Introduction: In the last thirty years, medical schools worldwide have revised and broadened the goals of medical education to ensure that graduates have the knowledge and skills appropriate to medical practice in the 21st century. To achieve the renewed goals, many schools have adopted problem-based learning (PBL). Because problem-based learning is perceived to be radically different from the traditional approach to medical education, preparing teachers to teach in PBL curricula is considered a vital element for successful change. The results of teacher preparation programs, however, have been variable. Of concern, some teachers continue to teach in PBL curricula in ways that are counterproductive to the achievement of the renewed goals of courses.
Aims: The aim of the study was to achieve an understanding of how teachers conceive PBL, and to develop principles, based on this understanding, to enhance teacher preparation for PBL in medical education.
Methods: The methodology combined empirical and non-empirical research methods to develop:
(i) A conceptual framework for understanding the meanings that teachers give to PBL in medical education. The framework was derived from:
• a conception of PBL as whole learning for medicine, extrapolated from Barrows' conception of PBL in medical education
• a critical review of the meanings that medical teachers in a range of schools give to PBL in terms of the whole conception;
• a critical review of and reflection on the experiences of PBL in the problem-based, integrated Graduate Medical Course at the School of Medicine, The University of Queensland, Australia, in terms of the whole conception;
• analysis of the findings about meanings in terms of educational theory and research pertaining to teachers' beliefs and values.
(ii) Proposals for teacher preparation for problem-based learning in medical education relevant to the findings.
Result: The result of the study is a set of principles for teacher preparation that acknowledges and respects the beliefs of teachers who teach in medical courses. The principles are eclectic in that they include who should teach in the PBL approach, the nature of the curriculum, the appropriate approach to working with teachers, the appropriate qualifications for teachers, and the appropriate qualifications for those who prepare teachers.
Conclusion: The diversity of teachers' belief systems that influence the meanings that they give to medical education requires the mediation of old beliefs and new beliefs if genuine change to PBL is to be achieved. This finding is relevant to teacher preparation in all fields where teachers face change.