Answer to "What constitutes an effective PBL ‘problem’?"

For Barrows, the ‘problem’ is at the heart of PBL and should drive learning. ‘Problems’ should be ‘ill-structured’ messy authentic patient scenarios, mirroring the complexities of the real world of uncertainty and in some circumstances, with no clear right or wrong answer. PBL is also about the journey (exploration and discovery; team work) rather than the destination (reaching a diagnosis and management or treatment). The ‘problem’ should be sufficiently complex to stimulate discussion so that learners generate a range of hypotheses to explain the underlying phenomena, raising questions and allowing learning issues to be identified.


Sockalingam and colleagues’ (2011) study on learners’ and tutors’ perceptions of the attributes of effective ‘problems’ confirmed some of the existing literature. Effective ‘problems should:

  • Lead to the formulation of appropriate learning goals (issues)

  • Relate to learners’ prior knowledge, and,

  • Be interesting


In addition, those authors also identified problem format as important. This refers to the physical structure of the problem and includes features such as length of the text in the triggers and the use of appropriate audio-visual material. As PBL cases comprise a series of triggers to stimulate discussion, long triggers might lead to cognitive overload. For further information on PBL case or ‘problem’ design, readers can consult Dolman’s and colleagues’ (1997) seven principles article and Hung’s (2009) 3C3R model.


It is important that ‘problems’ address all domains of the expected curriculum outcomes, i.e. basic medical and clinical sciences, social sciences, public and global health and professionalism. Problems should also address emerging issues such as climate change, refugees and LGBTQI.



BARROWS, H.S. (1992). The Tutorial Process. (Springfield: Southern Illinois University).

DOLMANS, D.H.J.M., SNELLEN-BELENDONG, H., WOLFHAGEN, I.H.A.P., and VAN DER VLEUTEN, C.P.M. (199). Seven principles of effective case design for a problem-based learning curriculum. (Med Teach. 19(3):185-189).

HUNG, W. (2009). The 3C3R model: A conceptual framework for designing PBL problems. (Interdiscip J PBL. 1(10):55-77).

SOCKALINGUM, N, ROTGANS, J., and SCHMIDTE, H.G. (2011). Student and tutor perceptions on attributes of effective problems in problem-based learning. (Higher Educ. 62:1-16).

TAYLOR, D., and MIFLIN, B. (2008). AMEE Guide No. 36. Problem-based learning: Where are we now? (Med Teach. 30:742-763).

© 2019 AMEE