Case-based Learning Exercises Research Articles

Student Engagement in Patient Safety and Healthcare Quality Improvement: A Brief Educational Approach.

Achieving optimal patient safety (PS) remains a challenge in healthcare. Effective educational methods are critical for improving PS. Innovative teaching tools, like case-based learning, augmented reality, and active learning, can help students better understand and apply PS and healthcare quality improvement (HQI) principles. This study aimed to assess activities and tools implemented to improve PS and HQI education, as well as student engagement, in medical schools. We designed a two-week course for fourth-year medical students at the Autonomous University of Guadalajara, incorporating Fink's taxonomy of significant learning to create engaging activities. The course featured daily synchronous and asynchronous learning, with reinforcement activities using tools, like augmented reality and artificial intelligence. A total of 394 students participated, with their performance in activities and final exam outcomes analyzed using non-parametric tests. Students who passed the final exam scored higher in activities focused on application and reasoning (p = 0.02 and p = 0.018, respectively). Activity 7B, involving problem-solving and decision-making, was perceived as the most impactful. Activity 8A, a case-based learning exercise on incident reporting, received the highest score for perception of exam preparation. This study demonstrates innovative teaching methods and technology to enhance student understanding of PS and HQI, contributing to improved care quality and patient safety. Further research on the long-term impact is needed.

Integration of Theory and Practice in Medical Morphology Curriculum in Postgraduate Training: A Flipped Classroom and Case-based Learning Exercise.

The integration of training in theory and practice across the medical education spectrum is being encouraged to increase student understanding and skills in the sciences. This study aimed to determine the deciding factors that drive students' perceived advantages in class to improve precision education and the teaching model. A mixed strategy of an existing flipped classroom (FC) and a case-based learning (CBL) model was conducted in a medical morphology curriculum for 575 postgraduate students. The subjective learning evaluation of the individuals (learning time, engagement, study interest and concentration, and professional integration) was collected and analyzed after FC-CBL model learning. The results from the general evaluation showed promising results of the medical morphology in the FC-CBL model. Students felt more engaged by instructors in person and benefited in terms of time-saving, flexible arrangements, and professional improvement. Our study contributed to the FC-CBL model in Research Design in postgraduate training in 4 categories: 1) advancing a guideline of precision teaching according to individual characteristics; 2) revealing whether a learning background is needed for a Research Design course to guide setting up a preliminary course; 3) understanding the perceived advantages and their interfaces; and 4) barriers and/or improvement to implement the FC-CBL model in the Research Design class, such as a richer description of e-learning and hands-on practice. Undertaking a FC-CBL combined model could be a useful addition to pedagogy for medical morphology learning in postgraduate training.

A Novel Case-Based Learning Activity With a Focus on Food Insecurity.

Food insecurity is a social determinant of health (SDOH) affecting 1 in 10 households per year in the United States and has major impacts on the course of chronic health conditions. It is beneficial to introduce screening and appropriate treatment plans to medical students. This study utilized a novel case-based learning exercise (CBLE) to assess confidence, attitudes and improvements in knowledge on recognizing and addressing food insecurity. A CBLE focused on food insecurity was developed to be implemented in a 2-h session as part of the curriculum for all first-year medical students at the Medical University of South Carolina. The CBLE included a case for discussion, followed by an interview with a standardized patient. Students received invitations to complete pre- and post-CBLE assessment surveys. Completion of both pre- and post-surveys was achieved by 29% of students (48 out of 166). Knowledge around the formal definition of "food insecurity," how to recognize food insecurity versus hunger, and how to screen for food insecurity all increased significantly (P < .05). Responses relating to the association between certain chronic diseases and food insecurity did not change pre and post-CBLE. This novel CBLE was successfully implemented within a 2-h teaching session and improved knowledge on recognizing food insecurity in practice. However, additional learning exercises are likely needed to improve knowledge of the relationship between food insecurity and chronic disease states. Nonetheless, the CBLE structure provided students with multiple formats of learning and integration of skills, which shows promise and may be applicable to improve knowledge of other SDOHs.

