Beyond knowledge acquisition: the role of problem-based learning in supporting competency and skills development in pharmacy education — a systematic review
Beyond cognitive gains, PBL appears to cultivate self-regulation, learner autonomy, and collaborative competencies essential for preparing pharmacists capable of navigating the evolving scope of contemporary practice.
Abstract
To synthesize evidence on the role of PBL in pre-registration pharmacy education in fostering metacognitive and interpersonal competency development, with particular emphasis on self-regulation, learner autonomy, and professional collaboration.
A systematic search of MEDLINE, Embase, ERIC, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) identified peer-reviewed primary studies exploring PBL-related competency and skill development among undergraduate pharmacy students. Quantitative, qualitative, and mixed methods studies were included. Two reviewers independently screened studies and extracted data. Findings were synthesized narratively, and methodological quality was appraised using the Mixed Methods Appraisal Tool 2018.
Twenty-six studies met the inclusion criteria (12 mixed methods, 11 quantitative descriptive, 3 qualitative). Three domains emerged from the narrative synthesis: (1) Self-regulated clinical reasoning, decision-making, and metacognitive development (
n
= 16); (2) Communication and teamwork skills (
n
= 12); and (3) Engagement, motivation, and learning management skills, including organization and accountability (
n
= 9). Across studies, PBL was associated with enhanced reflective capacity, greater ownership of learning, improved confidence in complex decision-making, and strengthened collaborative communication. However, experiences were not uniformly positive; some studies reported learner anxiety, resistance, or reduced engagement when cultural alignment was limited. Most studies were rated medium to high quality.
Beyond cognitive gains, PBL appears to cultivate self-regulation, learner autonomy, and collaborative competencies essential for preparing pharmacists capable of navigating the evolving scope of contemporary practice. Further longitudinal, theory-informed research is needed to clarify the contextual conditions under which PBL most effectively supports sustained learner development.
Early development of core competencies is essential in medical education, yet traditional medical curricula often struggle to bridge the gap between biomedical knowledge and humanistic application. Drawing on social constructivism, this study examines an integrated Narrative Medicine (NM) and Peer-Assisted Learning (PAL) model designed to facilitate the transition from foundational knowledge to contextualized professional application. An explanatory sequential mixed-methods design was employed. A 19-indicator Knowledge-Skills-Attitude (KSA) scale was developed via a Delphi process and evaluated for preliminary psychometric properties. Following a 10-month intervention with 128 first-year students (Experimental n = 64; Control n = 64), hybrid thematic analysis of 14 in-depth interviews explored the underlying pedagogical mechanisms. The experimental group reported significantly higher self-reported core competency scores than the control group (77.42 ± 7.45 vs. 68.00 ± 7.31; p < 0.001; Cohen's d = 1.28). At the item level, critical thinking and empathy-driven awareness did not reach statistical significance. Qualitative findings suggested that participants perceived narrative features of the integrated package as a catalyst for meaning-making, while peer-assisted elements were viewed as providing social scaffolding necessary for skill development. This exploratory study provides preliminary evidence that the integrated NM-PAL model may support students' self-reported development of contextualized clinical competence and early professional identity. By providing a low-pressure collaborative environment, the model may support early reflective engagement that could be foundational to professional development, warranting further longitudinal and confirmatory research.
Peixin Lin, Xiaolin Yin, Xuankun Zheng et al.· BMC Medical Education· 0 citations
Introduction Programmatic assessment (PA) is widely endorsed as a way to organize assessment around competency development in postgraduate medical education (PGME), yet no systematic review has synthesized the empirical evidence in this setting. We therefore synthesized the evidence on its contribution to competency development in PGME and on the factors that shape its implementation. Methods A systematic review was conducted following PRISMA 2020 guidelines (PROSPERO: CRD420261349850). We searched MEDLINE, Embase, Scopus, Web of Science, and EBSCOhost from January 2005 onward. Each included study was mapped against four operational features of PA derived from van der Vleuten et al. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT), and findings were synthesized using a narrative approach. Results Twenty studies met inclusion criteria. Four reported competency-related outcomes, all with observational designs. Two evaluated purposefully designed PA systems, and two analyzed milestone-based data generated within regulated competency-based training without an explicitly designed PA system. These studies reported increases in competency ratings and improved examination outcomes over training, though none could establish a causal link to the assessment system. The remaining 16 studies focused on implementation processes, stakeholder perceptions, and measurement properties. Challenges including feedback documentation barriers, misalignment between intended and perceived assessment stakes, and variable stakeholder engagement were reported consistently across settings. Methodological quality was uneven across the included studies (nine rated High, six Moderate, and five Low on a descriptive MMAT-based quality index). Discussion The empirical evidence for PA in PGME remains limited relative to its theoretical foundations. Most evidence reflects how stakeholders experience the system or whether assessment tools produce reliable data, rather than whether the system improves competency or patient care. Future research should extend outcome measurement beyond system-internal metrics and account for the contextual specificity of PA across diverse educational and regulatory environments.
