Problem-Based Learning as a Pedagogical Methodology in Nursing Education

  • Fátima Mendes Marques
  • Anabela Ferreira dos Santos
  • M. Teresa Leal
  • Maria José Pinheiro
Keywords: Problem-Based Learning; Nursing Students; Clinical Skills; Nursing Education; Pedagogic Methodology.


Nursing education aims to empower students to respond effectively to highly complex clinical problems, many times new and without known pre-defined solutions. Problem-based learning (PBL) fosters the acquisition and development of competencies necessary for professional nursing practice. In a recently implemented Undergraduate Nursing Program at Lisbon School of Nursing (ESEL), Decision-Making Process in Nursing was introduced as an innovative course in the curriculum. PBL, a student-centered methodology, is used as a means of learning the nursing process and how to create nursing clinical plans for hypothetical patients like those, students will find in clinical contexts.

The objective of this study was to analyze the competencies acquired by nursing students using PBL in this course/program.

The study was exploratory, descriptive, transversal and qualitative, with data collected through an open question questionnaire. The inclusion criteria were being a second-year student in the nursing program and have attended this course. The research project was approved by ESEL’s Ethics Committee. Confidentiality, anonymity and freedom to participate were guaranteed. Research data were analyzed according to Bardin. Answers were categorized according to King, based on the assumption that nursing students are open systems in interaction with other and with the environment.

The participants, 219 students, were 87% females, ranging from 19 to 45 years old, with a mean age of 20,9. They corresponded to 75 % of the students enrolled in the course during the academic year of 2016/17. Through the analysis process three dimensions were identified: “Student as a Personal Being”, “Student as an Interpersonal Being” and “Student as a Social Being”. Several competencies were highlighted by the students, corresponding to each of the three dimensions. Consistent to Student as a Personal Being, “nursing knowledge about the nursing process and taxonomies” had the highest number of registration units; “teamwork” and “communication” were the competencies with higher frequency in the dimension of Student as Interpersonal Being; and “decision-making” and “leadership” were the most mentioned in the dimension of Student as a Social Being.

The results indicate a relationship between PBL and the development of competences in students. Considering the outcomes of the course and of the Nursing Education Program, some of the most important expected competencies were mentioned. However, creativity was referred only by one student, even though all students have created a complex, individualized and holistic nursing care plan for a hypothetical situation of a patient. Creating is the most complex and top competency of the Revised Bloom’s Taxonomy. Students did not associate creativity with hypothesis and/or nursing care plans creation.

Further understanding is needed of the tutor role development and if it fosters the awareness of the complexity in the construction of a nursing care plan. However, the other competencies identified are a major part of the clinical goals and evaluation process.