Opioid Use Disorder Curriculum: Preclerkship Pharmacology Case-Based Learning Session.

IntroductionDuring the first year of the COVID-19 pandemic, over 93,000 Americans lost their lives to a preventable overdose. Medications for opioid use disorder (OUD) have been shown to decrease mortality in OUD but are underutilized. Through this case-based learning exercise, first-year medical students applied physiologic and pharmacologic principles to the diagnosis and treatment of OUD.MethodsFaculty facilitated a case discussion over a 1-hour large-group case-based learning (CBL) session. Facilitators utilized PowerPoint slides to illustrate graphs and figures while discussing the case. To evaluate students on the CBL learning objectives, three pharmacology exam questions were administered; students also evaluated the CBL's effectiveness in meeting educational objectives on three Likert-scale questions and via open-ended feedback.ResultsFirst-year medical students (n = 200) completed the CBL. The mean score on the exam questions was 91%. Students agreed or strongly agreed that the CBL was an effective way to learn pharmacology principles (69%), that it reinforced pharmacologic fundamentals (70%), and that it showed how pharmacology fundamentals were important in the real world of clinical medicine (86%). Qualitative feedback on the CBL was generally positive, including satisfaction with the small-group setting and practical applications of pharmacology to clinical practice.DiscussionThis CBL exercise contains content critical for preparing students to combat the modern opioid epidemic. The exercise provides an opportunity for learners to review fundamental pharmacodynamic and pharmacokinetic principles so as to ready them for clinical clerkships and beyond.

Engaging Rural High School Students in STEM Utilizing Graduate Mentors, Virtual Reality and Case‐based Learning

High school students exposed to early mentorship opportunities and targeted development of critical thinking skills are better prepared for success in higher education. Rural high school students can face barriers that limit access to content experts and scholastic growth. Here we demonstrate the use of a virtual reality (VR) curriculum as a novel method of instruction, fostering mentorship and the development of critical thinking skills. Graduate mentors remotely connected with high school students to facilitate learning using a virtual, dissectible cadaver and volumized medical imaging (CT and MRI). The curriculum features weekly case-based learning exercises, providing students an opportunity to develop problem solving, critical thinking and oral presentation skills. We hypothesized that VR is an effective method of connecting high school students to graduate mentors and novel STEM learning opportunities, while the VR case-based curriculum enhances critical thinking skill and helps prepare students to succeed in higher education. Qualitative data assessed critical thinking, problem-solving skills, student motivation, mentorship engagement, and satisfaction utilizing the VR program as compared to 2D methods. Quantitative data assessed progression of student spatial abilities during the semester. Preliminary findings suggest an improvement in student interest and engagement while promoting intellectual engagement with graduate mentors. Research on the implementation of virtual reality in education is in its early stages, but there is a growing need to investigate the effectiveness of technology in overcoming barriers to learning among high school students. This course is an early exploration of how VR can enhance STEM teaching, improve student learning, and prepare students for success in higher education.

A case-based learning exercise to increase students' understanding of the pharmacist's role in public health interventions for individual patients

