Developing higher-order thinking through blended problem-based learning

Tong Edmond Tak Fai and Paula Hodgson
The Hong Kong Polytechnic University
Hong Kong SAR, China.


Authentic learning experience is an essential component of programmes that provide a form of professional apprenticeship to become a lawyer, doctor, teacher and the like. In nursing, clinical placement gives students a valuable opportunity to synthesize theory, research and practice; they can consolidate their knowledge and skills and develop professional attitudes. To assist nursing students to becoming inquisitive, problem-based learning (PBL) was incorporated into the curriculum of a four-year undergraduate degree programme (Wong et al. 2004). To support the development of higher-order thinking skills, it is necessary to use authentic situations (Herrington and Oliver 1999; Weiss 2003). The provision of ample opportunities for students to interact with one another is important.

In order to acquire professional competence, students need to experience a variety of situated cases. However, contact hours in term time are limited, and students cannot be provided with full exposure to all clinical situations, as is required for designated learning activities. Therefore, a web-based PBL environment consisting of different clinical cases was created in one nursing course. Students have the option to discuss and debate the cases through an online forum and reconsolidate the threaded discussion in face-to-face tutorials.

In the course, students were divided into groups, which were required to learn by assessing the situated cases, analysing and synthesizing the contextual information, identifying the learning issues and reviewing solutions for the issues thus identified. On the one hand, the online forum served as a platform for peers to share knowledge and provide feedback. On the other, the teacher was able to provide additional information to students and comments when required, so that students could take ownership of their learning.

The online group discussion on the cases was analysed by using a framework adopted from Bloom's taxonomy (McNaught and Lam, in press). This paper examines whether students develop inquisitive learning behaviour and assesses whether higher-order thinking skills are adopted. Students' overall performance, including examinations and other individual work in the course, is compared with their performance in the forum discussions, and the correlation between various performance indicators is explored.