PT  - JOURNAL ARTICLE
AU  - Gerald Choon-Huat Koh, MD MMed
AU  - Hoon Eng Khoo, PhD
AU  - Mee Lian Wong, MD MPH
AU  - David Koh, MD PhD
TI  - The effects of problem-based learning during medical school on physician competency: a systematic review
AID  - 10.1503/cmaj.070565
DP  - 2008 Jan 01
TA  - Canadian Medical Association Journal
PG  - 34--41
VI  - 178
IP  - 1
4099  - http://www.cmaj.ca/content/178/1/34.short
4100  - http://www.cmaj.ca/content/178/1/34.full
SO  - CMAJ2008 Jan 01; 178
AB  - Background: Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. Methods: We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Results: Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Interpretation: Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.