IntroductionThe purpose of this study was to evaluate whether a public health (PH) micro-level case-based learning exercise increased pharmacy students' self-perceived understanding and confidence in their role as PH pharmacists. MethodsThree PH micro-level case-based learning exercises in community pharmacy settings were developed and integrated into the third professional year PH course. Students enrolled in the PH course from January 2012 – May 2015 completed a pre- and post-activity survey consisting of 22 statements with Likert scale responses. Survey questions were grouped into domains: perceptions of pharmacist roles (ROLES) in PH, confidence in ability to identify and address PH problems (CONF), pharmacist impact on improving PH outcomes for patients with human immunodeficiency virus (IMPACT-HIV), diabetes (IMPACT-DM), or alcoholism (IMPACT-AL), perceiving pharmacists as role models in PH (MODEL), and whether PH is beyond the scope of pharmacy practice (SCOPE). Within each domain, paired t-tests were performed on summated scores (pre- vs. post-, alpha = 0.05). ResultsBoth surveys were completed by 271 of 336 students (80.7%). Baseline scores were lowest in the CONF and MODEL domains. The activity resulted in significant changes in 21 out of 24 survey questions. Significantly higher scores were found for domains of ROLES (+1.22), CONF (+1.60), IMPACT-HIV (+0.65), IMPACT-DM (+0.42), IMPACT-AL (+0.70), and MODEL (+1.50). Cronbach's alpha ranged from 0.73 to 0.93 for each domain. ConclusionA PH case-based learning session increased students' scores on a pre- and post-activity survey regarding PH challenges at the micro-level. The activity improved students' perceptions and confidence in providing PH interventions.

Building Provider-Caregiver Partnerships: Curricula for Medical Students and Residents.

A disconnect exists between caregivers and health care providers, resulting in fragmented communication, which increases caregiver stress and compromises patient care. Although providers have a responsibility to recognize caregiver burden, they receive scant training on issues important to caregivers. From 2014 to 2017, as part of the Building Caregiver Partnerships Through Interprofessional Education project-a collaborative effort between Northeast Ohio Medical University and Summa Health-the authors developed curricula to foster effective partnerships between health care providers and caregivers by exposing medical students and residents to highly personal caregiving narratives. The curricula center on a short film featuring 4 families representing diverse caregiving experiences. The authors crafted several discussion guides, case-based learning exercises, structured clinical encounters, team-based simulations, and clinical cases as companion educational tools for the film. Medical students reported the educational tools piloted to be valuable in broadening their understanding of caregivers' needs, while residents reported the educational tools piloted to also be valuable in improving their communication and building partnerships with caregivers. Undergraduate and graduate faculty reported finding the pilots valuable. Future goals include conducting an outcome evaluation, based on ACGME milestones, to identify and examine clinical outcomes to determine whether communication increases and quality of care improves as a result of the project. The authors would also like to include caregivers in the evaluation. Finally, because caregiving is best addressed from a team approach, the authors plan to pilot the project at other health professions programs.

Improving nursing student cultural competence: Comparing simulation to case-based learning

Background: Cultural competence encompasses knowledge, skills, and comfort in caring for patients from diverse cultures and is a core competency in providing patient-centered care. Simulation provides an opportunity to expose students to diverse cultures. Case-based learning has been effective in improving nursing student communication and problem-solving skills, but no research describes its use in cultural education. The purpose of this study was to compare the effect of simulation to case-based learning on nursing students’ perceived cultural competence, awareness, and sensitivity.Methods: Eighty baccalaureate nursing students were randomly assigned to a simulation experience or case-based learning exercise. The Cultural Competence Assessment Survey was used to measure perceived cultural competence, awareness, and sensitivity. Results: Both simulation and case-based learning improved nursing student perceived cultural awareness and sensitivity. Case-based learning improved perceived cultural competence.Conclusions: Integration of cultural learning opportunities into nursing education provides a foundation for continued development of cultural competence.

Evaluation of the role of incentive structure on student participation and performance in active learning strategies: A comparison of case-based and team-based learning

Background: Student participation is important for the success of active learning strategies, but participation is often linked to the level of preparation. At our institution, we use two types of active learning activities, a modified case-based learning exercise called active learning groups (ALG) and team-based learning (TBL). These strategies have different assessment and incentive structures for participation. Non-cognitive skills are assessed in ALG using a subjective five-point Likert scale. In TBL, assessment of individual student preparation is based on a multiple choice quiz conducted at the beginning of each session.Methods: We studied first-year medical student participation and performance in ALG and TBL as well as performance on course final examinations.Results: Student performance in TBL, but not in ALG, was strongly correlated with final examination scores. Additionally, in students who performed in the upper 33rd percentile on the final examination, there was a positive correlation between final examination performance and participation in TBL and ALG. This correlation was not seen in students who performed in the lower 33rd percentile on the final examinations.Conclusions: Our results suggest that assessments of medical knowledge during active learning exercises could supplement non-cognitive assessments and could be good predictors of performance on summative examinations.

