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This paper gives an account of a small-scale longitudinal study that examined changes in conceptions and approaches to learning as 14 students experience a problem-based learning (PBL) curriculum for the first time. The course in oral biology aimed to encourage conceptual understanding of the topic and improve student learning through its PBL curriculum and assessment method. Those who entered the course with a surface approach and fragmented conception of learning left with a deep-learning approach, cohesive conception and quality learning outcomes. There were no observable changes in the students who started the course with a deep-learning approach and cohesive conception, except for two who reported surface approaches and fragmented conceptions at the end. These two students also achieved the lowest examination scores. To help explain these findings we examine the wider context for student learning including student motivation.