One size doesn’t fit all: PBL tutor training and development

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Stella A. Nicolaou
Alexandros Heraclides
Costas S. Constantinou
Stella Loizou
David J. Gillott


PBL tutors in medical schools worldwide are a diverse population of faculty (subject-expertise, employment status and tutoring experience). Tutors often receive a common initial training program followed by structured support. This study aims to understand tutor motivation, challenges and support needed, the relationship between them and whether a common training and support program is understood as effective. Tutor data (n =50) were analyzed based on age, gender, background, experience, employment status and campus location. Interestingly, the study revealed some evidence that a challenge for tutors is what disrupts their motivation and thus a relevant support mechanism is needed in order to re-establish or maintain this motivation. Specifically, the motivator “interaction with students” correlated with challenges “management of group dynamics”, “student adherence with PBL rules” and “professional behavior of students” whilst motivator “educational value of PBL” correlated with “student adherence with PBL rules”, “professional behavior of students” and “student information and expectations of PBL”. Further, tutors benefited from peer-reviews and opportunities to provide feedback whilst, their needs diverged in terms of content and assessment-related support, motivation and management of group dynamics. Thus, implementation of a framework for restructuring the tutor support system is necessary paving the way for an individualized support system.  

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Albanese, M. A. (2010). Problem based learning. In T. Swanwick (Ed.), Understanding medical education theory and practice (pp. 37). Wiley-Blackwell.

Azer, S. A., McLean, M., Onishi, H., Tagawa, M., & Scherpbier, A. (2013). Cracks in problem-based learning: what is your action plan? Medical Teacher, 35(10), 806-814. 10.3109/0142159X.2013.826792 [doi]

Baroffio, A., Nendaz, M. R., Perrier, A., & Vu, N. V. (2007). Tutor training, evaluation criteria and teaching environment influence students' ratings of tutor feedback in problem-based learning. Advances in Health Sciences Education : Theory and Practice, 12(4), 427-439. 10.1007/s10459-006-9008-4 [doi]

Baroffio, A., Vu, N. V., & Gerbase, M. W. (2013). Evolutionary trends of problem-based learning practices throughout a two-year preclinical program: a comparison of students' and teachers' perceptions. Advances in Health Sciences Education : Theory and Practice, 18(4), 673-685. 10.1007/s10459-012-9408-6 [doi]

Boelens, R., De Wever, B., Rosseel, Y., Verstraete, A. G., & Derese, A. (2015). What are the most important tasks of tutors during the tutorials in hybrid problem-based learning curricula? BMC Medical Education, 15, 84-015-0368-4. 10.1186/s12909-015-0368-4 [doi]

Bosse, H. M., Huwendiek, S., Skelin, S., Kirschfink, M., & Nikendei, C. (2010). Interactive film scenes for tutor training in problem-based learning (PBL): dealing with difficult situations. BMC Medical Education, 10, 52-6920-10-52. 10.1186/1472-6920-10-52 [doi]

Chng, E., Yew, E. H., & Schmidt, H. G. (2015). To what extent do tutor-related behaviours influence student learning in PBL? Advances in Health Sciences Education : Theory and Practice, 20(1), 5-21. 10.1007/s10459-014-9503-y [doi]

Cho, Y. J., & Perry, J. L. (2012). Intrinsic Motivation and Employee Attitudes: Role of Managerial Trustworthiness, Goal Directedness, and Extrinsic Reward Expectancy. Review of Public Personnel Administration, 32(4), 382-406. 10.1177/0734371X11421495

Chung, E., Hitchcock, M. A., Oh, S., Han, E., & Woo, Y. (2011). The relationship between student perceptions of tutor performance and tutors' background in problem-based learning in South Korea. Int J Med Educ, 2, 7-11. 10.5116/ijme.4d38.d07e

Coffin, P. (2013). Identifying needs to develop a PBL staff development program. Journal of Problem Based Learning in Higher Education, 1(1), 194.

