Challenges in Problem-Based Learning and Suggested Solutions at the School of Medicine, Walailak University: A Mixed-Methods Study

Background: Problem-based learning (PBL) was used in basic and clinical sciences learning in an integrated approach. Despite its implementation into medical curricula around the world over four decades ago, group dynamic issues in PBL are still abundant. To date, there is no publication addressing the difficulties in PBL for Thai medical students.

Objective: To explore difficulties in PBL and suggest solutions at the School of Medicine, Walailak University.

Methods: A sequential explanatory mixed method was employed using the triangulation method to get the information from students, facilitators, and a medical curriculum expert. Anonymous online survey data from students emphasised barriers to PBL and respondents’ suggestions. Content analysis was performed on written feedback from facilitators. Finally, a researcher performed a semi-structured interview with a medical curriculum expert. Data were collected throughout the academic year 2016.

Results: A total of 83 (86.5%) medical students responded to the survey, 58 students (69.9%) reported no difficulties in their learning process; 25 students (30.1%) disclosed challenges in learning. Facilitators’ feedback was collected from a total of 23 PBL sessions. Factors affecting the PBL process included facilitators’ characteristics, course organisation, and learning environment. Favourable characteristics for facilitators included thinking process support (28.7%), appropriate and constructive feedback (27.9%), listening skills (24.3%), safe environment (14.0%), and being concise (5.1%).

Conclusions: Three major factors contributing to PBL difficulties among Thai medical students were facilitator’s quality, course organisation, and learning environment. Hence these factors should be optimized to allow students to achieve the best learning process and outcome.