Respiratory therapists are professionals who assess, cure and take care of patients who present with breathing and other cardiopulmonary problems (United States Bureau of Labor Statistics, 2010). Respiratory therapists work under the supervision of physicians but they take chief responsibility for all treatments and procedures that are related to respiratory care. They work hand in hand with doctors and other healthcare personnel to create specialized care programs for their patients. They also offer multifaceted therapies that require independent judgment and reasoning, for instance, caring for patients in intensive care units (United States Bureau of Labor Statistics, 2010). Because of their critical role, respiratory therapists require effective education and training programs. In order to become a respiratory therapist, one needs to have at least an associate or bachelor’s degree. Education and training is provided after a person completes his or her high school education. “Majority of respiratory therapy programs give associate or bachelor’s degree and prepare students for jobs as advanced respiratory therapists,” (United States Bureau of Labor Statistics, 2010, p. 398).
In the United States, respiratory therapy as a profession began in 1947 through the formation of the Inhalation Therapy Association. Today, the American Association for Respiratory Care is in charge of respiratory therapy education (United States Bureau of Labor Statistics, 2010). The aim of this paper is to compare and contrast the problem-based learning (PBL) approach with the traditional lecture-based teaching approach. A special focus will be on the respiratory care education.
Problem-Based Learning Approach versus Traditional Teaching Approach
It is too unfortunate that majority of students not only in secondary but also in tertiary levels finish their studies with only knowledge on how to be taught (Beers, 2005). The educational system has brought about and spread this dire situation. Beginning in the first grade and ending in college, students sit passively in class while the tutors implement the art of teaching. A substantial volume of information is passed on from the teachers to the students, and at the end of the semester students are examined on their ability to retain the information they gained (Beers, 2005). This is the traditional method of teaching. With the advent of information technology, the amount of information that students have to acquire is increasing exponentially, not only on a daily basis but also on an hourly basis. As a result, it is imperative for the education system to be adaptive to these situations (Beers & Bowden, 2005).
Problem-based learning (PBL) is an approach to teaching that nurtures these capabilities (Murphy, Hartigan, Walshe, Flynn & O’Brien, 2010). The revolt in curricular that is taking place in general education is also taking place in nursing and medical education. The swift changes that are taking place in health care delivery have necessitated adjustments in nursing practice, employment, and education. Teachers have a professional duty to train nurses to adapt to the ever-changing professional environment. PBL is a useful method of transforming the focal point of education from gaining content to attaining wider educational objectives (Rogal & Snider, 2008). Problem-based learning utilizes teaching and learning methods that create valuable linkages between theory and practice. Making use of the PBL approach avails students with the chance to actively participate in the learning process and to have critical thinking skills (Op’t Holt, 2000; White et al., 2004).
One of the differences between traditional teaching and problem-based learning is in the utilization of problems. Problem-based learning enables students to come face to face with real-life challenges and teaches them to recognize what they already know and what they do not know and need to know so as to gain the information needed, evaluate it, and converse with peers about it (Beers & Bowden, 2005). The unswerving characteristics of PBL entail provision of a challenge without the information required to tackle it, working in small groups, and direction and advice from the instructor (Op’t Holt, 2005). Although PBL has attracted attention from the education experts, many concerns surround this approach. Of significance is the concern of whether or not the PBL approach is as effective as the traditional lecture approach in teaching core courses to nursing and medical students. It is argued that unlike the traditional teaching method, PBL makes it impossible for instructors to cover all the core contents. Thus, even though PBL inculcates critical thinking and problem-solving skills that are critical in nursing and medical practice (Ceconi, Op’t Holt, Zip, Olson & Beckett, 2008), there is doubt about the ability of PBL to sufficiently prepare students in objective evaluation.
Traditional teaching method also differs from the problem-based learning in the management of learning. Whereas the traditional teaching method uses lectures to drive the learning process, PBL utilizes original and informal real-world scenarios to drive and manage all learning (Beachey, 2007). The PBL approach is therefore a philosophy rather than a teaching approach. As a philosophy, PBL converts the whole curriculum into a customer-focused approach by giving emphasis to knowledge creation rather than knowledge diffusion. Whereas the traditional teaching approach puts emphasis on the wide coverage of content areas via lecture, the PBL approach relies on the problem as the driving force of the learning process by guiding students to appropriate content information (Mishoe & Hernlen, 2005). This learning philosophy is different from the traditional supposition that information should be gained before the beginning of the problem-solving process, and that learning ought to be done in a chronological manner, starting from elementary scientific concepts and progressing to clinical practice (Mishoe, 2007). Traditional lecture-based programs put emphasis on teaching instead of learning. They also emphasize passive instead of active participation of students and acquiring rather than constructing knowledge.