Constantinou, C., Nicolaou, S. (2018). Motivation, Challenges, Support (MCS) Cycle Model for the Development of PBL Tutors. Qualitative Research in Education, 7(1)10.17583/qre.2018.3064

Dalrymple, K. R., Wong, S., Rosenblum, A., Wuenschell, C., Paine, M., & Shuler, C. F. (2007). PBL Core Skills Faculty Development Workshop 3: understanding PBL process assessment and feedback via scenario-based discussions, observation, and role-play. Journal of Dental Education, 71(12), 1561-1573. 71/12/1561 [pii]

De Grave, W. S., Dolmans, D. H., & Van Der Vleuten, C. P. (2002). Student perspectives on critical incidents in the tutorial group. Advances in Health Sciences Education : Theory and Practice, 7(3), 201-209. 5089791 [pii]

Dent, J. A., Harden, R. M., Hunt, D., & Hodges, B. D. (2017;). A practical guide for medical teachers (Fifth ed.). Elsevier.

Dolmans, D. H., Janssen-Noordman, A., & Wolfhagen, H. A. (2006). Can students differentiate between PBL tutors with different tutoring deficiencies? Medical Teacher, 28(6), e156-61. Q2W2W53820451X61 [pii]

Dolmans, D. H., Wolfhagen, I. H., Scherpbier, A. J., & Vleuten, C. P. (2001). Relationship of tutors' group-dynamics skills to their performance ratings in problem-based learning. Academic Medicine : Journal of the Association of American Medical Colleges, 76(5), 473-476.

Emery, C. R., Kramer, T. R., & Tian, R. G. (2003). Return to academic standards: a critique of student evaluations of teaching effectiveness. Quality Assurance in Education, 11(1), 37-46. 10.1108/09684880310462074

Fan, C., Jiang, B., Shi, X., Wang, E., & Li, Q. (2018). Update on research and application of problem-based learning in medical science education. Biochemistry and Molecular Biology Education : A Bimonthly Publication of the International Union of Biochemistry and Molecular Biology, 46(2), 186-194. 10.1002/bmb.21105 [doi]

Finucane, P., Nichols, F., Gannon, B., Runciman, S., Prideaux, D., & Nicholas, T. (2001). Recruiting problem-based learning (PBL) tutors for a PBL-based curriculum: the Flinders University experience. Medical Education, 35(1), 56-61. med830 [pii]

Froiland, J. M., Oros, E., Smith, L., & Hirchert, T. (2012). Intrinsic Motivation to Learn: The Nexus Between Psychological Health and Academic Success. Contemporary School Psychology: Formerly "the California School Psychologist", 16(1), 91-100. 10.1007/BF03340978

Garcia, I., James, R. W., Bischof, P., & Baroffio, A. (2017). Self-Observation and Peer Feedback as a Faculty Development Approach for Problem-Based Learning Tutors: A Program Evaluation. Teaching and Learning in Medicine, 29(3), 313-325. 10.1080/10401334.2017.1279056 [doi]

Gilkison, A. (2003). Techniques used by "expert" and "non-expert" tutors to facilitate problem-based learning tutorials in an undergraduate medical curriculum. Medical Education, 37(1), 6-14. 1406 [pii]

Gliem, J. A., & Gliem, R. R. (2003). Calculating, Interpreting, And Reporting Cronbac�s Alpha Reliability Coefficient For Likert-Type Scales. Paper presented at the

Golding, C., & Adam, L. (2016). Evaluate to improve: useful approaches to student evaluation. Assessment & Evaluation in Higher Education, 41(1), 1-14. 10.1080/02602938.2014.976810

Grand'Maison, P., & Des Marchais, J. E. (1991). Preparing faculty to teach in a problem-based learning curriculum: the Sherbrooke experience. CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne, 144(5), 557-562.

Grant, A. M. (2008). Does intrinsic motivation fuel the prosocial fire? Motivational synergy in predicting persistence, performance, and productivity. The Journal of Applied Psychology, 93(1), 48-58. 10.1037/0021-9010.93.1.48 [doi]

Grasl, M. C., Kremser, K., Breckwoldt, J., & Gleiss, A. (2020). Does the tutors' academic background influence the learning objectives in problem-based learning? GMS Journal for Medical Education, 37(1), Doc8. 10.3205/zma001301 [doi]

Groves, M., Rego, P., & O'Rourke, P. (2005). Tutoring in problem-based learning medical curricula: the influence of tutor background and style on effectiveness. BMC Medical Education, 5(1), 20. 10.1186/1472-6920-5-20

Guest, G., Bunce, A., & Johnson, L. (2006). How Many Interviews Are Enough?: An Experiment with Data Saturation and Variability. Field Methods, 18(1), 59-82. 10.1177/1525822X05279903

