Evaluation of hybrid problem-based learning in large classrooms: a qualitative and quantitative analysis

Sonia S. Kharay, Anu Sharma, Priya Bansal


Background: Problem Based Learning (PBL) for teaching preclinical sciences has been proposed in curricular reform by Medical Council of India. PBL is a student-centred approach, enabling deep and transformative student learning. A 'hybrid' approach to PBL uses a range of class-based teaching methods; delivering a mode of PBL which is less resource intensive and more flexible than ‘pure’ PBL. In hybrid PBL, problems are solved in groups, but lectures are used to present the fundamental concepts and difficult topics. Our institution follows a traditional lecture-based curriculum. The present cohort study was undertaken to determine student and faculty perceptions for hybrid PBL as well as impact on student engagement.

Methods: Hybrid PBL method was implemented for one cohort of hundred first year medical students. Previous batch was used as control taught by traditional lecture-based curriculum alone. Methodological triangulation design was employed for impact of hybrid PBL on student engagement (attendance scores-Chi square) and student and faculty perception to hybrid PBL (reflections- grounded theory)

Results: The mean attendance score of MBBS batch 2016 was significantly better than batch 2015 (p=0.0001). The emerging themes in student reflections were innovative method, collaborative learning, quest for knowledge, promote long term retention and links to real-life scenario. Acquisition of soft skills (social and moral responsibility) was novel emerging theme in student reflections. Active student participation and improved critical thinking were themes expressed in faculty perceptions.

Conclusions: Hybrid PBL with small groups is successful in large classrooms. Introduced at the initial phase of undergraduate medical education, it can assist robust self-appraisal in students and strengthen soft skills.


Student engagement, Student reflections, Soft skills, Undergraduate

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Deo MG. Doctor population ratio for India - The reality. The Indian J Med Res. 2013;137(4):632-5.

Regulations by Medical Council of India. 2017/10/Minimum-Standard-Requirements-for-100-Admissions.pdf. Accessed on 15 August 2018.

Basu M, Das P, Chowdhury G. Introducing integrated teaching and comparison with traditional teaching in undergraduate medical curriculum: A pilot study. Med J DY Patil Uni. 2015;8:431-8.

Nandi PL, Chan JN, Chan CP, Chan P, Chan LP. Undergraduate medical education: comparison of problem-based learning and conventional teaching. Hong Kong Med J. 2000;6:301-6.

Lian J, He F. Improved performance of students instructed in a hybrid PBL format. Biochem Mol Biol Edu. 2013;41:5-10.

Kusurkar RA, Croiset G, Mann KV, Custers E, Cate OT. Have motivation theories guided the development and reform of medical education curricula? a review of literature. Acad Med. 2012;87:735-43.

Kate MS, Kulkarni UJ, Supe A, Deshmukh YA. Introducing integrated teaching in undergarduate medical curriculum. International J Pharma Sci Res (IJPSR). 2010;1(1):18-22.

Singh A. Student performance and their perception of a patient-oriented problem-solving approach with audiovisual aids in teaching pathology: a comparison with traditional lectures. Advan Med Edu Prac. 2011;2:9-15.

Wu Y. Applying a hybrid problem-based learning method to the teaching of computer programming. The China Papers. 2006;63-6.

Chilkoti G, Mohta M, Wadhwa R, Saxena AK, Sharma CS, Shankar N. Students’ satisfaction to hybrid problem-based learning format for basic life support/advanced cardiac life support teaching. Indian J Anaesthesia. 2016;60(11):821-6.

Nanda B, Manjunatha S. Indian medical students’ perspectives on problem-based learning experiences in undergraduate curriculum: One size does not fit all. J Edu Eval Health Prof. 2013;10:11-4.

Ghosh S, Pandya HV. Implementation of Integrated Learning Program in neurosciences during first year of traditional medical course: Perception of students and faculty. BMC Med Edu. 2008;8:44.

Vyas R, Jacob M, Faith M., Isaac B., Rabi S., Sathishkumar S, et al. An effective Integrated Learning Programme in the First Year of the Medical Course. The Natl Med J India. 2008;21:21-6.

Medical Council of India. Minutes of the General Body Meeting held on 31st October 2017. Available at: B-31.10.2017.pdf. Accessed on 15 August 2018.

Klegeris A, Bahniwal M, Hurren H. Improvement in generic problem-solving abilities of students by use of tutor-less problem-based learning in a large classroom setting. CBE Life Sci Edu. 2013;12:73-9.

Rimal J, Paudel BH, Shrestha A. Introduction of problem-based learning in undergraduate dentistry program in Nepal. Int J Appl Basic Med Res. 2015;5(1):S45-9.

Khaki AA, Tubbs RS, Zarrintan S, Khamnei HJ, Shoja MM, Sadeghi H, et al. The first year medical students’ perception of and satisfaction from problem-based learning compared to traditional teaching in gross anatomy: Introducing problem-based anatomy in traditional curriculum in Iran. Inter J Heal Sci. 2007;1(1):113-8.

Yeo S, Chang BH. Students’ perceptions and satisfaction level of hybrid problem-based learning for 16 years in Kyungpook National University School of Medicine Korea. Korean J Med Educ. 2016;28(1):9-16.