Problem-Based Learning in Professional Entry-Level Therapy Education: A Review of Controlled Evaluation Studies

Main Article Content

Grainne O'Donoghue
Sinead McMahon
Catherine Doody
Kathyrn Smith
Tara Cusack


Although there has been growing interest in Problem Based Learning (PBL) by professional entry-level therapy educators, its effectiveness is as yet unclear. Existing overviews of the field do not provide high quality evidence in terms of the effectiveness or otherwise of PBL in professional therapy education. The purposes of this article is to systematically review the current literature on PBL and determine its effectiveness when compared to other didactic approaches in physiotherapy, occupational therapy, speech-language therapy, dietetics, podiatry, orthoptics and therapeutic radiography entry-level education. Eight databases were searched for controlled evaluation studies investigating the effectiveness of PBL in the seven therapy professions. Four competencies were analysed; students’ knowledge, performance, approaches to learning and satisfaction. Data were extracted and risk of bias assessed by independent reviewers. One scoring system was used to assess the quality of the studies and another determined the level of evidence for each competency. The search yielded 3885 articles, of which six met inclusion criteria after full text review; three in physiotherapy, one each in occupational therapy, dietetics and podiatry. Three of the six studies were categorised as high quality. No study measured all four competencies. When compared to other didactic approaches, there is no evidence that PBL has a more positive effect on students’ knowledge and performance and satisfaction levels and limited evidence that it improves students’ approaches to learning. Currently available literature revealed no convincing evidence that PBL is more effective than traditional didactic education for entry level therapy professions.

Article Details



Albanese, M. A. & Mitchell S. (1993). Problem-based learning: A review of literature on its outcomes and implementation issues. Academic Medicine, 68, 52-81.

Antepohl, W. & Herzig, S. (1999). Problem-based learning versus lecture-based learning in a course of basic pharmacology: a controlled, randomized study. Medical Education, 33, 106-113.

Barrows, H. (1980). Problem-based learning: An approach to medical education. New York: Springer.

Barrows, H. (1986). A taxonomy of problem-based learning methods. Medical Education, 20, 480-486.

Berliner, D. C. (2002). Educational research: The hardest science of all. Educational Researcher, 31, 18-20.

Berkson, L. (1993). Problem-based learning: Have the expectations been met ? Academic Medicine 68, S79-88

Blumberg,P.&Michael,J.(1992).Developmentofself-directedlearningbehaviorsinapartially teacher-directed problem-based learning curriculum. Teaching and Learning in Medicine, 4, 3-8.

Boud, P. & Feletti G. (1991). The challenge of problem -based learning. London: Kogan Page. Bransford, J. D., Franks, J. J., Vye, N. J., & Sherwood, R. D. (1989). New approaches to instruction: Because wisdom can’t be told. In S. Vosiadou & A. Ortony (Eds.), Similarity and analogical reasoning. New York: Cambridge University Press.

Busuttil, J. (1988). A problem-based learning occupational therapy course: The second year? British Journal of Occupational Therapy, 51, 8-10.

Choon-Huat Koh, G., Eng Khoo, H., & Lian Wong, M. (2008). The effects of problem-based learning during medical school on physician competency: A systematic review. Canadian Medical Association Journal, 178, 34-41.

De Vries, M., Schmidt, H. & De Graf, E. (1989) Dutch comparisons: Cognitive and motivational effects of PBL on medical students. In H. Schmidt, J. R. Lipkin, M. De Vries, & , J. De Greep. (Eds.), New directions for medical education: Problem-based learning and community oriented medical education. New York: Springer, Verlag.

Distlehorst, L. H. & Robbs, R. S. (1998). A comparison of problem-based learning and standard curriculum students: three years of retrospective data. Teaching and Learning in Medicine, 10, 131-137.

Dochy, F., Segers, M., van den Bossche, P. & Gijbels, D. (2003). Effects of PBL: a meta-analysis. Learning and Instruction, 13, 533-568.

Eksteen, C. A. & Slabbert, J. A. (2001). Problem-based curricula and problem-based learning in physiotherapy: A critical review. South African Journal of Physiotherapy, 57, 23-28.

EPOC. (2007). Cochrane Effective Practice and Organization of Care Group: Guide for review authors 4: Developing a review. Aberdeen; EPOC.

Finch, P. N. (1999). The effect of problem-based learning on the academic performance of students studying podiatric medicine in Ontario. Medical Education, 33, 411-417.

Kaufman, R. R., Portney, L. G., & Jette, D. (1997). Clinical performance of physical therapy students in traditional and problem-based learning. Journal of Physical Therapy Education, 11, 26-31.

Lieux, E. (1996). A comparative study of learning in lecture vs. problem-based format. University of Delaware. Retrieved from http://www.

Liotta-Kleinfeld, L. & S. McPhee (2001). Comparison of final exam test scores of neuroscience students who experienced traditional methodologies versus problem-based learning methodologies. Occupational Therapy in Health Care 14(3-4), 35-53.

Lohse, B., Nitzke, S. & Ney, D. (2003). Introducing a problem-based unit into a lifespan nutrition class using a randomized design produces equivocal outcomes. Journal of the American Dietetic Association, 103, 1020-1025.

