An Integrative, Longitudinal Case-Based Learning Model as a Curriculum Strategy to Enhance Teaching and Learning

Abstract

Background and Purpose. Indiana University faculty and students developed a multi-generational case family series as a tool for implementing the Integrated Longitudinal Case-Based Learning (ILCBL) model supporting the achievement of program objectives. The purposes of this paper are to present the development of the Indiana University Doctor of Physical Therapy Family Tree as a tool for the application of the ILCBL model and to discuss preliminary findings evaluating the model's effectiveness. Method/Model Description and Evaluation. The Indiana University Doctor of Physical Therapy Family Tree: An Integrated Case Series, comprised of 37 interrelated cases spanning 4 generations, was co-created by faculty and students to serve as a tool to enhance teaching and learning. ILCBL is a novel perspective on casebased learning. Its aim is to facilitate the development of student problem-solving and clinical decision-making skills, as well as cultural and ethical competence in preparation for clinical practice. Outcomes. Outcome measures included student course surveys (n = 89/102; 87.25% response rate) and clinical discussion forum comments (n = 69/69; 100% response rate). Student survey results were supportive of the ILCBL model, citing benefits in problem solving, critical thinking, and clinical preparation; however, a desire for more consistent use was indicated. Clinical discussion forum comments reflected the longitudinal value of ILCBL in translating classroom knowledge into clinical application. Faculty comments also highlighted the efficiency and effectiveness of the ILCBL model. Discussion and Conclusions. The ILCBL model successfully supports course and program objectives. The case family series is an effective and efficient means for implementation of the ILCBL model. The most promising aspect of ILCBL is students' perspective of its longitudinal value in fostering critical thinking skills and cultural and ethical sensitivity. Future developments will focus on more consistent and integrated applications of the case family series towards expansion of the ILCBL concept. Key Words: Teaching methods, Critical thinking, Case-based learning, Curricular strategy. BACKGROUND AND PURPOSE In 2003, in its first year of a newly designed Doctor of Physical Therapy curriculum, Indiana University (IU) was presented an opportune moment to foster faculty collaboration toward a comprehensive education model. The goal was to implement the Integrated Longitudinal Case-Based Learning (ILCBL) model with the goals of decreasing course isolation, facilitating effective learning, and increasing efficiency. A pedagogical instrument, The Indiana University Doctor of Physical Therapy Family Tree: An Integrated Case Series, was constructed connecting the mission, vision, and curricular threads with the hope of facilitating learning across the curriculum. The IU physical therapy curriculum is derived from an analysis of current practice standards articulated in the American Physical Therapy Association's (APTA) Guide to Physical Therapist Practice1 and the Normative Model of Physical Therapist Professional Education,2 as well as from disablement3 and clinical decision-making models.46 Integration of these various resources has led to a progressive curricular design where basic science forms a knowledge base from which applied sciences build. The goal is to prepare new clinicians to think critically and to problem solve for all types of patient conditions. While the structure of the curriculum lends itself to the development of these skills, creating educational experiences that draw these components together can be challenging. Consequently, implementing pedagogical approaches within the classroom that foster applied learning becomes essential. The literature describes several different strategies to promote effective clinical reasoning, including problem-based learning (PBL),'8 case-based learning (CBL),911 and standardized patient simulations (SPS). …