Han, J., & Yin, H. (2016). Teacher motivation: Definition, research development and implications for teachers.3(1), 1217819. 10.1080/2331186X.2016.1217819

Hatem, C. J., Searle, N. S., Gunderman, R., Krane, N. K., Perkowski, L., Schutze, G. E., & Steinert, Y. (2011). The educational attributes and responsibilities of effective medical educators. Academic Medicine : Journal of the Association of American Medical Colleges, 86(4), 474-480. 10.1097/ACM.0b013e31820cb28a; 10.1097/ACM.0b013e31820cb28a

Hendry, G. D. (2009). Problem-based learning tutors' conceptions of their development as tutors. Medical Teacher, 31(2), 145-150. 10.1080/01421590802146026 [doi]

Huston, T., & Weaver, C. (2007). Peer Coaching: Professional Development for Experienced Faculty. Innovative Higher Education, 33, 5-20. 10.1007/s10755-007-9061-9

Joiner, T. A., & Bakalis, S. (2006). The antecedents of organizational commitment: the case of Australian casual academics. International Journal of Educational Management, 20(6), 439-452.

Kandemir, M., & Gür, H. (2009). What motivates mathematics teachers? Procedia - Social and Behavioral Sciences, 1, 969-974. 10.1016/j.sbspro.2009.01.172

Khong, T. D. H., & Saito, E. (2014). Challenges confronting teachers of English language learners.66(2), 210-225. 10.1080/00131911.2013.769425

Kindler, P., Grant, C., Kulla, S., Poole, G., & Godolphin, W. (2009). Difficult incidents and tutor interventions in problem-based learning tutorials. Medical Education, 43(9), 866-873. 10.1111/j.1365-2923.2009.03423.x; 10.1111/j.1365-2923.2009.03423.x

Leary, H., Walker, A., Shelton, B., & Fitt, M. (2013). Exploring the Relationships Between Tutor Background, Tutor Training, and Student Learning: A Problem-based Learning Meta-Analysis. Interdisciplinary Journal of Problem-Based Learning, 7, 40-66.

Lee, G. H., Lin, C. S., & Lin, Y. H. (2012). How experienced tutors facilitate tutorial dynamics in PBL groups. Medical Teacher, 10.3109/0142159X.2012.714883

Maudsley, G. (2002). Making Sense of Trying Not to Teach: An Interview Study of Tutors' Ideas of Problem-based Learning. Academic Medicine, 77(2)

McCrorie, P. (2010). Teaching and learning in small groups

. In T. Swanwick (Ed.), Understanding medical education: evidence, theory and practice (pp. 124). Wiley-Blackwell.

McDowell, M., Bedford, L., & Downs, L. (2014). Enhancing Faculty Performance through Coaching: Targeted, Individualized Support. Higher Learning Research Communications, 4, 3. 10.18870/hlrc.v4i4.221

McLean, M., Cilliers, F., & Van Wyk, J. M. (2008). Faculty development: yesterday, today and tomorrow. Medical Teacher, 30(6), 555-584. 10.1080/01421590802109834 [doi]

McLean, M., & Van Wyk, J. (2006). Twelve tips for recruiting and retaining facilitators in a problem-based learning programme. Medical Teacher, 28(8), 675-679. 777036047 [pii]

O Doherty, D., Mc Keague, H., Harney, S., Browne, G., & McGrath, D. (2018). What can we learn from problem-based learning tutors at a graduate entry medical school? A mixed method approach. BMC Medical Education, 18(1), 96-018-1214-2. 10.1186/s12909-018-1214-2 [doi]

Papinczak, T. (2010). An exploration of perceptions of tutor evaluation in problem-based learning tutorials. Medical Education, 44(9), 892-899. 10.1111/j.1365-2923.2010.03749.x [doi]

Papinczak, T. (2012). Perceptions of job satisfaction relating to affective organisation commitment. Medical Education, 46(10), 953-962. 10.1111/j.1365-2923.2012.04314.x [doi]

Park, S. E., Susarla, S. M., Cox, C. K., Da Silva, J., & Howell, T. H. (2007). Do tutor expertise and experience influence student performance in a problem-based curriculum? Journal of Dental Education, 71(6), 819-824. 71/6/819 [pii]

Paslawski, T., Kearney, R., & White, J. (2013). Recruitment and retention of tutors in problem-based learning: why teachers in medical education tutor. Canadian Medical Education Journal, 4(1), e49-e58.

