Effectiveness of Problem-based learning versus conventional lectures on knowledge retention and engagement, among adult nursing students in Pakistan.

Abstract

Objective: To compare the difference in outcome, educational experience and knowledge retention of PBL and conventional (lecture based) teaching of adult nursing students of Pakistan. Study Design: Quasi-experimental Cross Over study. Period: January to March 2025. Setting: College of Nursing, Bahawal Victoria Hospital/QAMC, Bahawalpur. Methods: After taking ethical approval (Ref No: 2387/DME/QAMC Bahawalpur) total of 60 4^th year nursing students were included (30 PBL and 30 conventional). Knowledge and competency related to myocardial infarction (MI) were assessed using a pretest posttest design with cross over to compare the knowledge acquisition and retention. The class attractiveness and overall educational experience was measured using a structured 12-item questionnaire. Perceptions regarding PBL were measured using a Likert-scale instrument. Data were analyzed using independent sample t-tests with significance set at p ≤ 0.05. Results: PBL students demonstrated significantly higher knowledge in multiple MI-related domains including symptom recognition (p=0.01), ECG interpretation (p=0.02), laboratory interpretation (p=0.009), counseling confidence (p=0.005), and pathophysiology understanding (p=0.01). They also reported significantly higher motivation and perceived understanding with PBL compared to traditional methods (p<0.05). The PBL groups showed significantly higher knowledge retention in first post-test score (p=0.001). After crossover, final scores were even better and comparable though the group who took PBL later had a slightly higher scores. There was a significant time effect (f-value 112.5 and p-value <0.001). Reliability was acceptable to good and improved in post-test (Cronbach’s alpha 0.84). Conclusion: PBL (Problem based learning) is associated with improved knowledge retention, greater perceived benefit, engagement, active participation and motivation as compared to traditional teaching. Exposure to both modalities/ hybrid approach maximizes benefits, leading to deeper understanding and better learning outcomes.