Original article
Validation of a short questionnaire to assess the degree
of complexity and structuredness of PBL problems
Alexandra E J P Jacobs,1 Diana H J M Dolmans,1 Ineke H A P Wolfhagen1 & Albert J J A Scherpbier2
Background In problem-based learning (PBL), problems
represent the starting point of students’ learning activit-
ies. Therefore, the quality of these problems should be
high, in that they should be of an adequate level of
complexity and structuredness. Previous research has
proposed several guidelines for constructing problems,
but some of them are rather vague and are not based on
empirical evidence. The present study aimed to validate a
short questionnaire that can be used to assess the degree
of complexity and structuredness of PBL problems.
Method This paper outlines Jonassen’s theory, on
which the questionnaire is based, and its relation-
ship and applicability to PBL problems. The question-
naire was validated by means of confirmatory factor
analysis.
Introduction
In problem-based learning (PBL), students are con-
fronted with problems that are intended to serve as the
driving force behind student learning. Typically, a
problem is a description of phenomena that require
additional explanation, and the students try to explain
the phenomena presented in the problem. For this
purpose, they have a discussion in a small group, called
a tutorial group. As the students discuss the problem,
they realise that their present knowledge is not suffi-
cient to clarify everything. Consequently, unanswered
questions emerge from the discussion. These questions
are called learning issues, and they motivate students to
engage in self-study.1 This self-study component
requires students to individually search for relevant
literature with which to answer the learning issues.
1 processes (e.g. discussion in the tutorial group and
Department of Educational Development and Research, University
of Maastricht, the Netherlands
2
Institute for Medical Education, University of Maastricht, the
Netherlands
Correspondence: Diana Dolmans, Department of Educational
Development and Research, Maastricht University, PO Box 616,
620 MD Maastricht, the Netherlands. Tel.: 00 31 43388 1121; Fax:
00 31 43388 4140; E-mail: D.Dolmans@educ.unimaas.nl
 Blackwell Publishing Ltd M ED I C A L E D UC A T I O N 2003;37:1001–1007
Results The results showed that students were able to
distinguish PBL problems that were too simple and
those that were too well-structured, but found it
difficult to distinguish problems that were too complex
or too ill-structured.
Conclusion The questionnaire may be used to measure
the levels of complexity and structuredness of a
problem as perceived by students and can provide
teachers with feedback about the quality of problems.
Keywords education, medical, undergraduate ⁄
*methods; problem based learning ⁄ *methods ⁄
standards; reproducibility of results; questionnaires;
guidelines; Netherlands.
Medical Education 2003;37:1001–1007
Problems are thus extremely important in determin-
ing the quality of student learning in PBL. Gijselaers
and Schmidt2 examined several elements of PBL and
their interrelationships in a causal model and found
that the quality of the problems used in PBL has a
major influence on the activation of prior knowledge,
the functioning of the tutorial group and the time spent
in self-study. It can be concluded from these findings
that the learning of students in PBL can be enhanced
by manipulating the quality of the problems.2 These
findings were replicated in a study by van Berkel and
Schmidt,3 who tested a causal model similar to that of
Gijselaers and Schmidt.2 This second study demon-
strated that the influence of the quality of problems on
student learning is even more important than that
indicated by the Gijselaers and Schmidt model.3
A study by van den Hurk et al.4 examined the influence
of the quality of problems and other tutorial group
functioning of the tutor) on generating useful learning
issues. Its results showed that the quality of the
problems influences the generation of useful learning
issues.4 Thus, the quality of student learning activities
in PBL is greatly dependent on the quality of the
problems presented to students in tutorial groups.
1001
1002 Validation of a questionnaire to assess PBL problems • A E J P Jacobs et al.
Key learning points
Students are able to distinguish PBL problems
that are too simple or too well-structured, but have
difficulty in distinguishing problems that are too
complex or too ill-structured.
A short questionnaire was validated that can be
used to measure 2 main characteristics of PBL
problems: complexity and structuredness.
Students find structuredness a more important
characteristic of PBL problems than complexity.
Several guidelines and principles have been proposed
for constructing problems,5,6 based on experience or on
