From case-based reasoning to problem-based learning

Acad Med. 2003 May;78(5):491-6. doi: 10.1097/00001888-200305000-00011.


Many medical schools today are questioning whether they should implement a problem-based learning (PBL) curriculum. Educators have raised serious questions regarding the efficiency of PBL and therefore recommend learning more about the cognitive processes developed by PBL before implementing it broadly. In addition, it is important to determine whether PBL best matches the human reasoning process. The authors' theoretical discussion examines the relationship between the case-based reasoning (CBR) model and the PBL model. CBR indicates that the knowledge source one uses while solving a new problem includes not only generalized rules or general cases, but often a memory of stored cases recording specific prior episodes. CBR enables the reasoner to recommend solutions to problems quickly and to propose solutions in domains that are not completely understood, such as medicine. The authors' analysis reveals a strong association between the CBR and PBL models, and thus it can be argued that PBL is a successful teaching method that should be encouraged by medical schools.

MeSH terms

  • Curriculum
  • Education, Medical, Undergraduate / methods*
  • Humans
  • Problem-Based Learning*
  • Thinking
  • United States