Problem-Based Learning as a Tool for Competency-Based Education

AUGUST 2013 Enews Articles

Problem-Based Learning as a Tool for Competency-Based Education
by Pat Burkhardt

As educators, we struggle to find more effective ways to help students attain the competencies required for safe, high-quality midwifery practice. Some focus on PowerPoint™ or Prezi technology to make classes more interesting and engaging. Others conduct learner inventories to determine how their students learn and then try to adapt their teaching to the learning styles that fit them. It is a never-ending quest to be entertaining and/or appropriate for each student so they grasp the content being delivered.

Problem based learning (PBL) as a teaching strategy changes all this. It shifts the focus from the teacher to the student. Instead of the teacher being the ‘sage on the stage’ or the entertainer competing with all those other genres of US society, the student’s learning becomes the focus, as determined by her elaboration of her learning needs.

The benefits of PBL include: it better fits the needs of midwifery students, many of whom come with different life experiences and previous preparation; and it meets the current needs of the student or student group as determined by them. For these reasons, PBL is an effective teaching tool in competency-based learning environments. Although groups of students may use different processes and take varying lengths of time to reach the correct answer, they are assessed on achieving the competencies embedded in the assignment.

Education in the 21st century requires the development of students as effective problem solvers in an era in which they are bombarded with a vast amount of information from multiple and diverse sources reflective of both the art and science of the professions. PBL is a method of active, student-centered and driven, collaborative, inquiry-based learning that helps us meet this challenge. In PBL, students act as adult learners, confronting problems as they occur, with fuzzy edges, insufficient information and a need to determine the best solution possible. Posing the problem before learning tends to motivate students. They determine what new knowledge they need to learn. These practical, real-world challenges help students develop the clinical problem-solving competencies that are at the core of midwifery practice.

Learning in the context of the need-to-solve-a-problem also tends to store the knowledge in memory patterns that facilitate later recall. Critical thinking skills, attaining competency in information literacy, working together to solve problems and having control over individual learning are foundational PBL principles. Therefore, it sets a pattern for life-long professional learning.

In this teaching strategy, faculty serve as facilitators during tutorials, clarifying, guiding and facilitating the learning of the students, not as the “all knowing one” that pours knowledge into students whether they need it or not. It is self-learning, which is the only effective learning there is.

Different constructs and concepts require different language. Thus, in the context of PBL, the faculty are tutors, the class is a tutorial, the students are learners and the preparation for the next tutorial occurs in the previous one using a tutor developed scenario, giving the students the opportunity to determine their learning needs and develop their learning objectives around the content of the scenario for the next tutorial.

Thus, the essential anatomy of PBL consists of:

  • Tutorials
  • Learners
  • Tutors (facilitators)
  • Scenarios
  • White board
  • Content map
  • Evaluations – for each class, of the process, the interaction, who dominated, who balanced or didn’t and the course overall

The essential physiology:

1. Considering the scenario

2. Formulating the learning needs as defined by the students

3. Constructing the learning objectives as determined by the students

4. Transition for both students and teachers, from ‘traditional’ delivery of content to letting students drive the process; change of roles

5. Taking up the objectives in the next tutorial

6. Tutor needs to STOP TALKING (a difficult transition for us)


  • Learning more important than teaching
  • Learners come with knowledge and experience
  • Not the ‘sage on the stage’ – tutors can be content ignorant

At the heart of it, education is much like birthing. As midwives, we assist and facilitate the woman who births the baby. As teachers using PBL as our education strategy, we assist and facilitate the students as they engage in defining their learning needs and achieving competencies for successful midwifery practice.

Patricia Burkhardt developed and opened the Midwifery Education Program at New York University in 1994 and served on the inaugural New York State Board of Midwifery. Fundamental to all her activities is the strong belief that midwifery exists to serve women and their health needs, including childbearing. Since her retirement from NYU in 2009, Pat has worked in policy and politics at the city, state and national level.

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