general theories of learning and cognition. These
guidelines recommend, for example, that a problem
should fit in with students’ prior knowledge and that it
should be of an adequate level of complexity and
structuredness. The difficulty with these guidelines is
that some of them are rather vague and are not based
on empirical evidence. Furthermore, it is unclear what
complexity and structuredness mean, and what the
difference is between these constructs.
Writing about the design of educational problems,
Jonassen, an authority in the field of learning in a
constructivist learning environment, makes a distinction
between structuredness and complexity that might be
useful when designing PBL problems.7 The complexity
of a problem is determined by the number of factors,
functions or variables that play a role in it, the strength of
the connection between the characteristics, the type of
functional relation between these characteristics and the
stability of the characteristics over time.8 The level of
complexity ranges from being too simple at 1 end of the
continuum to being too complex at the other. Complex
problems demand that more cognitive actions and steps
be taken to solve them. Therefore, complex problems
make greater demands on the working memory. A
problem that involves too many components can over-
burden the working memory and make it impossible to
solve.7 A problem that is too simple will not stimulate
student learning either, because it is not challenging to
students and often has no clear relationship with the
context of
real life (i.e. it is not authentic). In other
words, problems that are too complex contain too many
elements that seem to be unrelated to students, whereas
those that are too simple contain too few elements that
seem too obviously related to students.
According to Jonassen, problems can also vary in
their level of structuredness.7 Problems vary from being
 Blackwell Publishing Ltd ME D I C A L E D UC A T I O N 2003;37:1001–1007
too well-structured to being too ill-structured. Prob-
lems that are too well-structured present all the
elements of the problem to the student, require the
application of a limited number of regular and well-
structured rules and principles organised in a predictive
and prescriptive way, and have solutions that can be
understood fully, where the relationships between the
choices of decision and the states of the problem are
known or likely.7 This is the type of problem most
frequently presented in the educational setting. At the
other end of the continuum are ill-structured problems,
which involve elements that are not known with any
degree of certainty, and which allow for more than 1
solution, multiple ways of solving the problem or no
solution at all.7 The solutions to an ill-structured
problem can be evaluated in several ways and, thus,
involve uncertainty about the particular concepts, rules
and principles needed for solving the problem. Students
often have to make judgements and express personal
opinions about the problem. As a result, solving ill-
structured problems is a uniquely interpersonal activity.
Poorly structured problems are mostly encountered in
daily life. In other words, in the students’ opinion,
problems that are too well-structured usually contain 1
simple solution, whereas problems that are too ill-
structured can be solved or addressed in too many
ways.
For a long time it was thought that if students could
solve well-structured problems, they could also solve ill-
structured problems. Research has shown this to be
untrue, as solving ill-structured problems requires
totally different cognitive skills to solving well-struc-
tured problems.9 An ill-structured problem is usually
more complex than a well-structured problem. How-
ever, this is not always the case and is dependent on the
number of cognitive components in the problem. It is
important for student learning that the levels of
complexity and structuredness are optimised, because
the problems have to elicit active discussion between
students in tutorial groups. To this end, they have to
correspond to the level and nature of students’ prior
knowledge. For example, if a problem is too complex or
too ill-structured, it is difficult for students to activate
prior knowledge. Consequently, it is difficult for
students to engage in active discussion and as a result
it is difficult to formulate useful learning issues. If, by
contrast, a problem is too simple or too well-structured,
the problem is not challenging for students and group
discussion will not be very active, because there is not
much to discuss and no useful learning issues will be
generated from this discussion. It is thus important that
the levels of complexity and structuredness are optim-
ised to stimulate student learning in PBL.10
Validation of a questionnaire to assess PBL problems • A E J P Jacobs et al. 1003

