Why is evidence from ethnographic and discourse research needed in medical education: the case of problem-based learning.

While the need for evidence-based medical education is widely acknowledged, it is often assumed that the 'gold standard' used in evidence-based medicine is sufficient evidence for practising evidence-based medical education. Using the introduction of a problem-based learning (PBL) curriculum as an example, this paper argues that evidence from ethnography can provide valuable insight into medical education, although few such studies have been carried out. Ethnography attempts to capture the true nature of human social behaviour by going beyond what individuals say to what they actually do, and explores social and educational phenomena beyond mere mechanical products of our purported educational interventions. Applied to problem-based learning, ethnographic accounts would be valuable to help us understand the PBL process and improve our educational practice.