İbrahim Ulaş Özturan, Pinar Daylan, Cansu Alyeşil Özturan et al.· Frontiers in Medicine· 0 citations
Although BL is highly effective in HPE, its long-term sustainability depends on transitioning from ad hoc implementation to institutionally supported, theory-driven instructional design, and educators and higher education institutions should prioritise intentional pedagogical design and sustained institutional support.
Mira Istiana, Eveline Siregar, T. Iriani et al.· Jurnal Paedagogy· 0 citations
Interprofessional collaboration (IPC) and intraprofessional collaboration (IntraPC) are core competencies in interprofessional education (IPE), but resident physicians often encounter difficulties in practice. Understanding residents’ perceptions of IPE is essential for developing effective education. This scoping review aims to map and synthesize existing literature on residents’ perceptions of IPE. A systematic search was conducted on the PubMed and ScienceDirect databases. The selection process followed the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) framework. Data from eligible studies were extracted and analyzed thematically. Ten studies met the inclusion criteria from 337 identified articles. Thematic analysis revealed four interrelated main themes regarding residents' perceptions of IPE. These themes included “knowledge, skills, and attitudes,” as well as implications for medical education that highlight the urgent need for a formal, structured, and longitudinal IPE curriculum, utilizing methods such as simulation and discussion-based learning. Residents' perceptions of IPE are characterized by tension between cultural barriers and systematic drivers of collaboration. The gap between these barriers and drivers of collaboration underscores the need for residency programs to proactively integrate ongoing IPE training to prepare residents for collaborative challenges in clinical practice.
D. Wardhana, I. Yusuf, S. As'ad et al.· Korean Journal of Medical Ed...· 0 citations
INTRODUCTION
Competency-based assessment (CBA) is central to competency-based education (CBE) in nursing, yet the evidence about its effectiveness is fragmented across methods, settings, and outcomes.
AIM
To synthesize the strengths and limitations of CBA approaches in nursing education and to map them onto established educational frameworks.
METHODS
An umbrella review of reviews was conducted, including systematic, scoping, integrative, and theoretical reviews of CBA in pre-registration and early-career nursing. Searches of PubMed, CINAHL, Scopus, Web of Science, and ERIC (from inception to November 2025) were conducted in accordance with Joanna Briggs Institute and PRISMA guidance, with eligibility defined using the Population, Concept, and Context (PCC) framework, and data were integrated through narrative synthesis.
RESULTS
Twenty reviews, encompassing more than 700 primary studies, identified six CBA domains: simulation-based and Objective Structured Clinical Examination (OSCE) assessments, workplace-based assessments (WBAs), technology-enhanced assessments, learning-based and reflective assessments, research competency assessments, and program-level CBE evaluations. Across domains, CBAs predominantly targeted higher-order cognitive and performance outcomes aligned with the upper levels of Bloom's taxonomy and Miller's pyramid. Simulations and OSCEs showed strong validity and acceptability but were resource-intensive and often anxiety-provoking. Workplace-based tools captured authentic performance but were constrained by assessor variability and limited psychometric properties. Technology-enhanced and reflective approaches fostered engagement and self-regulation yet frequently relied on heterogeneous, weakly validated measures. Evidence for research competencies and program-level CBE remained limited and methodologically modest.
CONCLUSION
CBAs in nursing provide rich information on complex competencies but are unevenly developed. Integrated, theory-informed, and programmatic assessment systems are required to optimise their contribution to practice-ready graduates.
R. K. Ibrahim, A. Darwish, Lisa Bayliss-Pratt et al.· Nurse Education Today· 0 citations
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