Blended problem based learning in postgraduate education: The Eastern Allergy Conference and the PBL Institute experience

Problem-based learning (PBL) is an interactive learning model well accepted in undergraduate medical education. Utilization of PBL in most postgraduate continuing medical education (CME) programs has been limited. The traditional didactic lecture (TDL) model alone in CME programs, although much more commonly used, may fail to assess self-efficacy, educational needs, and appropriate use of shared decision-making (SDM). These aspects of practice are essential, and assessment of these skills is necessary to ensure effective change in physician behavior to improve patient outcomes. PBL case discussions during CME breakout groups foster a participant-centered interactive environment that strengthens critical thinking, team collaboration, and clinical reasoning. Through engagement with clinically relevant cases, PBL allows for tailored educational interventions. Integrating or blending PBL with TDL engages the learners in a real-world case discussion first, followed by succinct post-PBL lectures, which are uniquely "in context" to the actual case discussion. The post-PBL lectures are designed to address knowledge gaps that may have been uncovered during the PBL case discussions and reinforce practice guidelines to correct identified misinformation by learners. The PBL approach not only improves knowledge retention but also leads to better adherence to clinical guidelines by producing significant changes in physician behavior, leading to higher-value patient care. Furthermore, PBL promotes effective and appropriate SDM. Still, there are challenges to PBL implementation in postgraduate CME, including logistical constraints and facilitator training requirements. Thus far, integration of PBL is variable across fields of medicine. Further research is needed to optimize PBL application in postgraduate training. This review advocates for a shift from passive learning systems by TDLs alone to interactive educational models, e.g., blended PBL, which synergizes the two adult learning theories.