Abstract
Objectives: To use methods from the field of marketing research to involve students in the redesign of McMaster University’s small group, problem-based undergraduate medical education program. Methods: We used themes from a focus group conducted in an electronic decision support lab to compose 14 four-level educational attributes. Undergraduate medical students completed a discrete choice experiment composed of 15 web-administered, partial-profile, conjoint-choice tasks. Results: Latent class analysis revealed two segments with different preferences. Segment 1, (86% of students), preferred a problem-based approach with more small group tutorial sessions led by expert tutors who facilitated the tutorial process without teaching didactically. Segment 2, (14% of students), preferred more large group lectures, explicit learning objectives, expert tutors who taught didactically, and streaming options based on learning preferences. Although Segment 1 preferred smaller tutorial groups, simulations predicted these students would trade increases in tutorial group size for a conceptually integrated program that included tutorial problems based on core curriculum concepts, greater integration of the content of clinical skills training sessions and the tutorial curriculum, and a link between clerkship patient selection and the program’s curriculum. A majority of both segments would accept a more conceptually integrated program if the savings associated with increases in tutorial group size was reinvested in web-enhanced tutorial processes and computer-simulated health care problems. Conclusions: Most students preferred a small group, web-supported, problem-based learning approach led by content experts who facilitated group process. Students favored a program in which tutorial group problems, clinical skills training sessions and the patients selected for clerkship activities were more closely linked to core curriculum concepts.
Article PDF
Similar content being viewed by others
References
G.M. Allenby N. Arora J.L. Ginter (1995) ArticleTitleIncorporating prior knowledge in the analysis of conjoint studies Journal of Marketing Research 32 152–162 Occurrence Handle10.2307/3152044
N. Arora G. Allenby J.L. Ginter (1998) ArticleTitleA hierarchical Bayes mode of primary and secondary demand Marketing Science 17 29–44
W. Arulampalam R. Naylor J. Smith (2004) ArticleTitleFactors affecting the probability of first year medical students dropout in the UK: A logistic analysis for the intake cohorts of 1980–92 Medical Education 38 492–503 Occurrence Handle10.1046/j.1365-2929.2004.01815.x
R.S. Barbour (1999) ArticleTitleThe case for combining qualitative and quantitative approaches in health services research Journal of Health Services & Research Policy 4 39–43
M. Bearman B. Cesnik M. Liddell (2001) ArticleTitleRandom comparison of ‘virtual patient’ models in the context of teaching clinical communication skills Medical Education 35 824–832 Occurrence Handle10.1046/j.1365-2923.2001.00999.x
J.A. Colliver (2000) ArticleTitleEffectiveness of problem-based learning curricula: Research and theory Academic Medicine 75 259–266 Occurrence Handle10.1097/00001888-200003000-00017
M. Das D.J.S. Mpofu M.Y. Hasan T.S. Stewart (2002) ArticleTitleStudent perceptions of tutor skills in problem-based learning tutorials Medical Education 36 272–278 Occurrence Handle10.1046/j.1365-2923.2002.01148.x
W.S. DeGrave D.H.J.M. Dolmans C.P.M. Vleuten Particlevan der (1999) ArticleTitleProfiles of effective tutors in problem-based learning: Scaffolding student learning Medical Education 33 901–906 Occurrence Handle10.1046/j.1365-2923.1999.00492.x
W.S. DeSarbo V. Ramaswamy S.H. Cohen (1995) ArticleTitleMarket segmentation with choice based conjoint analysis Marketing Letters 6 37–148 Occurrence Handle10.1007/BF00994929
P. Dev K. Montgomery S. Senger W.L. Heinrichs S. Srivastava K. Waldron (2002) ArticleTitleSimulated medical learning environments on the internet Journal of the American Medical Informatics Association 9 437–447 Occurrence Handle10.1197/jamia.M1089
I.A. Dhalla J.C. Kwong D.L. Streiner R.E. Baddour A.E. Waddell I.L. Johnson (2002) ArticleTitleCharacteristics of first-year students in Canadian medical schools Canadian Medical Association Journal 166 1029–1035
D.H.J.M. Dolmans W.H. Gijselaers J.H.C. Moust W.S. Grave Particlede I.H.A.P. Wolfhagen C.P.M. Vleuten Particlevan der (2002) ArticleTitleTrends in research on the tutor in problem-based learning: Conclusions and implications for educational practice and research Medical Teacher 24 173–180 Occurrence Handle10.1080/01421590220125277
