| Until the 1960s, undergraduate medical education was predominantly taught in the traditional "lecture-based" manner typical of most university curricula. As this method of teaching came under increasing criticism, a group at McMaster University in Hamilton, Ontario, Canada devised a new approach to teaching medicine which they called "problem-based learning" (PBL). The premise of PBL was to start the learning process by presenting learners with a clinical problem. Students would then combine group work with a well-trained tutor and self-directed learning to understand and diagnose the problem and present a management solution. The success of the PBL program at McMaster led to its spread to medical schools around the globe. The majority of medical schools in a number of regions, including Canada, the United States, and the United Kingdom currently use some form of PBL.;Despite its success as a teaching and learning methodology, there has been a lack of research into the issues medical schools have faced in trying to either transition into PBL from a traditional lecture-based curriculum or to implement a PBL program from the school's inception. This study was designed to inform the theoretical model for the implementation of PBL in medical schools based upon analytic generalization of two English institutions. This inquiry is a comparative case study of two medical schools that have implemented PBL in the last decade. The University of Liverpool transitioned from the traditional model to PBL in the 1990s, and the University of East Anglia (Norwich, England) started their medical school using PBL in 2002.;Results from this study showed that both schools successfully implemented PBL into their curricula while overcoming both similar and unique obstacles. This work presents details of how the change process was managed and executed at each school, and how the move to PBL specifically affected the change process. A discussion of past mistakes, current issues and future directions is designed to help inform those considering a move to a PBL-based curriculum in their medical school. Included also is a description of the curriculum at the University of Liverpool and the University of East Anglia. |