In the present study, Jonassen’s theory7 was used to
develop a short questionnaire to measure and assess the
2 main characteristics of PBL problems: complexity
and structuredness. The present study aimed to valid-
ate this questionnaire.
Method
Subjects
The study was conducted during the academic year
2001–02 at the Medical School at Maastricht Univer-
sity, the Netherlands. All first year students were
involved in the study (n ¼ 244). The total response
rate was 75%.
Instrument
complexity is:
Because the problems contain too many
aspects, the coherence is unclear (item 6). Most of the
statements had to be answered on a scale ranging from
1 to 5 (1 ¼ strongly disagree, 5 ¼ strongly agree). An
example of a statement on structuredness is:
Problems
often contain too many solutions, which makes it
difficult to gain insight into the learning material
(item 7). Six items were formulated to measure com-
plexity (items 1–6) and 6 items were formulated to
measure structuredness (items 7–12). All items are
presented in Table 1. Furthermore, students were asked
to indicate on a 5-point scale whether complexity
and structuredness were important criteria for determin-
ing the quality of PBL problems (1 ¼ strongly disagree,
5 ¼ strongly agree). Finally, 1 open-ended question was
included in which students were asked to define the
characteristics that determine the quality of problems.

A questionnaire based on Jonassen’s theory7 was

developed. This questionnaire was used to obtain
information about 2 important characteristics underly-
ing PBL problems, namely complexity and structured-
ness. The items in the questionnaire were formulated as
statements. An example of a statement dealing with
Statistical analysis
A confirmatory factor analysis was carried out to test
the construct validity of the instrument. It assessed
whether the 2 characteristics of complexity and structu-
redness could be supported by empirical data. The

Table 1 Number of items, number of students (n), minimum and maximum scores, mean score (scale 1–5) and standard deviation (SD)

Items in the questionnaire n students Minimum Maximum Mean (1–5) SD

Factor 1: Too simple

1 In many cases, the learning issues can be dealt with during 183 1 5 1.87 0.84
the discussion because the problems are too simple
2 The coherence between the various aspects of a problem is 183 1 5 2.60 0.87
too easy to state
3 The various aspects of a problem are too obviously related 183 1 4 2.56 0.84
Factor 2: Too difficult
4 Problems include too many elements, creating confusion 183 1 5 2.49 0.81
5 The various aspects of problems seem to have been combined 183 1 5 2.74 0.87
at random
6 Because the problems contain too many aspects, the coherence 183 1 4 2.52 0.81
is unclear
7 Problems often contain too many solutions, which makes 183 1 5 2.42 0.85
it difficult to gain insight into the learning material
8 Too much information is lacking in the problems, which 183 1 5 2.43 0.89
makes it difficult to engage in active discussion
9 Problems can be addressed in too many ways, which makes 183 1 4 2.55 0.82
it difficult for students to get a grip on the learning material
Factor 3: Too well-structured
10 Usually, there is only 1 way to explain the phenomena described 183 1 5 2.45 0.80
in the problem
11 All information is stated in the problem, which does not stimulate 183 1 5 2.29 0.88
active discussion
12 The problems usually contain only 1 solution 183 1 5 2.71 0.94

