A promising future for the problem-based approach in Nursing





Cossette, Raymonde
Mc Clish, Suzanne
Ostiguy, Kim

In a classroom scenario, a few students are sitting in a circle. They are taking turns reading a document that describes the situation of a person in need of care. What is happening with this person? What is their health problem? One student goes to the board to write down the thoughts expressed by the group on how to best deal with the problem. Another student jots down the final resolution of the exercise. The teacher steps in occasionally to question their choices. The students use the clues to formulate hypotheses – some may seem far out! Laughter is heard and a discussion gets underway. Keenly interested and focused on the problem, these students are participating in the first phase of a tutorial in problem-based learning. Elsewhere in a classroom at the hospital, a woman is describing her problem situation to a nurse who collects the data. As she jots down the information, she verbalizes her rationale out loud in the presence of six or seven colleagues and a tutor. When the student playing the role of the nurse runs short of hypotheses the tutor calls upon the group to assist. The student who plays the role of the patient only answers questions that are asked and does not offer any additional information until the group in training brings the interview to an end. This practical exercise is designed to promote the acquisition and development of clinical thinking among students. This is the type of learning climate that prevails in the Nursing program at Cégep du Vieux Montréal since the Fall of 2001. The Nursing department together with the contributive disciplines of biology, psychology and sociology, embarked on an educational reform focusing on problem-based learning (PBL). This interdisciplinary immersion experience, unique in college teaching, required the implementation of different evaluation mechanisms. At present, a number of people are observing the experiment with great interest and are eagerly awaiting its assessment. The research entitled Problem-based learning (PBL) in Nursing: a clinical adaptation and the evaluation of its impact, is funded by PAREA (Programme d’aide à la recherché et à l’apprentissage), an agency within the ministère de l’Éducation du Québec and is one of the evaluation mechanisms behind PBL implementation. Researchers Raymonde Cossette, Suzanne Mc Clish and Kim Ostiguy, responsible for the two-part study, are teachers in Nursing at Cégep du Vieux Montréal. In Part 1, they evaluated the impact of PBL on a series of variables linked to motivation and success. They did this by comparing the results of 124 first year students trained in PBL with those of 579 students who received traditional training in four francophone institutions within the college network. In Part 2, they describe an experiment where the impact of clinical reasoning learning (CRL), a variation of PBL, is studied relative to various indicators [...].


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