The study by Beachey (2007) is the first published study to investigate the efficacy of PBL versus the traditional lecture-based approach in respiratory therapy education. The results of the study supported the results of prior studies that examined the effectiveness of PBL in medical education programs. Specifically, the study showed that graduates of PBL respiratory therapy education programs report higher levels of satisfaction with their training than their peers enrolled in traditional lecture-based education programs. The study further showed that there was no difference between PBL and traditional graduates with regards to membership in state and national professional organizations, quest for professional credentialing, or participation in advanced education. This is not a surprise because credentialing is a necessity for state licensure and practice, and a big proportion of continuing education takes place through state and national professional conventions in which members receive discounted services.
On the other hand, Beachey (2007) found that graduates of traditional respiratory therapy education programs receive higher ratings from employers than the PBL graduates on four major areas. These areas include: the ability of the graduates to use diagnostic data to propose therapy and procedures; their abilities to carry out diagnostic procedures and make inferences of the diagnostic data; their abilities to communicate effectively with others; and their ethical and professional behaviors. These results contradict the results of other studies conducted on PBL nursing and medical education programs. Conversely, Beachey (2007) found that the employers’ rating of general graduate quality was similar between the PBL and the traditional graduates.
The traditional teaching method differs from problem-based learning in the degree of freedom of expression. In traditional teaching method, the educator is the authority. On the other hand in problem-based learning, there is freedom of expression and educators as well as learners accept different opinions (Scaffa & Wooster, 2004). The learners in PBL programs identify the objective of learning as the process of learning and takes responsibility for learning and the achievement of their own objectives (Goelen, De Clercq, Huyghens & Kerckhofs, 2006). This enables students to acquire strong reasoning and problem-solving abilities which become permanent skills (Darnton, Lucas, & Pearson, 2007).
Traditional teaching method and problem-based learning differ in the utilization of resources. In traditional teaching method, learners are provided with the resources whereas learning in a PBL program is self-directed (Distlehorst, Dawson, Robbs & Barrows, 2005) and therefore learners search for the required resources on their own. When team members obtain the resources required to solve a given problem, they embark on the process of finding the solution. This process is undertaken through extensive discussions among the group members (Spencer & McNeil, 2009). The group members give suggestions, carry out research on the efficacies of the options, create a list of potential solutions and then evaluate the suitability of each of the solutions to the given scenario thereby enhancing students’ communication skills (Spinello & Fischbach, 2004). This engaging and active learning process is lacking in the traditional teaching method in which learning tends to be more individualistic. Scaffa and Wooster (2004) argue that, “cumulative learning, when subjects or key points are introduced repeatedly at increasing levels of complexity, is threaded throughout the PBL process,” (p. 334). Educators in PBL programs create real-life scenarios whose complexity increases with time and whose emphasis is on students’ integrated and cumulative learning experiences (Wells, Warelow & Jackson, 2009).
PBL programs promote student-focused learning settings and inspire intrusive learning rather than repetitive memorization (Lloyd-Jones & Hak, 2004). Learning is the sole responsibility of the students who are active participants in the learning process (Ali & El Sebai, 2010; Albanese, 2000). Such graduates are more likely to exhibit better professional behaviors, an incorporation of different elements of their academic program, better readiness for clinical and practical work, higher clinical reasoning skills, higher self confidence, and quest for self-directed and continuous learning as compared to students who go through the traditional learning program (Bahar-Ozvaris, Cuhadaroglu, Turan & Peters, 2006). On a negative note, studies show that PBL approach leads to lower acquisition of content in basic knowledge as compared to students in traditional learning program. This is because whereas the PBL program emphasizes on problem-solving (Schmidt, Vermeulen & Molen, 2006), the traditional learning approach emphasizes on the acquisition of as much information as possible.
Reference List
Albanese, M. (2000). Problem based learning: Why curricula are likely to show little effect on knowledge and clinical skills. Journal of Medical Education, 34(9), 729-738.
Ali, W., & El Sebai, N. (2010). Effect of problem-based learning on nursing students’ approaches to learning and their self directed learning abilities. International Journal of Academic Research, 2(4), 188-195.
