Résumés
Abstract
Background: Educators have recently been compelled to incorporate more active instructional formats into medical education, such as problem-based learning (PBL). In view of the mixed outcome data on the use of PBL in postgraduate medical education (PGME), there is a need to synthesize the data to inform the application of PBL in PGME contexts.
Objective: The aim of this systematic review and meta-analysis was to synthesize learning outcomes of PBL in PGME contexts.
Methods: The authors systematically searched MEDLINE, Embase, APA PsycINFO, AMED, CINAHL, Web of Science, ERIC, and Cochrane databases from January 1, 1950, to July 1, 2022 for original studies that reported Kirkpatrick outcomes of PBL in PGME contexts. Outcomes data were extracted. Quantitative data relating to learning outcomes were meta-analyzed using a random-effects model to generate weighted mean differences.
Results: Of 4310 abstracts screened, the authors included 21 studies encompassing anesthesia, family medicine, internal medicine, occupational medicine, pediatrics, psychiatry, public health and surgical residency programs. The studies reported reaction (n = 12), learning (n = 15), behavioural (n = 6) and/or results outcomes (n = 4). Meta-analysis of the three eligible articles demonstrated no significant difference after PBL in pre- and post-test results (pooled mean difference=0.13%, 95% CI, -6.74–7.00). There were observed improvements in satisfaction levels and self-reported behavioural outcomes following PBL.
Conclusions: Although similar learning outcomes were observed using PBL and the usual teaching in PGME, PBL was associated with benefits in trainee satisfaction and behavioural changes that contribute to learning and performance. PGME programs should consider incorporating PBL into curricula.
Résumé
Contexte : Les éducateurs doivent maintenant incorporer des formats pédagogiques plus actifs dans l'enseignement médical, tels que l'apprentissage par problèmes (APP). Compte tenu des données mitigées concernant l'utilisation l’APP dans la formation médicale postuniversitaire, il est nécessaire de synthétiser l’état des connaissances à cet effet, afin d'éclairer l'application de l’APP dans les contextes de formation médicale postuniversitaire.
Objectif : L'objectif de cette revue systématique et de cette méta-analyse était de synthétiser les travaux concernant l’APP effectués dans les contextes de formation médicale postdoctorale.
Méthodes : Les auteurs ont effectué des recherches systématiques dans les bases de données MEDLINE, Embase, APA PsycINFO, AMED, CINAHL, Web of Science, ERIC et Cochrane entre le 1er janvier 1950 et le 1er juillet 2022 pour identifier les études originales faisant état du niveau d’apprentissage basé sur le modèle de Kirkpatrick concernant l’APP dans des contextes de formation médicale postdoctorale. Les données relatives aux résultats ont été extraites. Les données quantitatives relatives aux niveau d'apprentissage ont été méta-analysées à l'aide d'un modèle à effets aléatoires afin de générer des différences de moyennes pondérées.
Résultats : Sur les 4 310 résumés examinés, les auteurs ont inclus 21 études portant sur des programmes de résidence en anesthésie, en médecine familiale, en médecine interne, en médecine du travail, en pédiatrie, en psychiatrie, en santé publique et en chirurgie. Les études ont fait état des réactions (n = 12), de l'apprentissage (n = 15), du comportement (n = 6) et/ou des résultats (n = 4). La méta-analyse des trois articles admissibles n'a pas montré de différence significative après l'APP dans les résultats pré- et post-test (différence moyenne regroupée = 0,13 %, IC à 95 %, -6,74-7,00). Des améliorations ont été observées dans les niveaux de satisfaction et les résultats comportementaux autodéclarés à la suite de l'APP.
Conclusions : Bien que des résultats reliés à l'apprentissage similaires aient été observés en utilisant l'APP comparativement à l'enseignement habituel dans le cadre de la formation médicale postdoctorale, l'APP a été associé à des avantages en termes de satisfaction des apprenants et de changements de comportement qui contribuent à l'apprentissage et au rendement. Les programmes d’éducation médicale postdoctoraux devraient envisager d'intégrer l’APP dans les programmes d'études.
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