The relationships between problem characteristics, achievement-related behaviors, and academic achievement in problem-based learning

This study investigated the influence of five problem characteristics on students' achievement-related classroom behaviors and academic achievement. Data from 5,949 polytechnic students in PBL curricula across 170 courses were analyzed by means of path analysis. The five problem characteristics were: (1) problem clarity, (2) problem familiarity, (3) the extent to which the problem stimulated group discussion, (4) self-study, and (5) identification of learning goals. The results showed that problem clarity led to more group discussion, identification of learning goals, and self-study than problem familiarity. On the other hand, problem familiarity had a stronger and direct impact on academic achievement

Laparoscopic ileocolic resection versus infliximab treatment of distal ileitis in Crohn's disease: a randomized multicenter trial (LIR!C-trial)

Contains fulltext : 69534.pdf (publisher's version ) (Open Access)BACKGROUND: With the availability of infliximab, nowadays recurrent Crohn's disease, defined as disease refractory to immunomodulatory agents that has been treated with steroids, is generally treated with infliximab. Infliximab is an effective but expensive treatment and once started it is unclear when therapy can be discontinued. Surgical resection has been the golden standard in recurrent Crohn's disease. Laparoscopic ileocolic resection proved to be safe and is characterized by a quick symptom reduction.The objective of this study is to compare infliximab treatment with laparoscopic ileocolic resection in patients with recurrent Crohn's disease of the distal ileum with respect to quality of life and costs. METHODS/DESIGN: The study is designed as a multicenter randomized clinical trial including patients with Crohn's disease located in the terminal ileum that require infliximab treatment following recent consensus statements on inflammatory bowel disease treatment: moderate to severe disease activity in patients that fail to respond to steroid therapy or immunomodulatory therapy. Patients will be randomized to receive either infliximab or undergo a laparoscopic ileocolic resection. Primary outcomes are quality of life and costs. Secondary outcomes are hospital stay, early and late morbidity, sick leave and surgical recurrence. In order to detect an effect size of 0.5 on the Inflammatory Bowel Disease Questionnaire at a 5% two sided significance level with a power of 80%, a sample size of 65 patients per treatment group can be calculated. An economic evaluation will be performed by assessing the marginal direct medical, non-medical and time costs and the costs per Quality Adjusted Life Year (QALY) will be calculated. For both treatment strategies a cost-utility ratio will be calculated. Patients will be included from December 2007. DISCUSSION: The LIR!C-trial is a randomized multicenter trial that will provide evidence whether infliximab treatment or surgery is the best treatment for recurrent distal ileitis in Crohn's disease. TRIAL REGISTRATION: Nederlands Trial Register NTR1150

The relationship between students' small group activities, time spent on self-study, and achievement

The purpose of this study was to investigate the relationship between the contributions students make to the problem-based tutorial group process as observed by their peers, self-study time and achievement. To that end, the Maastricht Peer Activity Rating Scale was administered to students participating in Problem-Based Learning tutorial groups. With this rating scale students had to rate the constructive, collaborative and motivational activities of their peers within the tutorial group. In addition, time spent on self-study was measured with a self-estimation method and achievement was measured with a unit test and a group assignment. A causal model of these variables was developed, in which the three types of activities were assumed to affect time spent on self-study, which would in turn affect unit test scores and group assignment scores. A structural equation modeling analysis indicated acceptable model fit. Especially apparent was the evidence for the causal relations between a student's constructive activities and his/her unit test score and between a student's collaborative activities and the group assignment score. On the other hand, time spent on self-study was not affected by the students' contributions, nor did it have an effect on the unit test score. These results suggest that there are indeed causal relations between a student's contributions to the tutorial group process and achievement

The effect of midterm peer feedback on student functioning in problem-based tutorials

Within Problem-Based Learning successful learning depends on the quality of cognitive, social and motivational contributions students make to the tutorial group. But at the same time, not all students in PBL automatically contribute in a high quality manner, which might impede successful group functioning. This study investigated whether peer process feedback combined with goal setting can be used to improve the quality of students’ individual contributions. A mixed-methods explanatory design, in which 74 second-year Health Sciences students participated, combined a pre- and posttest with a focus group. The results indicated that the quality of the contributions only increased for students with a below average score on the pre-test. The qualitative data confirmed that the impact of the feedback could be increased by combining individual reflection by means of goal setting with face-to-face discussion. Another suggestion is to investigate whether midterm peer process feedback is more effective for first year students, because they are still developing their tutorial behavior, as opposed to second year students

Can students adequately evaluate the activities of their peers in PBL?

Background: In problem-based learning (PBL), high-quality discussions are crucial for student learning. The quality of the discussion is affected by the quality of the contributions students make during PBL tutorials. Aim: This study investigated whether students are able to evaluate the activities of their peers in PBL groups in a reliable and valid way. Method: For this purpose, the Maastricht-Peer Activity Rating Scale (M-PARS) was developed. The M-PARS was well-founded on the literature about effective tutorial performance. With this scale, students (N = 196) were evaluated by their peers on three main aspects: their constructive, collaborative, and motivational contributions to the group. Results: A confirmatory factor analysis demonstrated that the data fitted the three-factor model reasonably well. The generalizability studies demonstrated good internal consistency when students were evaluated by, at least, four of their peers. Furthermore, Hancock's coefficients indicated good construct reliability. Conclusions: The results prove that peers are able to provide reliable and valid information about a student's active participation in the tutorial group, if at least four peer ratings are attainable, out of a group of eight students. In conclusion, the M-PARS is a valid and reliable instrument