Skip to main content

Blended learning positively affects students’ satisfaction and the role of the tutor in the problem-based learning process: results of a mixed-method evaluation


Problem-based learning (PBL) is an established didactic approach in medical education worldwide. The impact of PBL depends on the tutors’ quality and the students’ motivation. To enhance students’ motivation and satisfaction and to overcome the problems with the changing quality of tutors, online learning and face-to-face classes were systematically combined resulting in a blended learning scenario (blended problem-based learning—bPBL). The study aims at determining whether bPBL increases the students’ motivation and supports the learning process with respect to the students’ cooperation, their orientation, and more reliable tutoring. The blended PBL was developed in a cooperation of students and teachers. The well-established Seven Jump-scheme of PBL was carefully complemented by eLearning modules. On the first training day of bPBL the students start to work together with the online program, but without a tutor, on the final training day the tutor participates in the meeting for additional help and feedback. The program was evaluated by a mixed-method study. The traditional PBL course was compared with the blended PBL by means of qualitative and quantitative questionnaires, standardized group interviews, and students’ test results. In addition log-files were analyzed. A total of 185 third-year students and 14 tutors took part in the study. Motivation, subjective learning gains and satisfaction achieved significantly higher ratings by the bPBL students compared with the students learning by traditional PBL. The tutors’ opinion and the test results showed no differences between the groups. Working with the web-based learning environment was assessed as very good by the students. According to the log-file analysis, the web-based learning module was frequently used and improved the cooperation during the self-directed learning.

This is a preview of subscription content, access via your institution.

Fig. 1


  • Albanese, M. A., & Mitchell, S. (1993). Problem-based learning: A review of literature on its outcomes and implementation issues. Academic Medicine, 68(1), 52–81.

    Article  Google Scholar 

  • Barrows, H. S., & Tamblyn, R. M. (1980). Problem-based learning: An approach to medical education. Heidelberg: Springer.

    Google Scholar 

  • Boud, D., & Feletti, G. I. (1997). Changing problem-based learning. Introduction to the second edition. In D. Boud & G. I. Feletti (Eds.), The challenge of problem-based learning (pp. 1–14). Milton Park: Routledge.

    Google Scholar 

  • Bruns, A. (2006). Kosten und Nutzen von Blended Learning Lösungen an Hochschulen. Lohmar: Eul Verlag.

    Google Scholar 

  • Cunningham, C. E., Deal, K., Neville, A., Rimas, H., & Lohfeld, L. (2006). Modeling the problem-based learning preferences of McMaster University undergraduate medical students using a discrete choice conjoint experiment. Advances in Health Sciences Education, 11, 245–266.

    Article  Google Scholar 

  • de Leng, B. A., Dolmans, D. H. J. M., Muijtjens, A. M. M., & van der Vleuten, C. P. M. (2006). Student perceptions of a virtual learning environment for a problem-based learning undergraduate medical curriculum. Medical Education, 40(6), 568–575.

    Article  Google Scholar 

  • Derntl, M. & Motschnig-Pitrik, R. (2004). Patterns for blended, person-centered learning: Strategy, concepts, experiences and evaluation. In SAC 2004: Proceedings of the 2004 ACM symposium on applied computing (pp. 916–923).

  • Dziuban, C. D., Hartman, J. L., & Moskal, P. D. (2004). Blended learning. EDUCAUSE Center for Applied Research Bulletin, 7, 1–12.

    Google Scholar 

  • Graham, C. R. (2004). Blended learning systems: Definition, current trends, and future directions. In C. J. Bonk & C. R. Graham (Eds.), The handbook of blended learning: Global perspectives, local designs (pp. 3–21). Zürich: Pfeiffer Publishing.

    Google Scholar 

  • Harding, A., Kaczynski D, & Wood L. (2005). Evaluation of blended learning: Analysis of qualitative data. In Proceedings of UniServe Science Blended Learning Symposium (pp. 56–61).

  • Hoffmann, B., & Ritchie, D. (1997). Using multimedia to overcome the problems with problem-based learning. Instructional Science, 25(2), 97–115.

    Article  Google Scholar 

  • Lloyd-Jones, G., & Hak, T. (2004). Self-directed learning and student pragmatism. Advances in Health Sciences Education, 9, 61–73.

    Article  Google Scholar 

  • Nistor, N., Schnurer, K., & Mandl, H. (2005). Akzeptanz, Lernprozess und Lernerfolg in virtuellen Seminaren. Wirkungsanalyse eines problemorientierten Seminarkonzepts. Research report no. 174, Ludwig-Maximilians-University, Chair of Education and Educational Psychology. Retrieved August 24, 2008 from, Munich.

  • Oliver, R. (2005). Using a blended learning approach to support problem-based learning with first year students in large undergraduate classes. In C. Looi, D. Joassen, & M. Ikeda (Eds.), Towards sustainable and scalable educational innovations informed by the learning sciences (pp. 848–851). Amsterdam: IOS Press.

    Google Scholar 

  • Rhem, J. (1998). Problem-based learning: An introduction. The National Teaching & Learning Forum, 8(1), 1–4.

    Google Scholar 

  • Schmidt, H. G. (1983). Problem-based learning—rationale and description. Medical Education, 17(1), 11–16.

    Article  Google Scholar 

  • Sharpe, R., Benfield, G., Roberts, G., & Francis, R. (2006). The undergraduate experience of blended learning: A review of UK literature and research. The Higher Education Academy, (October 2006). Retrieved August 24, 2008 from

  • Taradi, S. K., Taradi, M., Radic, K., & Pokrajac, N. (2005). Blending problem-based learning with Web technology positively impacts student learning outcomes in acid–base physiology. Advances in physiology education, 29(1), 35–39.

    Article  Google Scholar 

  • Vignare, K. & Starenko, M. (2005). Online Learning Department (RIT—Rochester Institute of Technology). Blended Learning Pilot Project. Final report for 2003–2004 and 2004–2005. Retrieved August 24, 2008 from

  • Voos, R. (2003). Blended learning—what is it and where might it take us? Sloan-C View, 2(1), 2–5.

    Google Scholar 

Download references


The authors thank Timm Dirrichs and Marcel Louis for their contribution and ideas developing the bPBL concept, Christina Menzies for proof-reading the manuscript, and the Department of Medical Statistics, RWTH Aachen for statistical advice. Last but not least, we like to thank the anonymous reviewers for their detailed and very helpful criticism and suggestions for improvement.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Vanessa Woltering.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Woltering, V., Herrler, A., Spitzer, K. et al. Blended learning positively affects students’ satisfaction and the role of the tutor in the problem-based learning process: results of a mixed-method evaluation. Adv in Health Sci Educ 14, 725 (2009).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI:


  • Blended learning
  • Hybrid learning
  • Medical education
  • PBL
  • Problem-based learning