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SUMMARY Problem-based learning (PBL) has been recognized as an important educational strategy and has been adopted in many medical schools. There is confusion, however, about what constitutes PBL. In the SPICES model for educational strategies PBL is presented as a continuum. This paper describes 11 steps in the continuum between problem-based learning and information-orientated learning. Task-based learning is viewed as the final step at the problem-based end of the spectrum. The continuum presented recognizes the two key variables-the problem and the information or principles derived from a study of the problem. It builds on the rul-eg/eg-rul approaches introduced in programme learning in the 1960s. The continuum offers a useful taxonomy to describe PBL. It emphasizes the range of options and in so doing helps to avoid a polarization of viewpoints between enthusiasts and traditionalists. The continuum can be used as a tool for curriculum evaluation and development.
The concept of a continuum
Since the potential value of problem-based learning in medical education was highlighted by Barrows (1980),the educational strategy has attracted increasing attention. New schools have adopted it as a major feature of their curriculum, established schools have incorporated it in curriculum revisions, and reports on medical education have featured it among recommendations as to good practice (General Medical Council, 1993; Walton, 1994).
Many courses purport to be problem based. It is often far from clear, however, in what way this is reflected in the curriculum. `What is problem-based learning?' is a question not infrequently asked by medical teachers and those engaged in curriculum planning and development. Views range from a rigid definition which identifies it with the approach adopted in schools such as McMaster and Maastricht, to suggestions that anything which includes problem solving can be designated problem-based learning (Barrows, 1986). "Problem-based" suggested Barrows (1986) "must be considered a genus for which there are many species and subspecies". Problem-based learning may be best thought of as a syndrome comprising a number of components (Walton & Matthews, 1989). The term PBL can have, according to Barrows (1986), "many different meanings depending on the design of the educational method employed and the skills of the teacher". He identified the need for a taxonomy to "facilitate an awareness of these differences and to help teachers to...