Iran Journal of Nursing

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Hajibabaee F, Ashrafizadeh H. A Comprehensive Review of Problem-based Learning in the Iranian Nursing Education. IJN 2019; 32 (118) :12-30
URL: http://ijn.iums.ac.ir/article-1-2899-en.html

Background & Aims: Evaluation and application of novel educational approaches are essential for improving educational programs. Problem-based learning (BPL) is a new education approach that is based on the principles of using problems as a starting point for acquiring and combining new knowledge. Problem-based skills are not taught in a codified and organized way in Iran. Research shows that while reviews have been conducted on PBL in other fields, no review has been carried out to in the nursing field in the country. Meanwhile, there is lack of consensus over the advantages and disadvantages of traditional and PBL teaching methods. Given the importance of applicability of PBL in nursing education, the present study aimed to review studies performed on the effect of PBL on nursing students’ abilities in the country, determine nursing students’ viewpoint about PBL and factors affecting PBL, compare PBL training with other education methods, and explain nursing students’ experience of PBL in Iran.
Materials & Methods: This comprehensive review study was performed to review all Farsi articles related to PBL in the nursing field. We searched Iranian databases such as Scientific Information Database (SID), Magiran, Iran Medex, and Iranian Research Institute for Information Science and Technology using the keywords of learning, training, education, problem-solving, PBL, problem-centered, and nursing. The timeline evaluated was April 2001-January 2018. The inclusion criteria were the Farsi language of articles and using PBL in nursing education. On the other hand, the exclusion criterion was a lack of access to the full text of articles. There were no restrictions on the entry of studies based on the type of studies performed. The full text of the articles was studied and related data were extracted based on research objectives using a pre-developed checklist that included variables such as sample size, as well as location, time, type, and results of studies.
Results: The initial search of keywords and a combination of the words using AND led to the extraction of 115 Farsi articles. A primary assessment of articles’ titles and abstracts in the screening stage resulted in the elimination of unrelated articles and duplicates. In total, 45 articles were entered the selection phase, and 70 articles were removed from the research due to lack of meeting the inclusion criteria, duplication, presentation of abstracts on conferences, and lack of access to the full text of the articles. Ultimately, 31 Farsi articles that were published in domestic research-scientific journals and their full text was available were selected. Most of the studies in this field were conducted by a quasi-experimental method (20 studies), seven by descriptive method, two by qualitative method, one by review method, and one by the clinical trial method. In addition, most studies were performed on BSc students and only one research included MSc nursing students. The studies reviewed in the present study were divided into several parts: 1) studies related to the effect of PBL on students’ abilities, such as self-concept, emotional intelligence, self-efficacy, determination and problem-solving skills, anxiety, empathy, the vision of success, learning and decision-making techniques, spirituality and philosophical mentality, and logical, avoidant and dependent decision-making styles; 2) studies related to the assessment and comparison of PBL teaching method with other techniques; 3) studies related to the evaluation of nursing students’ opinions about PBL training; 4) qualitative research, and 5) PBL and effective factors.
Conclusion: Given the fact that most studies reviewed reported the effectiveness of PBL in training nurses and enabling students and its comprehensive use in educating nursing students, and since limited studies have shown contradictory results, it could be expressed that students participate in the teaching process when using active training methods (e.g., PBL), which increases in-depth learning and self-confidence of students. Overall, more in-depth learning is extremely crucial for improving practical skills in clinical environments. In this regard, nursing schools can hold courses to familiarize and teach this type of teaching method to professors and inform them of the importance and benefits of this method to teach nursing students who will be working in clinical settings in the future. Students who are successful in their professional and clinical skills use creative and thoughtful strategies in dealing with problems. Usually, there are different levels of using PBL skills in educational environments. Since studies often indicate the superiority and positive effect of PBL methods over traditional teaching methods, it is expected that the method be used in the country's medical universities, especially nursing and midwifery schools with the support of officials and professors. It is suggested that comparative assessments be carried out in educational environments in the form of multi-year longitudinal studies to assess the effects of university education methods on the levels of these skills in students.