Conduct multi-centre, multi-country randomised controlled trials with adequate confounding adjustment to clarify PBL-career associations¶

Strategy · All strategies
Evidence · 6 claims (2 for, 1 mixed, 3 against) · 1 study (1 review), q2 · 0 of 1 report an effect size · 6 claims rest on one study

Description¶

The review recommends that the ideal way to clarify the conflicted results on PBL and career choice would be through a multi-centre, multi-country randomised-control trial with a large study population. It further calls for new longitudinal studies with good power that adequately adjust for confounding variables, noting that evidence has only been conducted in a small selection of the countries that use PBL in their medical education.

Design Implications¶

Context¶

Requirements¶

• Large study population with good statistical power
• Adequate adjustment for confounding variables
• Multi-centre and multi-country design

Constraints¶

• Current evidence is limited to a small selection of countries using PBL, with multiple studies from the same medical schools (three at University of New Mexico, two at McMaster, two at Harvard)

Target Learners¶

• medical students

Target Learning Goals¶

• career choice formation in medical education

Claims¶

• Kaufman et al. found significantly more PBL students retained or switched to an interest in primary care during medical school (P = 0.05) [+W]
• Matsui et al. found more non-PBL graduates working in primary care (9% difference) with no significance reported [-W]
• Three studies reported a significantly increased number of PBL graduates working in primary care compared to non-PBL graduates [+W]
• PBL-based medical curricula do not predispose students to a career in a specific specialty, with 7 of 11 studies showing no significant difference in career choice between PBL and non-PBL graduates [-W]
• One study found significantly fewer PBL graduates working in primary care, with the authors suggesting medical school admission as a confounding factor [-W]
• Woodward et al. found no significant difference in specialty choice but PBL graduates held a greater number of certificates in family medicine [~W]

Related Strategies¶

• Rigorously compare PBL with traditional methods before broad PGME implementation, using larger samples, controls, and follow-up

Examples¶

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Key Sources¶

• Tsigarides Jordan, Wingfield Laura R., Kulendran Myutan. (2017). Does a PBL-based medical curriculum predispose training in specific career paths? A systematic review of the literature. BMC Research Notes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5219658/