Case-based learning with worked examples in complex domains: Two experimental studies in undergraduate medical education

2011 ◽  
Vol 21 (1) ◽  
pp. 22-33 ◽  
Author(s):  
Robin Stark ◽  
Veronika Kopp ◽  
Martin R. Fischer
Author(s):  
Vandana Daulatabad ◽  
Prafull K. ◽  
Dr. Surekha S. Kadadi-Patil ◽  
Ramesh S. Patil

Introduction: Medical Education is witnessing a significant transition and global shift towards competency based medical education (CBME) which includes early clinical exposure (ECE) program to help students apply and correlate principles of preclinical subjects with clinical scenarios, in various forms and in a variety of settings. One of the easy and feasible methods of ECE being Case Based Learning (CBL), our study aimed to design a case scenario and to evaluate impact of case base learning as a part of ECE module in first year undergraduate medical teaching program in nerve muscle physiology. Methods: The present study was conducted in 96 students at Ashwini Rural Medical College Hospital and Research Centre, Solapur after obtaining institutional ethics committee approval. 3 hrs session of CBL was conducted for a case scenario on myasthenia gravis in the nerve muscle physiology module. The students’ responses on pre-test, post-test and their insights regarding the CBL were taken through a pre validated questionnaire using 5-point Likert scale. Results: High impact of CBL was seen as significant improvement in student’s performance. Maximum students felt CBL to be easy method of learning and was highly appreciated through their feedback. Conclusion: CBL was found to have positive impact on understanding and perception of topic. CBL helped students to understand, evaluate, analyze, diagnose and interpret the case, paving them towards newer approach of self-directed and vertical integrated learning. CBL is easier, feasible an effective method among other early clinical exposure methods as it involves students in deeper and self-directed active learning, encouraging and promoting them to reach higher levels of cognitive domain of Bloom’s taxonomy. This method will be very useful in its practical implementation during online classes for ECE module in the threat of COVID 19 situation as well.


Author(s):  
Jeff Schwartz

Although problem-based learning (PBL) is widely used in medical education for its many virtues, a number of deficiencies exist. As means of enhancing the experience of PBL for students, two relatively simple adjuncts to PBL are presented. What Ifs are short hypothetical scenarios, appended to the end of a PBL case, that require students to revisit elements of the PBL case just completed and apply their newly acquired knowledge to clinical reasoning in an altered scenario or to explore anew another dimension of the PBL case. Multi-directional symptoms PBL cases are cases where a common presenting symptom, rather than a specific pathology, is the focus of the PBL case and, following a core narrative of the initial patient presentation, a series of independent continuation narratives with appropriate histories, examination findings and investigation results, lead students to divergent diagnoses and management issues. In addition to keeping the PBL process fresh by rotating new materials regularly, these adjuncts extend the PBL process in the direction of case-based learning.


Author(s):  
Aaron L. Burshtein ◽  
Joshua G. Burshtein ◽  
Peter A. Gold ◽  
Luke Garbarino ◽  
David E. Elkowitz

Medical education has undergone an evolution from passive, lecture-based learning environments to curricula that accentuate an active and dynamic system. Stemming from technological innovation, a greater amount of responsibility has been placed on students during clerkships and residency. In addition, a shift in USMLE assessment focuses on interpretation and application as compared to the former memorization-heavy approach. Therefore, learning has been modified to prepare students for the future medical landscape. Through the use of Team-Based, Problem-Based, and/or Case-Based Learning, medical students are taught to understand content rather than memorize it. The authors elucidate the rationale behind active learning and present a guide for medical educators to adopt this style of learning in every part of the undergraduate medical school training process.


2015 ◽  
Vol 13 (3) ◽  
pp. 892-898 ◽  
Author(s):  
Ana Paula Galvao Damasceno Carrare ◽  
Cristiane Camilo Hernandez ◽  
Cristiane Kochi ◽  
Ismar Frango Silveira ◽  
Carlos Alberto Longui

2018 ◽  
Vol 22 (3) ◽  
pp. 273-279 ◽  
Author(s):  
Annie Liu ◽  
Linghong Linda Zhou ◽  
Andrea Lam ◽  
Erin Dahlke

Importance: The instruction of dermatology can be challenging due to its large scope, heavy clinical nature, and limited curriculum space. Case-based learning (CBL) is an emerging education paradigm and has no current literature on its use in dermatology. Objectives: Assess CBL in undergraduate dermatology medical education. Methods: Case-based learning was implemented in the preclerkship dermatology curriculum at the University of Toronto to 3 student cohorts (totaling 710 students and 93 tutors) between May 2016 and April 2017. We analyzed assignment performance, pre- and post-CBL knowledge test scores, and experience surveys on students and tutors. Surveys were evaluated using aggregate descriptive statistics for quantitative data and thematic data analysis for qualitative data. All assessments were anonymous and voluntary. Results: We received strong positive feedback on the CBL experience, with no score less than 3.8 on a 5-point scale (where 5 indicated strongly agree with a positively phrased question). Thematic data analysis revealed several key themes, including positive comments for a specialist tutor, the use of visual media, and the “mini-cases” style of CBL, while challenges included a lack of motivation. Group assignments scored high, ranging from 88.9% to 99.3%. Tracked pre- and post-CBL knowledge test scores showed a 32% (from 42% to 74%) increase in scores after the CBL experience. Conclusion and Relevance: CBL in dermatology medical education was well received by students and tutors, with high scores in content evaluation and knowledge assessment. Future studies should examine optimal delivery methods and its long-term effects on knowledge retention.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Martin Gartmeier ◽  
Theresa Pfurtscheller ◽  
Alexander Hapfelmeier ◽  
Marc Grünewald ◽  
Janina Häusler ◽  
...  

Abstract Background Case-based learning (CBL) is a highly interactive instructional format widely used in medical education. One goal of CBL is to integrate basic biomedical knowledge and its application to concrete patient cases and their clinical management. In this context, we focus the role of teacher questions as triggers for reproductive vs. elaborative student responses. Specifically, our research questions concern the kinds of questions posed by clinical teachers, the kinds of responses given by students, the prediction of student responses based upon teacher questions, and the differences between the two medical disciplines in focus of our study, internal medicine and surgery. Methods We analyse 19 videotaped seminars (nine internal medicine, ten surgery) taught by clinicians and attended by advanced medical students. Multiple raters performed a low-inference rating process using a theory-based categorical scheme with satisfactory interrater-reliability. Results We found that medical teachers mostly posed initial (instead of follow-up) questions and that their questions were more often closed (instead of open). Also, more reasoning (than reproductive) questions were posed. A high rate of student non-response was observed while elaborative and reproductive student responses had a similar prevalence. In the prediction context, follow-up reasoning questions were associated with low non-response and many elaborative answers. In contrast, the highest student non-response rate followed open reproduction questions and initial reasoning questions. Most reproductive statements by students were made following closed reproduction questions. Conclusions These results deepen our understanding of interactive, questions-driven medical teaching and provide an empirical basis for clinical teachers to use questions in didactically fruitful ways.


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