D.H.J.M. Dolmans I.H.A.P. Wolfhagen A.J.J.A. Scherpbier C.P.M. Vleuten Particlevan der (2001) ArticleTitleRelationship of tutors’ group-dynamics skills to their performance ratings in problem-based learning Academic Medicine 76 473–476 Occurrence Handle10.1097/00001888-200105000-00020
K. Eva H.J. Reiter J. Rosenfeld G. Norman (2004) ArticleTitleThe relationship between interviewers’ characteristics and ratings assigned during a multiple mini-interview Academic Medicine 79 602–609 Occurrence Handle10.1097/00001888-200406000-00021
R. Farrow G.R. Norman (2003) ArticleTitleThe effectiveness of PBL: The debate continues. Is meta-analysis helpful? Medical Education 37 1161–1132 Occurrence Handle10.1046/j.1365-2923.2003.01725.x
G.D. Hendry G. Ryan J. Harris (2003) ArticleTitleGroup problems in problem-based learning Medical Teaching 25 609–616 Occurrence Handle10.1080/0142159031000137427
D.B. Holmes D.M. Kaufman (1994) ArticleTitleTutoring in problem-based learning: A teacher development process Medical Education 28 275–283
Houldon, R.L., Collier, C.P., Frid, P.J., John, S.L. & Pross, H. (2001). Problems identified by tutors in a hybrid problem-based learning curriculum. Academic Medicine 76: 81
R.C. Hubal P.N. Kizakevich C.I. Guinn K.D. Merino S.L. West (2000) ArticleTitleThe virtual standardized patient. Simulated patient-practitioner dialog for patient interview training Studies in Health Information Technology 70 133–138
Huber, J. & Miller, R. (1999). Dealing with product similarity in conjoint simulations. Sawtooth Software Research Paper Series. Retrieved November 1, 2004, from http://www.sawtoothsoftware.com/download/techpap/prodsim.pdf
J.N. Hudson (2004) ArticleTitleComputer-aided learning in the real world of medical education: Does the quality of interaction with the computer affect student learning? Medical Education 38 887–895 Occurrence Handle10.1111/j.1365-2929.2004.01892.x
H.E. Khoo (2003) ArticleTitleImplementation of problem-based learning in Asian medical schools and student’s perceptions of their experience Medical Education 37 401–409 Occurrence Handle10.1046/j.1365-2923.2003.01489.x
C. Kulatunga-Moruzi G.R. Norman (2002) ArticleTitleValidity of admissions measures in predicting performance outcomes: The contribution of cognitive and non-cognitive dimensions Teaching and Learning Medicine 14 34–42 Occurrence Handle10.1207/S15328015TLM1401_9
P.K. Lenk W.S. DeSarbo P.E. Green M.R. Young (1996) ArticleTitleHierarchical Bayes conjoint analysis: recovery of partworth heterogeneity in reduced experimental designs Marketing Science 15 173–191
L. Lohfeld A. Neville G. Norman (2005) ArticleTitlePBL in undergraduate medical education: A qualitative study of the views of Canadian residents Advances in Health Sciences Education 10 189–214 Occurrence Handle10.1007/s10459-005-1293-9
G. Maudsley (1999) ArticleTitleRoles and responsibilities of the problem based learning tutor in the undergraduate medical curriculum British Medical Journal 318 657–661
K.J. Moffat A. McConnachie S. Ross J.M. Morrison (2004) ArticleTitleFirst year medical student stress and coping in a problem-based learning medical curriculum Medical Education 38 482–491 Occurrence Handle10.1046/j.1365-2929.2004.01814.x
A. Morgan P. Shackley M. Pickin J. Brazier (2000) ArticleTitleQuantifying patient preferences for out-of-ours primary care Journal of Health Services Service, Research and Policy 5 214–218
V.R. Neufeld C.A. Woodward S.M. MacLeod (1989) ArticleTitleThe McMaster MD program: A case study of renewal in medical education Academic Medicine 64 423–432 Occurrence Handle10.1097/00001888-198908000-00001
A.J. Neville (1999) ArticleTitleThe problem-based learning tutor: Teacher? Facilitator? Evaluator? Medical Teacher 21 393–401 Occurrence Handle10.1080/01421599979338
Newman, M. & The Pilot Review Group (2003). A Pilot Systematic Review and Meta-analysis on the Effectiveness of Problem-based Learning. Newcastle: Learning and Teaching Subject Network for Medicine, Dentistry, and Veterinary Medicine. http://www.ltsn-0.ac.uk/resources/features/pbl
G.R. Norman H.G. Schmidt (1992) ArticleTitleThe psychological basis of problem-based learning: A review of the evidence Academic Medicine 76 215–216
G.R. Norman H.G. Schmidt (2000) ArticleTitleEffectiveness of problem-based learning curricula: Theory, practice and paper darts Medical Education 34 721–728 Occurrence Handle10.1046/j.1365-2923.2000.00749.x
B.K. Orme (2006) Getting Started with Conjoint Analysis: Strategies for Product Design and Pricing Research Research Publishers Madison
Osman, L.M., Mckenzie, L., Cairns, J., Friend, J.A., Godden, D.J., Legge, J.S. & Douglas, J.G. (2001). Patient weighting of importance of asthma symptoms. Thorax 56: 138–142
M. Patterson (2003) Partial Profile Discrete Choice: What’s the Optimal Number of Attributes. Sawtooth Software Conference Proceedings Sawtooth Software Sequim