Bahar-Ozvaris, S., Cuhadaroglu, F., Turan, S., & Peters, A. (2006). Cooperative learning: a new application of problem-based learning in mental health training. Medical Teacher, 28(6), 553-557.
Beachey, W. (2007). A comparison of problem-based learning and traditional curricula in baccalaureate respiratory therapy education. Respiratory Care, 52(11), 1497-1506.
Beers, G. (2005). The effect of teaching method on objective test scores: Problem-based learning versus lecture. Journal of Nursing Education, 44(7), 305-309.
Beers, G., & Bowden, S. (2005). The effect of teaching method on long-term knowledge retention. Journal of Nursing Education, 44(11), 511-514.
Ceconi, A., Op’t Holt, T., Zip, G. P., Olson, V., & Beckett, R. (2008). Influence of problem-based learning instruction on decision-making skills in respiratory therapy students. Respiratory Care Education Annual, 17, 57-64.
Darnton, R., Lucas, B., & Pearson, D. (2007). Using problem-based learning in primary care: what do undergraduates on traditional medical courses make of it? Education for Primary Care, 18, 450-458.
Distlehorst, L. H., Dawson, E., Robbs, R. D., & Barrows, H. S. (2005). Problem based learning outcomes: The glass half full. Academic Medicine, 80(3), 294-299.
Goelen, G., De Clercq, G., Huyghens, L., & Kerckhofs, E. (2006). Measuring the effect of inter-professional problem-based learning on the attitudes of undergraduate health care students. Medical Education, 40, 555-561.
Lloyd-Jones, G., & Hak, T. (2004). Self-directed learning and student pragmatism. Advanced Health Science Education Theory and Practice, 9(1), 61–73.
Mishoe, S. C. & Hernlen, K. (2005). Teaching and evaluating critical thinking in respiratory care. Respiratory Care Clinics of North America, 11(3), 477-488.
Mishoe, S. (2007). Problem-based learning: any influence in respiratory care? Respiratory Care, 52(11), 1457-1459.
Murphy, S., Hartigan, I., Walshe, N., Flynn, A. V., & O’Brien, S. (2010). Merging problem-based learning and simulation as an innovative pedagogy in nurse education. Clinical Stimulation in Nursing, e1-e8.
Op’t Holt, T. B. (2000). A first-year experience with problem based learning in a baccalaureate cardio-respiratory care program. Respiratory Care Education Annual, 9, 47-58.
Op’t Holt, T. B. (2005). Problem-based and case-based learning in respiratory care education. Respiratory Care Clinics of North America, 11(3), 489-504.
Rogal, S. M., & Snider, P.D. (2008). Rethinking the lecture: The application of problem based learning methods to atypical contexts. Nurse Education in Practice, 8, 213-219.
Scaffa, M., & Wooster, D. (2004). Effects of problem-based learning on clinical reasoning in occupational therapy. American Journal of Occupational Therapy, 58, 333-336.
Schmidt, H., Vermeulen, L., & Molen, H. (2006). Long-term effects of problem-based learning: a comparison of competencies acquired by graduates of a problem-based and a conventional medical school. Medical Education, 40, 562-567.
Smalling, T. (2007, July). The best of times and the worst of times: The lost art of teaching physiology in the pulmonary function laboratory. RT: For Decision Makers in Respiratory Care. Web.
Spencer, A., & McNeil, M. (2009). Interdisciplinary curriculum to train internal medicine and obstetrics-gynecology residents in ambulatory women’s health: adapting problem-based learning to residency education. Journal of Women’s Health, 18(9), 1369-1375.
Spinello, E., & Fischbach, R. (2004). Problem-based learning in public health instruction: A pilot study of an online simulation as a problem-based learning approach. Education for Health, 17(3), 365-373.
United States Bureau of Labor Statistics. (2010). Occupational outlook handbook. Washington, D.C.: Government Printing Office.
Wells, S., Warelow, P., & Jackson, K. (2009). Problem-based learning (PBL): A conundrum. Contemporary Nurse, 33(2), 191-201.
White, M., Michaud, G., Pachev, G., Lirenman, D., Kolenc, A., & FitzGerlad, J. M. (2004). Randomized trial of problem-based versus didactic seminars for disseminating evidence-based guidelines on asthma management to primary care physicians. The Journal of Continuing Education in the Health Professions, 24, 237-243.