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1004 Validation of a questionnaire to assess PBL problems • A E J P Jacobs et al.
AMOS program was used to test the fit of the data to the
model.11 In addition, students’ answers on the open-
ended question were analysed.
Results
Descriptive statistics
The average scores on the items varied between 1Æ87
(SD ¼ 0Æ84) and 2Æ74 (SD ¼ 0Æ87) (Table 1).
Students were asked to rate whether complexity and
structuredness were important characteristics in deter-
mining the quality of PBL problems. The mean score
for complexity was 3Æ28 (SD 0Æ97, scale 1–5, range
1–5). The mean score for structuredness was 3Æ83 (SD
0Æ81, scale 1–5, range 2–5). The results are presented in
Table 2.
Construct validity
To assess the construct validity of the instrument, a
confirmatory factor analysis was conducted. A confirm-
atory factor model is supposed to fit if the following
conditions are met:
1 the chi-square divided by the degrees of freedom
should be lower than 2 and the P-value should differ
from 0;
2 the root mean square residual should be lower than
0Æ07, and
3 the goodness-of-fit index and the adjusted goodness-
of-fit-index should be higher than 0Æ80.12
A 2-factor model containing the factors complexity
(items 1–6) and structuredness (items 7–12) was tested.
The results of the 2-factor model were: chi-square (53
d.f.) ¼ 242Æ138, P ¼ 0Æ000, a root mean square resid-
ual of 0Æ100, a goodness-of-fit index of 0Æ787 and an
adjusted goodness-of-fit index of 0Æ698 (Table 3).
Thus, this 2-factor model met none of the conditions
described by Saris and Stronkhorst.12
A new model was constructed consisting of the
following 3 factors:
Table 2 Number of respondents (n), minimum and maximum scores, mean score (scale 1–5), standard deviation (SD)
Item
In my opinion, complexity is an important characteristic
of the quality of problems
In my opinion, structuredness is an important characteristic
of the quality of problems
 Blackwell Publishing Ltd ME D I C A L E D UC A T I O N 2003;37:1001–1007
Table 3 Two-factor model
Data Chi- Cmin ⁄
set n square d.f. P d.f. RMR GFI AGFI
Total 183 242.138 53 0.000 4.403 0.100 0.787 0.698
RMR ¼ root mean square residual; GFI ¼ goodness-of-fit index;
AGFI ¼ adjusted goodness-of-fit index.
1 too simple;
2 too difficult, and
3 too well-structured.
Factor 1 contained items that were formulated as too
simple (items 1–3). Factor 2 contained items that were
formulated as too complex and too ill-structured (items
4–9). Factor 3 contained items that were formulated as
too well-structured (items 10–12). To assess this
3-factor model, a confirmatory factor analysis was
conducted again. The results of the 3-factor model
(too simple, too difficult and too well-structured) were:
chi-square [51 d.f.] ¼ 86Æ534, P ¼ 0Æ001, a root mean
square residual of 0Æ047, a goodness-of-fit index of
0Æ928 and an adjusted goodness-of-fit index of 0Æ890
(Table 4). Thus, this 3-factor model met all the
conditions of Saris and Stronkhorst.12 The data set
was split up in order to further cross-validate the
proposed model. Subset A consisted of a random set of
92 students and subset B consisted of the remaining 91
students. When these 2 subsets were analysed, they
were seen to meet all the conditions of Saris and
Stronkhorst12 (Table 4). The results of the confirmat-
ory factor analysis indicated that the 3-factor model
showed a good fit, because it satisfied all the conditions
specified by Saris and Stronkhorst.12
Table 5 presents the descriptive statistics of the
3-factor model. The mean scores were 2Æ3 (SD 0Æ61)
for too simple, 2Æ5 (SD 0Æ53) for too difficult and 2Æ5
(SD 0Æ61) for too well-structured. As the items were
formulated as extremes, the average scores indicated
that students did not perceive the PBL problems they
n Minimum Maximum Mean (1–5) SD
183 1 5 3.28 0.97
183 2 5 3.83 0.81
Validation of a questionnaire to assess PBL problems • A E J P Jacobs et al. 1005

Table 4 Three-factor model

Data set n Chi-square Df P Cmin ⁄ d.f. RMR GFI AGFI

Total 183 86.534 51 0.001 1.697 0.047 0.928 0.890

Subset A 92 70.020 51 0.040 1.373 0.060 0.890 0.832
Subset B 91 62.695 51 0.126 1.229 0.063 0.898 0.844

RMR ¼ root mean square residual; GFI ¼ goodness-of-fit index; AGFI ¼ adjusted
goodness-of-fit index.

Table 5 Number of items, number of students (n), minimum and maximum scores, mean score (scale 1–5), standard deviation (SD) and
the coefficient alpha per factor

Factor n items Items n students Minimum Maximum Mean (1–5) SD Alpha

1 Too simple 3 1, 2, 4 183 1.0 4.0 2.3 0.61 0.53

2 Too difficult 6 3, 5, 6, 8, 11, 12 183 1.3 3.8 2.5 0.53 0.69
3 Too well-structured 3 7, 9, 10 183 1.0 4.0 2.5 0.61 0.47
All items 12 1–12 183 1.3 3.5 2.5 0.37 0.60

