INTRODUCTIONProblem-based learning (PBL) is student-centred, self-directed and collaborative. In medical education it is based on clinical cases and is widely considered to facilitate the development of key professional competencies. Whilst PBL is extensively employed in medical schools worldwide, Lake Erie College of Osteopathic Medicine is one of very few schools that offer it to pre-clinical students as a major pathway of study. We have identified several problems associated with implementation of the programme and attempted to provide solutions with 3 new learning tools. In this study we use action research to evaluate the success of our strategy.

METHODSWe examined the students' perception of the effectiveness of case-based formative assessment, case-based "question and answer" workshops, and reviews of annotated examinations as learning tools, using a 5-point Likert scale questionnaire.

RESULTSA majority of both first- and second-year students perceived all 3 learning tools to be helpful. In general, the most positive responses were received from second-year students. First-year students evaluated casebased formative assessments more positively when they were about to take examinations.

CONCLUSIONSCase-based formative assessments, case-based workshops and reviews of annotated examinations were perceived as helpful learning tools by both first- and second-year medical students in PBL learning pathways.