Improved student performance following instructional changes in a problem-based learning curriculum.

Problem-based learning (PBL) supplements the traditional curriculum at the University of Iowa College of Dentistry and is used to introduce basic critical thinking skills and evidence-based dentistry. The objective of this article is to describe instructional changes made in response to student and faculty concerns and to compare the quality of student performance before and after the instructional changes. Instructional changes introduced in fall 2008 included replacing one learning report with a structured peer-reviewed manuscript critique in each of four cases, having the same course director evaluate all written assignments rather than facilitating faculty members, and eliminating midterm and final assessment cases. The final learning reports from first-year dental students entering dental school in fall 2007 were compared to the final reports of students entering in fall 2008. Final learning reports were evaluated using course grading criteria. Scores for students from fall 2008 were higher than those from fall 2007 for overall performance (p<0.001), overall background quality (p<0.001), overall clinical significance (p<0.001), and overall reference quality (p<0.001) as well as for individual components within each category. These results suggest that the implemented instructional changes were effective in improving student performance and reinforce the need to evaluate and revise instructional strategies in response to student and faculty concerns.