were confronted with in their first year of study as too
simple or too well-structured, nor as too difficult.
Furthermore, alpha coefficients were computed. These
were 0Æ53 for factor 1, 0Æ69 for factor 2, 0Æ47 for factor 3
and 0Æ60 for all factors.
The correlations between the factors are presented in
Table 6. The correlations varied between 0Æ004 and
0Æ183, with the highest correlation found between the
factors too simple and too ill-structured.
Additional information was obtained by studying the
statements made by students about characteristics that
determine the quality of a problem. Of the character-
istics examined in the present study, students men-
tioned complexity and structuredness, although not in
exactly the same terms. One student wrote:
A well-
constructed problem contains just enough learning
cues, i.e. not too many or too few. This statement
can be regarded as referring to complexity. Another
student said:
It has to be obvious which direction the
problem is leading to. This statement can be regarded
Table 6 Correlations between the 3 factor scores
Factor 1 Factor 2
1 Too simple ⁄ 0.004
2 Too difficult ⁄ ⁄
3 Too well-structured ⁄ ⁄
*Correlation is significant at the 0.05 level (2-tailed).
as referring to structuredness. Besides complexity and
structuredness, 3 other desirable characteristics of PBL
problems were mentioned. The first was that the
problems have to be challenging by relating them to
practice. One student said:
Problems could be made
interesting by turning them into clinical cases. The
second frequently mentioned characteristic was a
problem must have a meaningful relationship to the
other problems in the unit. One student wrote:
The
problems discussed in a unit have to be connected.
The third characteristic was that the problems have to
fit in with students’ prior knowledge. One student
wrote:
A problem must fit in with prior knowledge, i.e.
a problem must not consist of only known or fully
unknown facts.
Discussion
The aim of this study was to validate a questionnaire
measuring 2 characteristics of PBL problems: com-
plexity and structuredness, based on Jonassen’s the-
ory.7 A confirmatory factor analysis indicated that a
3-factor model fitted the data better than a 2-factor
model, as the 3-factor model met all the conditions
Factor 3 specified by Saris and Stronkhorst,12 indicating a good
fit. The 3-factor model consisted of the following 3
0.183* factors: too simple, too difficult and too well-struc-
0.116 tured. The data showed that students were able to
⁄ distinguish between too simple and too well-structured.
An example of a problem that is too simple is presented
in Section 1, Appendix 1. This problem deals with

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1006 Validation of a questionnaire to assess PBL problems • A E J P Jacobs et al.
popular
health food products. Although the manufac-
turers of these products have commercial interests, the
product information they provide to consumers has to
be true. In the problem, a link to the Internet site of
such a popular health product is presented. A substan-
tial proportion of the students rated this problem as too
simple, but the structuredness seemed to be adequate.
The problem was too simple because the coherence
between the various aspects of this problem was too
easy to state (item 2). Furthermore, the problem
contained aspects that were clearly too obviously
related (item 3). Thus, this problem was rated as being
too simple but adequately structured.
However, the data also showed that it was difficult
for students to differentiate between problems that
were too complex or too ill-structured, which corres-
ponds to factor two. These problems were perceived as
being too difficult. The problem presented in Section 2,
Appendix 1 illustrates this. This problem concerns a
young woman who suffers from fatigue and slightly
disturbed bowel movements. The problem includes
various medical terms. The problem is too complex
because it contains too many different elements and the
relationship between the elements is not always clear
(items 3 and 6). Because there are too many ways of
dealing with the problem, it was not easy for the
students to get a grip on the learning material (item 9).
In other words, the problem was too complex and too
ill-structured. It was too difficult for the students to
address this problem, probably because it did not
adequately fit in with the students’ level of prior
knowledge. Finally, the correlations between the factors
in the 3-factor model were low, which implied that the
factors measured different aspects.
Finally, our data showed that students found structu-
redness (mean 3Æ83) more important than complexity
(mean 3Æ28) (Table 2). A possible explanation for this
is that students preferred some degree of structured-
ness, because this made it easier for them to select an
efficient approach with which to address the problem.
The information obtained from the statements students
made about characteristics that determine the quality of
problems confirmed the above results. Although the 3
additional characteristics mentioned by students were
not investigated in this study, it would seem worthwhile
to find more evidence for these characteristics in future
research. The present study represents an initial
attempt to develop a validated instrument and is meant
to indicate only 2 of the characteristics that determine
the quality of PBL problems. In future research it
would be valuable to develop a validated instrument
with which to provide feedback on other characteristics
of PBL problems.
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In conclusion, the data demonstrated that this short
questionnaire can be used to measure 2 main charac-
teristics of PBL problems: whether or not a problem is
too simple and whether or not it is too well-structured.
It is, furthermore, possible to measure whether a
problem is too difficult in terms of it being too
complicated and too ill-structured. However, the
results also indicated that the students had difficulty
in distinguishing between PBL problems that were too
complex or too ill-structured. A possible explanation is
that, as mentioned in the introduction, ill-structured
problems are usually more complex than well-struc-
tured problems, which means that students will not
encounter many simple, ill-structured problems, or very
complex but well-structured problems. Hence, too
complex and too ill-structured represent 1 factor
instead of 2 separate factors. Additionally, if a problem
was too ill-structured and too complex, the students
had difficulty in dealing with it, because it did not fit in
with the students’ level of prior knowledge.
An important limitation of the present study is that
the results are based on students’ perceptions only.
Teachers could also be asked to rate the structuredness
and complexity of problems using the short question-
naire developed in this study. Future research could
additionally focus on investigating whether students’
and teachers’ opinions about the quality of PBL
problems differ or not.
Finally, the questionnaire as developed and validated
in this study can be used to detect whether PBL
problems, in students’ opinions, are too simple, too
well-structured or too difficult. The scores on the items
in the questionnaire can provide detailed feedback
about a new PBL problem’s complexity and structu-
redness that can be used to improve the problem.
However, it is also necessary to collect information
about the other factors that determine the quality of a
PBL problem.
Contributors
All authors contributed to and participated in the
writing of this paper.
Funding
None.
References
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Appendix 1
Section 1
If we have to believe the manufacturers of so called