Maudsley, G. (1999). Do we all mean the same thing by problem-based learning? A review of the concepts and a formulation of the ground rules. Academic Medicine, 74, 178-185.

McCannon, R. & Robertson, D. (2004). Students’perceptions of their acquired knowledge du ing a problem-based learning case study. Occupational Therapy in Health Care, 18, 13-28.

McCarron, K. A. & D’Amico, F. (2002). The impact of problem-based learning on clinical reasoning in occupational therapy education. Occupational Therapy in Health Care, 16, 1-13.

Menahem, S. & Paget, N. (1990). Role play for the clinical tutor: towards problem-based learning. Medical Teacher, 12, 57-61.

Mok, C. K. F., Dodd, B., & Whitehall, T. L. (2009). Speech-language pathology students’ approaches to learning in a problem-based learning curriculum. International Journal of Speech-Language Pathology, 11, 472-481.

Newman, M. (2003). Campbell Collaboration Systematic Review Group on the Effectiveness of Problem Based Learning: A pilot systematic review and meta-analysis on the effectiveness of problem-based learning. Retrieved March 2010 from teaching/Research/PEPBL/index.htm

Norman, G. R. (2003). RCT = results confounded and trivial: The perils of grand educational experiments. Medical Education, 37, 582-584.

Norman, G. R. & Schmidt, H. G. (2000). Effectiveness of problem-based learning curricula: theory, practice, and paper darts. Medical Education, 34, 721-728.

Richards, B. F., Ober, P., Cariaga-Lo, L., Camp, L. G., Philip, J., McFarlane, M., Rupp, R. & Zaccaro, D. J. (1996). Ratings of students’performances in a third-year internal medicine clerkship: a comparison between problem-based and lecture-based curricula. Academic Medicine, 71, 187-189.

Royeen, C. B. (1995). A problem-based learning curriculum for occupational therapy education. American Journal of Occupational Therapy, 49, 338-346.

Royeen, C. B. & Salvatori, P. (1997). Comparison of problem-based learning curricula in two occupational therapy programmes. Canadian Journal of Occupational Therapy, 64, 197-202.

Scottish Intercollegiate Guidelines Network. (2008). Sign 50: Guideline developer’s handbook. Retrieved from

Shin J. H., Haynes, R. B. & Johnston, M. E. (1993). Effects of problem-based, self-directed undergraduate education on life-long learning. Canadian Medical Association Journal, 148, 969-976.

Smits, P., Verbeek, J., & de Buisonje, C. (2002). Problem-based learning in continuing medical education: A review of controlled evaluation studies. British Medical Journal, 324, 153-156.

Soloman, P. (2005). Problem-based learning: A review of current issues relevant to physiotherapy education. Physiotherapy Theory & Practice, 21, 37-49.

Stewart, J., O’Halloran, C., Barton, J. R., Singleton, S. J., Harrigan, P. & Spencer, J. (2000). Clarifying the concepts of confidence and competence to produce appropriate self-evaluation measurement scales. Medical Education, 34, 903-909.

Terry, P. H. & Seibels, D. R. (2008). Incorporating problem-based learning into an undergraduate community nutrition class. Journal of Nutrition Education and Behavior, 38, 121-122.

Titchen, A. C. (1987). Design and implementation of a problem-based continuing education program. Physiotherapy, 73, 313-323.

Titchen, A. C., & Coles, C. R. (1991). Comparative study of physiotherapy students’ approaches to their study in subject-centered and problem-based curricula. Physiotherapy Theory & Practice 7(2), 127-133.

Van Duijn, A. J., & Bevins, S. I. (2005). Clinical performance of physical therapist students in problem-based, mixed-model, and traditional curricula. Journal of Physical Therapy Education, 19, 15-21.

Van den Bossche, P., Gijbels, D., and Dochy, F. (2000, June). Does problem-based learning educate problem solvers? A meta- analysis on the effects of problem-based learning. Paper presented at the Seventh Annual EDINEB Int. Conference, Newport Beach, CA.

Van Langenberghe, H. (1988). Evaluation of students approach to studying in a problem-based physical therapy curriculum, Physical Therapy, 68, 522-525.

Verhoeven, B.,Verwijnen G. M., Scherpbier A. J. J. A., Holdrinet R. S. G., & Oes B. (1998). An analysis of progress test results of PBL and non-PBL students. Medical Teacher, 20, 310-316.

Vernon, D. T. & Blake, R. L. (1993). Does problem-based learning work ? A meta-analysis of evaluative research. Academic Medicine, 68, 550-563.

Walton H. J. & Matthew M. B. (1989). Essentials of problem-based learning. Journal of Medical Education, 23, 542-558.

Watson, D. E. & West, D. J. (1996). Using problem-based learning to improve educational outcomes. Occupational Therapy International, 3, 81-93.

Woodward, C. A. & Ferrier, B. M. (1983). The content of the medical curriculum at McMaster University: Graduates’evaluation of their preparation for post-graduate training. Medical Education, 17, 54-60.

World Health Organization. (1991). Changing medical education: An agenda for action. Geneva: Offices of the World Health Organization.