Study of the impacts of patient‐educators on the course of basic sciences in dental studies

Ever since 2006, Nantes University dental educators have started organising lectures led by the mother of a young patient suffering from ectodermic dysplasia (patient-educator) to help second-year students to better understand how important it is for their future dental work to better understand basic sciences. In this study, we have analysed this training experience on students' motivation. For this purpose, students were asked to complete questionnaires 10 days after the patient-educator's lecture (early assessment; n = 193) and 4 years later, during the last year of their dental studies (delayed assessment; n = 47). Moreover, 3 years after the first lecture, we analysed the ability of students to diagnose a mother carrying the ectodermic dysplasia genetic disorder, using a case-based learning exercise with a patient showing dental features similar to those exposed by the patient-educator (measure of knowledge; n = 42). Ten days after the lecture, the early assessment shows that all the students were interested in the lecture and 59% of the students declared being motivated to find out more about genetics whilst 54% declared the same thing about embryology courses. Moreover, 4 years later, 67% of the students remembered the patient-educator's lecture a little or very well. Three years after the course, 83% of the students diagnosed ectodermal dysplasia whilst studying the case-based example that listed typical dental phenotypes. In conclusion, this study shows that this original educational approach enhances dental students' motivation in learning basic sciences and that patient-educators could offer many benefits for students and patients.

Eric Smith - A Renal Physiology Case-based Learning Exercise

OPEN ACCESSNovember 18, 2013Eric Smith - A Renal Physiology Case-based Learning Exercise Ansley Splinter, MD, MACM, Daniel Castellanos, Carla Lupi, MD Ansley Splinter, MD, MACM Florida International University Herbert Wertheim College of Medicine Google Scholar More articles by this author , Daniel Castellanos Children's Hospital Los Angeles Google Scholar More articles by this author , Carla Lupi, MD Florida International University Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9609 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstract Introduction: This progressively disclosed case of a boy presenting with generalized edema was created as part of a case-based learning course for second- and third-year medical students and was designed to integrate with basic science and clinical learning. The case provides a strong opportunity for initial learning and/or targeted review of important pathophysiologic concepts. Methods: This case is designed for the small-group format; we have used it with groups ranging from four to eight students. When possible, groups have been facilitated by one basic science and one clinical faculty member. Nonetheless, a clinician well versed in the case and familiar with basic renal physiology can run the session alone. Results: We have used this case during our second-year organ system courses. Student ratings of this case have been uniformly high, with the common reaction that the case is critical in helping them integrate lecture and laboratory-based learning. They prefer to participate in these exercises toward the end of the organ system module, citing greater integrative value at this point. Discussion: We have found that initial participation in this case is preparing students well for robust involvement in the more open-ended and complex problem-based learning cases of our third year. We have yet to conduct any systematic assessment of learning from participation in these cases. Educational Objectives By the end of this case, learners will be able to: Explain the mechanism by which pathophysiologic changes in different organ systems can cause generalized edema.Identify laboratory tests necessary to diagnose a patient with generalized edema.Interpret laboratory test results to narrow a differential diagnosis.List the diagnostic criteria for nephrotic syndrome in a pediatric patient.Propose a treatment plan for a patient with nephrotic syndrome, edema, and respiratory distress.Describe the complications of nephrotic syndrome including the pathophysiology underlying those complications.Describe Starling forces and how they contribute to edema formation.Describe the normal barriers to protein filtration in the kidney.List the layers of the glomerular filtration barrier.Explain the pathophysiologic mechanisms of proteinuria.Explain the relationship between total calcium levels and albumin levels.Explain the renal primary defect that results in nephrotic syndrome.Explain the mechanism of action and common side effects of loop and thiazide diuretics. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Eric Smith Instructor's Guide.docx Eric Smith Facilitator Version.docx Eric Smith Student Version.docx Student Participation Rubric.docx To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Copyright & Permissions© 2013 Splinter et al. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsCase-Based LearningUndergraduateRenal PhysiologyUndergraduate Medical EducationEducationSecond-Year Medical StudentsNephrotic SyndromeThird-Year Medical StudentsMedical Disclosures None to report. Funding/Support None to report. Loading ...