health food products, our diet must be quite
unhealthy! We are strongly advised to detoxify our
bodies from time to time to restore the balance in them.
In view of the commercial context of such messages,
some reservations seem justified. What is wrong
with our
unhealthy food? According to the product
information, an important level of disturbance in the
bowels takes place at the border between the internal
 Blackwell Publishing Ltd M ED I C A L E D UC A T I O N 2003;37:1001–1007
1007
and external worlds. Therefore, according to the

experts, this is the area to focus on if we want to
bring our bodies into balance. What is this border
between the internal and external world in the bowels
that is influenced by health food products like Yakult?
And how does such an amazing product work? It is
highly appealing to use Yakult’s product information or
its commercials to find out about this. The information
may be coloured, but the manufacturers are not
allowed to deceive the public! (See also http://www.
yakult.nl)
Section 2
Mirjam Janssen, who is 23 years old, visits her GP
because she has felt extremely tired lately. Mirjam has a
very busy job. She also exercises a lot because she is in
training for her first marathon. She has the impression
that her physical condition has decreased slightly over
the last couple of months, and despite the use of
nutrition supplements and vitamins, she seems to
become breathless sooner when she is training. Accord-
ing to her fellow sportswomen and sportsmen, she looks
a bit pale. Her appetite is good, but her eating pattern is
very irregular because of her busy job. Her weight has
dropped by 2 kg, but she does not mind that. Apart
from contraceptive pills, she does not use any medica-
tion. Her menstruation is normal. Sometimes her
abdomen feels swollen and she is a bit windy, but she
attributes that to her irregular eating pattern. Her faeces
are often thin, but there is no blood in them. A physical
examination does not reveal anything unusual. The
assistant measures Hb, and finds it to be 6Æ2 mmol ⁄ L.
Mirjam is given a prescription for iron supplement
therapy. Her faeces have to be examined and Mirjam
brings some to the assistant the next day. They are
tested for the presence of blood (negative) and lipids
(positive). Mirjam asks what this positive result
means. The GP discusses this by phone with a gastro-
entrologist, who proposes additional blood examination
and an oesophago-gastro-duodenoscopy, with biopsies
to be taken from the small intestine for microscopical
investigation. One week later, Mirjam visits the gast-
roentrologist to discuss the results. He tells her that
the results of the blood tests show that her complaints
are due to iron deficiency. In addition, antibodies
that react to gliadine and endomysium have formed.
In the duodendal biopsies, the pathologist observes
lymphatic infiltrate and atrophy of the mucous
membrane.