Does blended problem-based learning make Asian medical students active learners? a prospective comparative study

Ikuo Shimizu*, Hideyuki Nakazawa, Yoshihiko Sato, Ineke H. A. P. Wolfhagen, Karen D. Koenings

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BackgroundAsian educators have struggled to implement problem-based learning (PBL) because students rarely discuss their work actively and are not sufficiently engaged in self-directed learning. Supplementing PBL with additional e-learning, i.e. blended' PBL (bPBL), could stimulate students' learning process.MethodsWe investigated the effects of bPBL on tutorial group functioning (discussion, self-efficacy, self-directed learning, active participation, and tutor's perceived authority) and students' level of acceptance of the e-learning elements. We compared PBL and bPBL in a medical university in Japan. In the bPBL condition, the tutor's instructions were replaced with online materials and short quizzes. After the course, a 13-item questionnaire using a 5-point Likert scale was distributed regarding the tutorial group functioning of the tutorial group (influence of discussion, self-efficacy, self-directed learning, active participation, and tutors' authority). The mean scores of subscales were compared with analysis of covariance. Knowledge levels were measured using a pre-test post-test design. A multiple regression analysis was performed to explore the association between e-learning acceptance and the subscales related to PBL.ResultsNinety-six students participated in the study (PBL: n=24, bPBL: n=72). Self-efficacy and motivation for learning triggered by group discussions was significantly higher for students in bPBL (p=0.032 and 0.007, respectively). Knowledge gain in test scores was also significantly better in the bPBL condition (p=0.026), and self-directed learning related positively to the acceptance of blended learning (p=0.044).ConclusionsbPBL seemed more effective in promoting active learning and improving knowledge, without affecting tutors' authority. Implementing e-learning into PBL is suggested to be an effective strategy in the Asian context.

Original languageEnglish
Article number147
Number of pages9
JournalBMC Medical Education
Publication statusPublished - 15 May 2019


  • Blended learning
  • Health professions education
  • Problem-based learning
  • Quiz
  • Self-directed learning

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