Problem-based learning in medical education : one of many learning paradigms

In 1978, when problem-based learning (PBL) was introduced in the University of Newcastle medical faculty, the prevailing educational style in 6-year undergraduate medical programs in Australia was teacher-led learning (TLL), wherein students first acquired core knowledge in basic sciences, which were taught in large class lectures, tutorials and laboratory sessions during the 3 preclinical years of the course. They then progressed to a multilayered, sequential, integrated approach incorporating fundamental clinical skills in history-taking and eliciting and interpreting physical signs, leading to differential diagnoses and patient management. These skills were taught in small tutorial groups at the bedside, in the operating room, in outpatient clinics and in consulting rooms.