Abstract
Problem-based learning has established a strong reputation within education programs delivered to a wide variety of healthcare professionals. Nevertheless, most accounts of problem-based learning relate to classroom settings, where issues of patient safety and competing demands upon time are not a primary concern. The authors explore ways in which problem-based learning may be utilized within clinical practice to enhance the professional development of nurses. A framework for thinking about problems and professional responses is outlined, and illustrations are drawn from the maternal-child health practice setting.
Clinical practice poses a conundrum to those nurses working to develop the skills and knowledge of professional colleagues. At once, practice is a rich source of experience, information, and challenge that is central to an appreciation of what it is to practice in a professional way. The practice setting is also a learning environment that may never achieve its full potential unless ways are found to manage education alongside other competing demands, tap the practice knowledge of nurses, and assist colleagues to synthesise theory, research, and practice so that they are therapeutic.
Problem-based learning claims to help healthcare professionals devise solutions that are highly relevant to practice (Barrows & Tamblyn, 1980; Barrows, 1994; Frost, 1996). Within problem-based learning inductive approaches are used to study clinical situations or case studies of patients, the student drawing inferences about what sorts of problems exist, what has yet to be understood, and longer term, what solutions might then be considered (Heliker, 1994). The education is pragmatic rather than ideologic (i.e., it does not focus on how nurses should think, what they should value, and what this represents in terms of the uniqueness of a profession's contribution to health care). Historically, however, problem-based learning has rarely been reported as transferred to the clinical setting, where the learning environment is also the setting for care delivery. This article describes problem-based learning within practice, demonstrating some of the adjustments that may be necessary before it can be completely successful there.