The problem with problem-based medical education - Promises not kept

More than a decade after a student-centered, problem-based learning (PBL) was implemented at many medical schools in the United States and other countries world wide, the debate about the merits of PBL medical education continues to embroil its proponents and those who favor the more traditional lecture-based approach to learning. The author, while believing that the premise of PBL medical education is still valid, is disappointed that poor implementation of PBL has compromised its potential. Several reasons that may explain why PBL has failed to live up to its promises and expectations include: first, inadequate support of the curriculum from basic scientists who either do not support the concept itself or who place much greater value on research than on teaching; second, poor oversight and inadequate assessment of the PBL curriculum on the part of administrators and faculty charged with its implementation; and third, excessive reliance on insufficiently knowledgeable or motivated clinician educators to teach basic science information and principles in the latter years of the curriculum. This essay is intended to stimulate discussion and analysis of the extent to which PBL medical education has failed to deliver on its promises.