title: Performance of academically at-risk medical students in a problem-based learning programme: a preliminary report.
abstract: BACKGROUND
  Racially segregated schooling, a legacy of Apartheid policies, continues to hamper education in South Africa. Students entering university from suboptimal circumstances are at significant risk of demonstrating poor academic performance and dropping out of their programmes. Attempts to address the educational needs of these students have included the introduction of extended medical programmes at several universities. Such a programme, the Academic Development Programme (ADP), was implemented at the University of Cape Town in 1991. Over the past decade the programme has graduated more than 100 students. Upon implementation of a new problem-based learning (PBL) programme in 2002, the ADP was discontinued and all students were entered directly into the new PBL programme. Students who demonstrate a need for additional academic support by the end of the first semester enter the Intervention Programme for 1 year before proceeding to the second semester of the PBL programme. An interim analysis was performed to compare the retention rates and academic performance of academically at-risk students in the new PBL programme and the ADP.
  
  
  METHODS
  The records of all academically at-risk students entering the ADP (1991-2000) and the new PBL programme (2002) were reviewed. Retention rates for all years of study, and academic performance in the fourth year clerkship courses of the respective programmes were compared.
  
  
  RESULTS
  A total of 239 academically at-risk students in the ADP and 43 at-risk students in the new PBL programme were studied. The median retention rates, per year of study, for at-risk students in the PBL programme was significantly better than for at-risk students in the ADP (p<0.02). Academic performance of the at-risk students in all the fourth year clinical clerkship courses of the PBL programme was significantly better than the mean performance over 10 years for at-risk students in the same fourth year courses in the ADP.
  
  
  CONCLUSIONS
  The introduction of PBL at the University of Cape Town has not had a deleterious effect on the performance of academically at-risk medical students. Interim analysis suggests that retention rates and academic performance in the PBL programme are better than those achieved in the extended traditional programme.
authors.affiliation: Department of Medicine, University of Cape Town, J-floor, Old Main Building, Groote Schuur Hospital Observatory, 7925 Cape Town, South Africa. vanessa@uctgsh1.uct.ac.za
authors.forename: V C
authors.initials: VC
authors.lastname: Burch
authors.forename: C N T
authors.initials: CN
authors.lastname: Sikakana
authors.forename: N
authors.initials: N
authors.lastname: Yeld
authors.forename: J L
authors.initials: JL
authors.lastname: Seggie
authors.forename: H G
authors.initials: HG
authors.lastname: Schmidt
mesh_terms: D044383:Black People / Q000193:education* / Q000523:psychology; D003467:Cultural Deprivation; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards; D004521:Educational Measurement; D006801:Humans; D011287:Prejudice; D018794:Problem-Based Learning / Q000379:methods* / Q000592:standards; D016730:Program Development; D015397:Program Evaluation; D012073:Remedial Teaching / Q000379:methods / Q000639:trends; D012570:School Admission Criteria / Q000639:trends; D013019:South Africa; D013332:Student Dropouts / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data; D013337:Students, Medical / Q000523:psychology*; D013995:Time