J.W. Payne J.R. Bettman E.J. Johnson (1993) The Use of Multiple Strategies in Judgment and Choice Lawrence Erlbaum Associates Hillsdale, NJ, England
K.A. Phillips R. Johnson T. Maddala (2002) ArticleTitleMeasuring what people value: A comparison of “attitude” and “preference” surveys Journal of Health Services Research 37 1659–1679 Occurrence Handle10.1111/1475-6773.01116
Reznich, C.B. & Werner, B. (2004). Facilitators’ influence on student PBL small group session on line information resource use: A survey. Downloaded from BMC Medical Education
L.A. Riesenberg B.W. Biddle S.L. Erney (2001) ArticleTitleMedical student and faculty perceptions of desirable primary care teaching site characteristics Medical Education 35 660–665 Occurrence Handle10.1046/j.1365-2923.2001.00954.x
G. Ryan T. Dolling S. Barnet (2004) ArticleTitleSupporting the problem-based learning process in the clinical years: evaluation of an online Clinical Reasoning Guide Medical Education 38 638–645 Occurrence Handle10.1111/j.1365-2929.2004.01839.x
M. Ryan K. Gerard (2003) ArticleTitleUsing discrete choice experiments to value health care: Current practice and future prospects Applied Health Economics and Policy Analysis 2 55–64
M. Ryan D.A. Scott C. Reeves A. Bate E.R. Teijlingen Particlevan E.M. Russell M. Napper C.M. Robb (2001) ArticleTitleEliciting public preferences for healthcare: A systematic review of techniques Health Technology Assessment 5 1–186
G. Salkeld M. Ryan L. Short (2000) ArticleTitleThe veil of experience: Do consumers prefer what they know best? Health Economics 9 267–270 Occurrence Handle10.1002/(SICI)1099-1050(200004)9:3<267::AID-HEC511>3.0.CO;2-H
Sawtooth Software Inc (2004a). The CBC Latent Class Technical Paper (version 3). Retrieved November 1, 2004, from http://www.sawtoothsoftware.com/download/techpap/lctech.pdf
Sawtooth Software Inc (2004b). The CBC/HB System for Hierarchical Bayes estimation (version 3.2). Sawtooth Software Technical Paper Series. Retrieved November 1, 2004, from http://www.sawtoothsoftware.com/download/techpap/hbtech.pdf
H.G. Schmidt (1993) ArticleTitleFoundations of problem-based learning: some explanatory notes Medical Education 27 422–432 Occurrence Handle10.1111/j.1365-2923.1993.tb00296.x
H.G. Schmidt (1994) ArticleTitleResolving inconsistencies in tutor expertise research: does lack of structure cause students to seek tutor guidance? Academic Medicine 69 652–662 Occurrence Handle10.1097/00001888-199408000-00015
E.J. Stanek M.B. Oates W.F. McGhan D. Denofrio E. Loh (2000) ArticleTitlePreferences for treatment outcomes in patients with heart failure: Symptoms versus survival Journal of Cardiac Failure 6 225–232 Occurrence Handle10.1054/jcaf.2000.9503
P. Stark (2003) ArticleTitleTeaching and learning in the clinical setting: A qualitative study of the perceptions of students and teachers Medical Education 37 975–982 Occurrence Handle10.1046/j.1365-2923.2003.01675.x
D.L. Streiner G. Norman (2003) Health Measurement Scales: A Practical Guide to their Development and Use Oxford Medical Publications New York
H. Stromso P. Grottum K.H. Lycke (2004) ArticleTitleChanges in student approaches to learning with the introduction of computer-supported problem-based learning Medical Education 38 390–400 Occurrence Handle10.1046/j.1365-2923.2004.01786.x
T. Svoboda B. Henry L. Shulman E. Kennedy E. Rea W. Ng T. Wallington B. Yaffe E. Gournis E. Vicencil S. Asrur R.H. Glazier (2004) ArticleTitlePublic health measures to control the spread of the severe acute respiratory syndrome during the outbreak in Toronto The New England Journal of Medicine 350 2352–2361 Occurrence Handle10.1056/NEJMoa032111
B.G. Tabachnik L.S. Fidell (2001) Using Multivariate Statistics EditionNumberFourth Harper Collins College Publishers New York
S.C. Willis A. Jones C. Bundy K. Burdett C.R. Whitehouse P.A. O’Neill (2002) ArticleTitleSmall-group work and assessment in a PBL curriculum: A qualitative and quantitative evaluation of student perceptions of the process of working in small groups and its assessment Medical Teacher 24 495–501 Occurrence Handle10.1080/0142159021000012531
C.A. Woodward B.M. Ferrier (1982) ArticleTitlePerspectives of graduates two or five years after graduation from a three-year medical school Journal of Medical Education 57 294–302
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cunningham, C.E., Deal, K., Neville, A. et al. Modeling the Problem-based Learning Preferences of McMaster University Undergraduate Medical Students Using a Discrete Choice Conjoint Experiment. Adv Health Sci Educ Theory Pract 11, 245–266 (2006). https://doi.org/10.1007/s10459-006-0003-6
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s10459-006-0003-6