Barbara's recommendations are a great start.  To answer your question better, what exactly are you trying to 'reform'?  Is there an identified issue or problem you are trying to address or are you just trying to update?  Do you currently have a PBL curriculum?  What outcome are you working towards?

There is a considerable amount of work being done to integrate high-fidelity simulation into PBL programs.  It adds realism and may potentially help translation to practice (although this needs to be proven).

Great ideas proposed by both Barbara and Jay.  I would add that you need to keep in midn that PBL is both Project-based and Problem-Based learning.  Keep that in mind.  Problems are a great place to start, and PBL proposes that the problems are not well-defined so the learners can fill in the gaps using their knowledge and cognitive repertoire to solve them.   

Problems can range from a case-study analyzing the symptoms of a patient, to how to present this topic to the community to have a stronger impact.   Make sure to keep learners and their creativity at the center of your reforms, so you can have an actually student-centered program.

Thanks a lot dear Barbara, Jay and Juan. You all touched upon the great educational strategy of PBL which we have implemented since 1988. Please download following short account on the programme: https://www.researchgate.net/publication/282506592_The_fully_integrated_problem_based_medical_curriculum_experience_in_Tikrit_University_College_of_Medicine  

The question I posed is not concerned with starting a PBL curriculum but asks about experience in revising, updating and reforming an already existing PBL programme towards better performance and better outcomes. In particular your own opinion and experience on such reforming process. There are articles from different universities like Harvard (HMS), Sydney and many others. I am looking for concise plan of several points prioritizing what steps to follow in such case. Do you first conduct situation analysis including evaluation of the programme’s input, process and outcomes or set out to improve your outcomes first, or utilize global benchmarks like standards and outcomes or some other steps??  

Research The fully integrated problem based medical curriculum: exper...

Hi Mustafa, the link below is not a substitute for a thorough exploration of the academic literature. However, I thought it could provide a useful starting point. The authors also provide some useful references.

http://www.facultyfocus.com/articles/instructional-design/problem-based-learning-six-steps-to-design-implement-and-assess/

Thanks for the clarification.  Part of the debate you may be having is 'what to improve'.  My work is on defining outcomes from learning, and my advice would be to better define what outcome you are looking for and the problem you are trying to solve.  What you may find is that the question about 'how to improve PBL' may not get you the outcome you are looking for.  In the US there has been extensive work looking at completely new models of medical schools.  Take a look at 

http://medicine.hofstra.edu/pdf/about/medicine_doc_macy1009.pdf

Hello Mustafa

I have recently worked on the redesign of an undergraduate 3rd Year PBL program and used the following as a guide to implementation.  Its based on a blended learning model (case based scenarios) and the instructional strategies and education design are underpinned by cognitive principles:

The online content is specifically designed to introduce new concepts through a series of worked examples that allow the student to process the information through decision making tasks, clinical reasoning and observations.

The relevant science is described in context to support understanding of the condition being presented.  Cases feature a video demonstration of patient symptoms or presenting complaint to provide authenticity to the scenario.  The clinical reasoning required to explain symptoms and signs, order and interpret investigations and start management is demonstrated as the case develops.

The inclusion of authentic learning tasks, guided instruction and supportive information will assist in knowledge acquisition and the transfer of learning to new contexts.

Students complete scenario based assessments to determine readiness for group discussion.

Students are equipped to attend the face to face activity with:

•       a good understanding of the relevant basic science and patient presentation

•       basics in clinical reasoning and decision making.

The format of the group discussion has been designed as an interactive case based discussion, drawing upon elements of the online case, but providing different contexts to enable students to apply and practice their clinical reasoning skills to new patient scenarios. The format is structured to ensure small group collaboration around authentic patient tasks.

hope that helps

Kate Jurd

LinkedIn: https://au.linkedin.com/in/kate-jurd-32689a31

Digital learning and design: http://bit.ly/1ODIQxS

What best strategies to adopt in reforming a PBL medical school curriculum?

In Problem Based Learning, problem is set out first as a context for developing knowledge and understanding. In PBL the problem that is defined and examined why and how it becomes a problem will produce knowledge and understanding (PBL). Solution or intervention is designed based on the knowledge and understanding that emerge from the problem that was examined. What are the desired competencies to implement the solution or intervention. This is the question leading to competency-based learning. Are the needed competencies readily transferable to the work environment?  This is the question leading to outcome based learning.

To reform PBL, learning is re-designed by setting out first the desired focus from problem to competence (competency based learning), to outcome (outcome based learning). Re-designing to re-set or move the focus of learning does not displace the problem in the PBL. The problem is re-positioned in the learning process. I had similar question like yours in the past. In analyzing the curriculum I observed that content, problem, competence, outcome are being re-position in learning process base on the focus of learning that we want to set out first. 

There are many interpretations of PBL, but if the primary instructional strategy is to give learners a problem and ask them to discover the solution themselves with minimal guidance, then there is little evidence  for effectiveness (See Kirschner, Sweller, and Clark, 2006), except perhaps for learners with substantial prior knowledge.  For complex tasks, the evidence reveals the effectiveness of using cognitive task analysis with multiple experts to capture the knowledge and skills they use to perform complex tasks and solve difficult problems.  CTA results can then be demonstrated and practiced by learners using increasingly complex problems to enhance transferability and adaptability. 

Richard E. Clark has written extensively on medical education and I recommend following him on RG.

Some years ago at a small US private baccalaureate/masters institution an inter-disciplinary group of faculty sought to apply PBL to the General Education segments of the first two years. Our goal was to remove the discipline silos by employing PBL projects designed to integrate the humanities, sciences, social sciences and mathematics. For example, the first semester freshman year’s unifying project was the redesign of the campus landscaping for environmental and economic sustainability.  Five sub or contributing projects were employed.  Each was team designed and to be team taught. All had an unforeseen soft skills loading.  Unfortunately, the administration got cold feet and the project was shelved.

Nice Contribution William Patrick Leonard