Comparison of cognitive domain scores after lecture-based and problem-based learning in community medicine

Sundaram Kartikeyan, Aniruddha A. Malgaonkar


Background: Problem-based learning is a student-centred, problem-based, small-group method of learning that emphasizes use of scenarios. The objective of this comparative descriptive study was to determine the difference in cognitive domain scores after lecture-based learning and problem-based learning.

Methods: This comparative descriptive study was conducted at a municipal medical college in Thane, Maharashtra, India. After approvals, the study was explained to third-year MBBS students and written informed consent was obtained from willing students. After delivering lectures on five topics in environmental health in the subject of Community Medicine, a pre-test was conducted, which comprised five short-answer questions (ten marks per question; maximum 50 marks). Scenarios pertaining to the same topics were devised for problem-based learning. To enable small-group discussion, the students were randomly assigned to two groups. The post-test questionnaire was identical to that used for the pre-test.

Results: A total of 61 students (males=26; 42.62% and females=35; 57.38%) participated. The overall mean pre-test scores increased from 26.44±3.58 (95% CI: 25.55-27.34) to 32.74±4.46 (95% CI: 31.62-33.86). The difference between the overall pre- and post-test scores was highly significant (Z=8.604; p<0.00001). However, the gender differences in pre- and post-test scores were not statistically significant.

Conclusions: Since problem-based learning offers a stan­dardized method of teaching wherein the knowledge can be applied, it can be used as an adjunct in educational settings that focus mainly on lecture-based learning.


Community medicine, Problem based learning, Cognitive domain scores

Full Text:



Neufeld VR, Woodward CA, MacLeod SM. The McMaster M.D. programme: A case study of renewal in medical education. Acad Med 1989;64:423-32.

Mateti UV, Konda SS, Khan MGIA, Nagappa AN. Need for Problem-Based Learning in Clinical Pharmacy Education in India. Indian J Pharmacy Pract. 2014;7(3):10-13.

Camp G. Problem-Based Learning: A Paradigm Shift or a Passing Fad? MEO. 1996;1:2.

Knowles ME. The Modern Practice of Adult Education: From Pedagogy to Andragogy. Englewood Cliffs, NJ, USA: Cambridge Adult Education; 1980: 57-58.

Savery JR, Duffy TM. Problem based learning: An instructional model and its constructivist framework. Educ Technol. 1995;35(5):31-7.

Brookfield SD. Understanding and facilitating adult learning: A Comprehensive Analysis of Principles and Effective Practices. San Francisco, CA: Jossey-Bass, 1986.

Clarke R. Problem-based learning. In: Cox KR, Ewan CEM, eds. The medical teacher. London: Churchill Livingstone, 1988.

Barrows HS. Problem-based, self-directed learning. JAMA. 1983;250:3077-80.

Bligh J. Problem-based learning in medicine: an Introduction. Postgrad Med J. 1995;71:323-6.

Edwards P, Wallace B, Houston H. Group project work by general practice trainees. Post Educ Gen Pract. 1990;1:178-84.

Wood DF. ABC of learning and teaching in medicine Problem based learning. BMJ. 2003;326(7384):328.

Onyon C. Problem-based learning: a review of the educational and psychological theory. Clin Teach. 2012;9(1):22-6.

McParland M, Noble LM, Livingston G. The effectiveness of problem-based learning compared to traditional teaching in undergraduate psychiatry. Med Educ. 2004;38(8):859-67.

Towle A. Medical education: a future in primary care? Primary Health Care Man. 1992;2:8-9.

Nanda B, Manjunatha S. Indian medical students’ perspectives on problem-based learning experiences in the undergraduate curriculum: One size does not fit all. J Educ Eval Health Prof. 2013;10:11.

Imran M, Shamsi S, Singh A, Goel S, Sharma P, Panesar S. Problem-based learning versus lecture-based learning in pharmacology in a junior doctor teaching program: a crossover study from northern India. Int J Res Med Sci. 2015;3(11):3296-9.

Faisal R, Khalil-ur-Rehman, Bahadur S, Shinwari L. Problem-based learning in comparison with lecture-based learning among medical students. J Pak Med Assoc. 2016;66(6):650-3.

Tack CJ, Plasschaert AJ. Student evaluation of a problem-oriented module of clinical medicine within a revised dental curriculum. Eur J Dent Educ. 2006;10(2):96-102.

Lin CF, Lu MS, Chung CC, Yang CM. A comparison of problem-based learning and conventional teaching in nursing ethics education. Nurs Ethics. 2010;17(3):373-82.

Goodyear HM. Problem based learning in a junior doctor teaching programme. Arch Dis Child. 2005;90(3):275-8.

Smits PB, de Buisonje CD, Verbeek JH, van Dijk FJ, Metz JC, ten Cate OJ. Problem-based learning versus lecture-based learning in postgraduate medical education. Scand J Work Environ Health. 2003;29(4):280-7.

Johnston JM, Schooling CM, Leung GM. A randomised-controlled trial of two educational modes for undergraduate evidence-based medicine learning in Asia. BMC Med Educ. 2009;9:63.

Choi E, Lindquist R, Song Y. Effects of problem-based learning vs. traditional lecture on Korean nursing students' critical thinking, problem-solving, and self-directed learning. Nurse Educ Today. 2014;34(1):52-6.

Dehkordi AH, Heydarnejad MS. The impact of problem-based learning and lecturing on the behavior and attitudes of Iranian nursing students. A randomised controlled trial. Dan Med Bull. 2008;55(4):224-6.

Yang L-H, Jiang L-Y, Xu B, Liu S-Q, Liang Y-R, Ye J-H, et al. Evaluating team-based, lecture-based, and hybrid learning methods for neurology clerkship in China: A method-comparison study. BMC Medical Education. 2014;14:98.

Michaelsen LK, Parmelee DX, McMahon KK, Levine RE, Billings DM. Team-Based Learning for Health Professions Education: A guide to using small groups for improving learning. Sterling, VA, USA: Stylus Publishing. 2008: 14.

Michaelsen LK, Knight AB, Fink LD. Team-based learning: A transformative use of small groups. Westport: Greenwood Publishing Group; 2002: 157-171.

Kelly PA, Haidet P, Schneider V, Searle N, Seidel CL, Richards BF. A comparison of in-class learner engagement across lecture, problem-based learning, and team learning using the STROBE classroom observation tool. Teach Learn Med. 2005;17:112-8.

Chakraborty M, Gouroju S, Garg P, Karthikeyan P, Singh P. CBL in Medical Education Effective Learning Methodology than PBL. Int J Integ Med Sci. 2015;2(8):140-50.

Norman GR, Schmidt HG. The psychological basis of problem-based learning: a review of the evidence. Acad Med. 1992;67:557-65.