Sa, B., Ezenwaka, C., Singh, K., Vuma, S., & Majumder, M. A. A. (2019). Tutor assessment of PBL process: does tutor variability affect objectivity and reliability? BMC Medical Education, 19(1), 76-019-1508-z. 10.1186/s12909-019-1508-z [doi]

Salinitri, F. D., Wilhelm, S. M., & Crabtree, B. L. (2015). Facilitating Facilitators: Enhancing PBL through a Structured Facilitator Development Program. Interdisciplinary Journal of Problem-Based Learning, 9(1)

Schmidt, H. G., & Moust, J. H. (1995). What makes a tutor effective? A structural-equations modeling approach to learning in problem-based curricula. Academic Medicine : Journal of the Association of American Medical Colleges, 70(8), 708-714.

Steinert, Y., Mann, K., Centeno, A., Dolmans, D., Spencer, J., Gelula, M., & Prideaux, D. (2006). A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8. Medical Teacher, 28(6), 497-526. J582GH1L185X7430 [pii]

Sullivan, P. B., Buckle, A., Nicky, G., & Atkinson, S. H. (2012). Peer observation of teaching as a faculty development tool. BMC Medical Education, 12, 26-6920-12-26. 10.1186/1472-6920-12-26 [doi]

Thomas, D. R. (2006). A General Inductive Approach for Analyzing Qualitative Evaluation Data. American Journal of Evaluation, 27(2), 237-246. 10.1177/1098214005283748

Tremblay, M., Tryssenaar, J., & Jung, B. (2001). Problem-based learning in occupational therapy: why do health professionals choose to tutor? Medical Teacher, 23(6), 561-566. 10.1080/01421590120090989 [doi]

Van Wyk, J., & McLean, M. (2007). Maximizing the value of feedback for individual facilitator and faculty development in a problem-based learning curriculum. Medical Teacher, 29(1), e26-31. 779132117 [pii]

Vansteenkiste, M., Lens, W., & Deci, E. L. (2006). Intrinsic versus extrinsic goal contents in self-determination theory: Another look at the quality of academic motivation. Educational Psychologist, 41(1), 19-31. 10.1207/s15326985ep4101_4

Vermote, B., Aelterman, N., Beyers, W., Aper, L., Buysschaert, F., & Vansteenkiste, M. (2020). The role of teachers’ motivation and mindsets in predicting a (de)motivating teaching style in higher education : a circumplex approach. (2020) Motivation and Emotion,

Vogt, K., Pelz, J., & Stroux, A. (2017). Refinement of a training concept for tutors in problem-based learning. GMS Journal for Medical Education, 34(4), Doc38. 10.3205/zma001115 [doi]

Watson, S. L., Koehler, A., Ertmer, P. A., Kim, W., & Rico, R. (2017). An Expert Instructor's Use of Social Congruence, Cognitive Congruence, and Expertise in an Online Case-Based Instructional Design Course. Interdisciplinary Journal of Problem-Based Learning, 12, 3.

Wetzel, M. S. (1996). Developing the role of the tutor/facilitator. Postgraduate Medical Journal, 72(850), 474-477. 10.1136/pgmj.72.850.474 [doi]

Williams, J. C., Alwis, W. A., & Rotgans, J. I. (2011). Are tutor behaviors in problem-based learning stable?: a generalizability study of social congruence, expertise and cognitive congruence. Advances in Health Sciences Education : Theory and Practice, 16(4), 505-515. 10.1007/s10459-011-9295-2 [doi]

Woltering, V., Herrler, A., Spitzer, K., & Spreckelsen, C. (2009). Blended learning positively affects students' satisfaction and the role of the tutor in the problem-based learning process: results of a mixed-method evaluation. Advances in Health Sciences Education : Theory and Practice, 14(5), 725-738. 10.1007/s10459-009-9154-6 [doi]

Yew, E. H. J., & Yong, J. J. Y. (2014). Student perceptions of facilitators’ social congruence, use of expertise and cognitive congruence in problem-based learning. Instructional Science, 42(5), 795-815. 10.1007/s11251-013-9306-1

Young, L., & Papinczak, T. (2013). Strategies for sustaining quality in PBL facilitation for large student cohorts. Advances in Health Sciences Education : Theory and Practice, 18(4), 825-833. 10.1007/s10459-012-9387-7 [doi]