The 'expert' in problem-based and case-based learning: necessary or not?

Background Problem-based learning (PBL) and other small-group teaching meth ods which incorporate principles of adult learning, are exciting innovation s in medical education. In the application of these methods to medical curr icula many schools have introduced non-expert tutors. However, research eva luating the effectiveness of non-expert lead teaching has been inconclusive . Aim The present study aim was to compare the outcome of teaching in small g roups facilitated by either an 'expert' or a 'non-expert' tutor, in a singl e topic area. Method Fourth-year medical students were allocated randomly to teaching of eating disorders either by a non-expert or an expert tutor. Outcomes were e valuated by (i) a knowledge test, and (ii) self-report ratings by tutors an d students of their learning methods and other qualities. Results The study found that while the non-expert tutor was rated more high ly for her group management skills, and she also rated her students more hi ghly in the area of oral communication, students who were taught by the exp ert scored higher in the end-of-course test in the topic area. Conclusion The findings suggest that caution should be exercised, and the n eed for more research before widespread adoption of teaching by non-expert tutors.