Outcomes Assessment of Case-Based Writing Exercises in a Veterinary Clinical Pathology Course

Our second-year core clinical pathology course uses free-response case-based learning exercises in an otherwise traditional lecture or laboratory course format to augment the development of skills in application of knowledge and critical thinking and clinical reasoning. We previously reported increased learner confidence accompanied by perceived improvements in understanding and ability to apply information, along with enhanced feelings of preparedness for examinations that students attributed to the case-based exercises. The current study prospectively follows a cohort of students to determine the ability of traditional multiple-choice versus free-response case-based assessments to predict future academic performance and to determine if the perceived value of the case-based exercises persists through the curriculum. Our data show that after holding multiple-choice scores constant, better performance on case-based free-response exercises led to higher GPA and better class rank in the second and third years and better class rank in the fourth year. Students in clinical rotations reported that the case-based approach was superior to traditional lecture or multiple-choice exam format for learning clinical reasoning, retaining factual information, organizing information, communicating medical information clearly to colleagues in clinical situations, and preparing high quality medical records. In summary, this longitudinal study shows that case-based free-response writing assignments are efficacious above and beyond standard measures in determining students' GPAs and class rank and in students' acquisition of knowledge, skills, and clinical reasoning. Students value these assignments and overwhelmingly find them an efficient use of their time, and these opinions are maintained even two years following the course.

University of Iowa Carver College of Medicine

University of Iowa Carver College of Medicine

Patau Syndrome With Holoprosencephaly: A Multidisciplinary Interactive Case-Based Learning Exercise

OPEN ACCESSAugust 5, 2010Patau Syndrome With Holoprosencephaly: A Multidisciplinary Interactive Case-Based Learning Exercise Edward Klatt, MD, Tina Thompson, PhD Edward Klatt, MD Mercer University School of Medicine Google Scholar More articles by this author , Tina Thompson, PhD Mercer University School of Medicine Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.8181 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail AbstractAbstractThis educational resource is organized as a case history with laboratory and ultrasound findings for discussion by a group of students. It is woven around a pregnancy with abnormal findings that are the result of Patau syndrome. Several fetal central nervous system (CNS) malformations are explored from a basic science, diagnostic, and counseling standpoint. This case study is designed to support basic science education in genetics and pathology disciplines and to integrate the use of diagnostic tools and testing in prenatal care to facilitate understanding of the application of basic science knowledge to patient care and counseling. This case study could be discussed in a minimum of 15 minutes if much of the information in the facilitator guide were given to the students for self-study. Most of the key concepts could be discussed within an hour. Facilitators can be directed to promote student discussion by asking the students to explain the findings and to compare and contrast CNS malformations and their causes.Educational goals include an understanding of genetic mechanisms, embryologic development, prenatal laboratory testing, and parental counseling regarding outcomes and options. The primary author field-tested a version of this exercise for 7 years (2002–2008) as part of a case-based learning module in genetic diseases, presented within a course teaching fundamentals of pathology in the second-year curriculum at the Florida State University School of Medicine. Suggestions for improvement by students and faculty have been incorporated to enhance its quality. Course evaluations by students in that venue pertinent to this group exercise ranged from 4.23 to 4.82 on a scale of 0 (worst) to 5 (best). Examination and quiz items scored in the 80% to 90% range. Educational Objectives By the end of the module, the learner will be able to: Describe prenatal testing for congenital malformations.Discuss the embryology in the context of this case.Describe normal development of the central nervous system (CNS) with particular attention to the brain.Describe the development of the eye and eye-related structures.Compare and contrast forebrain anomalies with posterior fossa anomalies and with neural tube defects.Compare and contrast CNS deformations with abnormalities from congenital infections.Describe the mechanisms for the appearance of the karyotype in this case. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Patau Facilitators.doc Patau Students.doc To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. Cited ByDotters-Katz S, Vora N and Kuller J (2019) Genetics for the Women's Health Trainee: A Five-Module Curriculum, MedEdPORTAL, 15, Online publication date: 1-Jan-2019. Copyright & Permissions© 2010 Klatt and Thompson. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial license.KeywordsCongenitalTrisomy 13Prenatal TestingCBLUltrasound ExaminationGeneticsPatau SyndromeCongenital Infection Disclosures None to report. Funding/Support None to report. Loading ...

