Implementing a problem-based learning curriculum in an Argentinean medical school: implications for developing countries.

The authors review the difficulties that Argentina's medical schools, particularly the public ones, are likely to face when implementing a problem-based learning (PBL) curriculum, describe the barriers that were faced by their medical school as it implemented PBL, and point out the implications for medical education in developing countries with conditions and education programs similar to those in Argentina. Specifically, they (1) outline the basic requirements for successful implementation of a PBL curriculum, (2) describe the training contradiction in Argentina between a complex and heterogeneous health care system that forces specialization and medical schools' attempts to train generalists, and (3) review the effects on curriculum change of the size and the training levels of the student population and the availability of human and financial resources. This information indicates the context in which the Rosario University School of Medicine designed a new PBL curriculum and implemented it in 2002. The authors close by suggesting that schools in developing countries that are in circumstances similar to that of Rosario should consider whether a PBL curriculum is even appropriate for them, and should realize the difficulties (discussed in the article) they will have to overcome. Also, uncertainties about the efficacy of PBL create a case for exploring alternatives to PBL, including hybrid curricula. Considering the available research on curricular innovations such as PBL and the particular situations of their countries may help schools anywhere avoid wrong decisions about what curricula to implement.