The definition of problem-based learning (PBL) as an educational concept is as elusive in 2008 as it has been since the concept was first expressed over forty years ago. A definitive guide to the practice of PBL is equally elusive. Like all worthwhile educational ideas, PBL has proved attractive to those teachers who seek improvements for their courses. Its appeal has transcended the traditional boundaries in formal education so that there are examples of PBL from primary to tertiary education, and across many disciplines within these. Dissemination, however, has wrought confusion in understanding and practice, and consequent difficulties for researchers in evaluating its efficacy, and lack of clear advice for those who would like to adopt PBL. Rather than attempting to be definitive, this Guide explores the various interpretations and practices that claim the label PBL, and critiques these against the original concept and practice. The primary aim is to provide insight into the causes of the confusion about PBL in 2008. The second aim is to point a feasible way forward so that, where appropriate, the potential of PBL as a whole-of-curriculum concept may be realised; and, where it is not possible to implement the whole concept, worthwhile educational principles that have been associated more or less with PBL may be recognised as such and given value in their own right.

It may be useful for others who are experiencing difficulties with implementing problem-based curricula, and for those who are contemplating changing to problem-based models.

Consistency in interpretation of key concepts is an important factor in the success of problem-based curricula.

Recently, commented that there is a need for better ways of looking at how teaching and learning work in the PBL approach before it is banished to the wilderness of other educational innovations. The premise of this paper is that better ways of looking at how PBL works are dependent on better ways of understanding PBL. The recent exchange of views in the literature about the value of the small-group learning environment in PBL suggests that there is a variety of perspectives on the role and purpose of the small group. The debaters will have difficulty settling their differences or even understanding each other's point of view if they are not 'singing from the same hymn sheet'. In pursuit of clarifying the issue and contributing to an enhanced understanding of PBL, this paper critiques published views of the small-group learning environment against a way of looking at PBL as a whole approach to learning medicine.

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This paper reports a critique of the literature of problem-based learning (PBL) in medical education. The objective of the review was to examine the various meanings that medical teachers attribute to concepts of adult learning and self-directed learning within the context of PBL. The critique found that there are assumptions about the meanings of adult learning and self-directed learning that are accepted uncritically as appropriate to PBL. The nature and the origins of teachers' conceptions of these ideas are explored in an attempt to clarify the meanings of the concepts and the relationships amongst them. An alternative meaning for self-directed learning in PBL curricula is proposed.

During 1992-93, the authors produced a video-based teacher development resource kit for rural and isolated general practitioners and hospital medical personnel who are involved in medical teaching. As part of the development process, we surveyed 240 medical undergraduate students of the University of Queensland about their experiences and perceptions of teaching and learning in rural settings in Queensland. For approximately 90% of undergraduate learners, the experience with a rural medical practitioner was extremely positive. The major positive features identified by students were: being treated as a colleague; being allowed/encouraged to work independently; receiving feedback on their work; and being given ample 'hands-on' minor procedural experience and/or teaching. The 10% of students who reported unfavourably on their rural terms identified lack of opportunities to carry out solo consultations/work independently, lack of structure in teaching/learning experiences, and lack of hands-on experience as the major disappointments. The results demonstrate clearly how and why the majority of rural medical teachers in Queensland are effective facilitators of undergraduate learning.