Format of cases affects learning outcomes in first year medical students.

Abstract

Longitudinal problem-based learning (PBL) tutorials are practiced at the Tokyo Women's Medical University. First year medical school students - most of whom are high school graduates with no medical background - often encounter difficulty identifying problems while solving PBL cases in basic science. The format of PBL case presentation may affect learning. This study compares the learning outcomes of two cohorts of first year students who learned basic human biology through PBL cases presented in clinical vs. non-clinical formats. All first year students in 1995 and 2000 undertook PBL tutorials. The 1995 case was presented in a non-clinical format; the 2000 case was presented in a clinical format. Both cases had five identical pre-set learning objectives in basic science. By examining all written materials generated during the tutorial sessions, learning outcomes were categorized and the accomplishment of preset objectives was analysed. In 2000, the number of learning outcomes for clinical medicine was more than double compared to 1995, whereas the numbers of total and basic science learning outcomes were not significantly different. The number of preset objectives accomplished by the students was significantly higher in 2000. Thus, PBL case format affected the learning outcomes, enabling these first year students to achieve basic science objectives, while enhancing their interest in the clinical aspects of human biology. Learning outcomes in first year medical students may be enhanced when PBL cases designed to learn basic science contain relevant clinical elements.