To the Editor: The article by Sanson-Fisher and Lynagh on problem-based learning (PBL)1 is very timely, raising important questions about the popularity and efficacy of this method.

My “traditional” education included lectures involving 600 students, as well as small-group sessions on the wards and in tutorial rooms. The sessions focused on real patients. Problem-based sessions often deal with videos, at best, and, at worst, paper case histories and laboratory data.

I believe the differences between PBL and the standard “curriculum” have been overstated. The quality of the teacher is a critical factor that is understated by proponents of PBL. An excellent teacher can captivate large groups with highly relevant and exciting deliveries, and there is nothing to suggest that such teaching is less effective, stimulating or encouraging than PBL-based teaching.

The authors challenge the proponents of PBL to provide evidence that their methodology works. It is also time for those who teach PBL curricula to ask whether this approach is cost-effective.

With the knowledge base of medical science increasing exponentially, it is hard to understand how students, without some guidance, can be expected to take on board the complexities of some of the problems that they are faced with. Taking a humane approach and communicating well with patients are commendable goals, but not if they are pursued to the point where patients fail to receive a correct diagnosis and appropriate treatment.

Good teaching is provided by good teachers rather than by a particular teaching approach. The PBL system is just as fallible as any other system. I applaud the authors for raising this matter and for asking the questions they asked. I look forward to seeing answers provided in the months to years ahead.