Albert Einstein College of Medicine of Yeshiva University.

Albert Einstein College of Medicine of Yeshiva University.

Distributed radiology clerkship for the core clinical year of medical school.

The central role that diagnostic radiology has in the modern practice of medicine has not always been reflected in radiology's place in the curriculum. We developed a new radiology clerkship for undergraduate medical students during their core clinical year that was supported by Web technology. The assumptions underlying the design of the clerkship were that radiology is best learned from radiologists and that students are most receptive to learning radiology when it is related to concurrent patient care experiences. Beginning in May 2000, a required radiology clerkship experience was incorporated into the core clinical year at Wake Forest University School of Medicine. The core clinical year was organized into three 16-week blocks of clerkships. Two or four independent half-day radiology tutorial sessions were included with each clerkship block, and attended by all students in the block (approximately 35 students), regardless of their specific clerkship assignments. There were ten different radiology tutorials, each given three times during the year as students rotated through the clerkship blocks. Thus, each student attended a radiology tutorial session every four to eight weeks during the year. The topics covered during the tutorials were correlated with the content of the clerkship blocks and included adult and pediatric chest radiology, adult and pediatric abdominal radiology, body CT, neuroradiology, obstetric ultrasound, gynecologic ultrasound, osteoporosis, adult and pediatric fractures, mammography, and cervical spine trauma. The tutorials included pre- and post-test, lectures, case presentations, and sometimes tours of the radiology department. The educational emphasis was on pragmatic case-based learning exercises, development of verbal and visual vocabulary, and learning when and where to seek more information. To provide continuity and organization, Web-based curriculum materials were designed and implemented as a component of the clerkship. The home page of the Web site provided the schedule, faculty names, attendance and grading policies, course overview, and links to individual tutorials. The pages for individual tutorials included educational objectives, glossary of radiology terminology relevant to the subject, lecture slides and handouts, and teaching cases. All students had laptop computers and access to the academic network, but did not use them during the actual tutorial sessions. Implementation of the radiology clerkship required extensive negotiation with directors of other clerkships so that students could be released from their other responsibilities in order to attend the radiology tutorials. The radiology clerkship format has proven to be complex in its administration, with faculty and students on different schedules commuting to the radiology lecture hall from various locations. Extensive use of e-mail and communication via the Web site have been instrumental in reminding faculty and students of upcoming sessions. Preliminary evaluations have indicated that students liked the radiology sessions and learned a great deal, but disliked the scheduling and the lack of continuity. An evaluation of the curriculum and its components is ongoing.

Nutrition in the medical curriculum

Summary Despite the fact that nutrition is a crucial component of health promotion and disease prevention, nutrition education have received inadequate attention in medicaleducation. Comprehensive lists are available of essential topics that should be part of the medical school curriculum. It is important to identify problems that have stiffed previous attempts to reform nutrition education and to use creative pedagogical strategies (problem-based learning, case-based learning exercises), new educational material (CD, videotape, www etc) and innovative assessment methods. Faculty development programs are also considered to be important to help address the long-standing problem of deficiencies in the application of the science of nutrition in the training of physicians and other health professionals.