning: The students’ perspective. Interdisciplinary Journal of Problem-Based Learning, 5(1). https://doi.org/10.7771/1541-5015.1135

Solomon, P., & Salfi, J. (2011). Evaluation of an interprofessional education communication skills initiative. Education for Health: Change in Learning & Practice, 24(2). PMID:22081661

Strobel, J., & van Barneveld, A. (2009). When is PBL more effective? A meta-synthesis of meta-analyses comparing PBL to conventional classrooms. Interdisciplinary Journal of Problem-Based Learning, 3(1). https://doi.org/10.7771/1541-5015.1046

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042

Tuomi, J., & Äimölä, A-M. (2014). PBL pistää enemmänkin ajattelemaan asioita kuin opettaa. Hoitotyön opiskelijoiden kokemuksia ongelmaperustaisesta oppimisesta. [PBL makes you think more than teaches. Nurse students’ experiences of problem-based learning]. In J. Tuomi (Ed.), Sitkeästi reilut 10 vuotta ongelmaperustaista oppimista hoitotyön koulutusohjelmassa [Roughly over 10 years of problem-based learning in a nursery education program] (Tampereen ammattikorkeakoulun julkaisusarja. Sarja B. Raportteja 76) (pp. 59–79). Tampere, Finland: Tampere University Press.

Yardley, L. (2000). Dilemmas in qualitative health research. Psychology & Health, 1(2), 215–228. https://doi.org/10.1080/08870440008400302

Yardley, L. (2008). Demonstrating validity in qualitative psychology. In J. A. Smith (Ed.), Qualitative psychology. A practical guide to research methods (2nd ed., pp. 235–251). London: Sage.

Yew, E. H. J., & Goh, K. (2016). Problem-based learning: An overview of its process and impact on learning. Health Professions Education, 2(2), 75–79. https://doi.org/10.1016/j.hpe.2016.01.004