Case-based Learning Research Articles

Case-Based E-Learning Tool Affects Self-Confidence in Clinical Reasoning Skills among Veterinary Students—A Survey at the Norwegian University of Life Sciences

Veterinary education plays a crucial role in equipping veterinarians with the necessary skills and knowledge to navigate the challenges they will face in their professional careers. As part of enhancing the veterinary students’ training in clinical reasoning, an online electronic veterinary clinic was introduced to a group of students during their final semester. This platform, called Veterinary eClinic, provides access to digital, real-life clinical cases, allowing students to apply their knowledge and develop critical thinking skills in a practical context. In this research project, the veterinary students were asked to assess how confident they felt in different clinical tasks related to a clinical investigation before and after using Veterinary eClinic. An exploratory sequential mixed-methods design was used when collecting data. The students answered pre- and post-use questionnaires, and semi-structured interviews were conducted to elaborate on the quantitative results. Our results showed that the students were significantly more confident in making a problem list ( p = .005), completing diagnostic tests ( p = .022), making a diagnosis ( p = .041), and performing assessments of animal welfare in the clinic ( p = .002) after solving different clinical cases in Veterinary eClinic. As much as 97% of the respondents reported that Veterinary eClinic was a valuable learning resource in veterinary education, to a fairly large or very large extent. Our findings suggest that the use of a case-based e-learning tool might contribute to increased self-confidence in clinical reasoning skills.

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.

Knowledge, skills, and confidence gaps impacting treatment decision making in relapsed/refractory chronic lymphocytic leukemia and mantle cell lymphoma: a quantitative survey study in France, Germany, and the United States

BackgroundWith recent advancements in the treatment of chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), healthcare specialists may face challenges making treatment and management decisions based on latest evidence for the optimal care of patients with these conditions. This study aimed to identify specific knowledge, skills, and confidence gaps impacting the treatment of CLL and MCL, to inform future educational activities.MethodsHematologists and hemato-oncologists (HCPs, n = 224) from France (academic settings), Germany, and the United States (academic and community settings) responded to a 15-minute quantitative needs assessment survey that measured perceived knowledge, skills, and confidence levels regarding different aspects of treatment and management of CLL and MCL patients, as well as clinical case questions. Descriptive statistics (cross tabulations) and Chi-square tests were conducted.ResultsFour areas of educational need were identified: (1) sub-optimal knowledge of treatment guidelines; (2) sub-optimal knowledge of molecular testing to inform CLL/MCL treatment decisions; (3) sub-optimal skills when making treatment decisions according to patient profile (co-morbidities, molecular testing results); and (4) challenges balancing the risk of toxicities with benefits of treatment. Over one-third of the respondents reported skill gaps when selecting suitable treatment options and prescribing therapies and reported a lack in confidence to initiate and manage treatment. Larger gaps in knowledge of guidelines and skills in patient assessment were identified in MCL, compared to CLL.ConclusionsThis study suggests the need for continuing medical education specifically to improve knowledge of treatment guidelines, and to assist clinicians in developing skills and confidence when faced with clinical decision-making scenarios of patients with specific comorbidities and/or molecular test results, for example, through case-based learning activities.

2224 What are we teaching UK medical students about ageing? Results of the third BGS national curriculum survey

Abstract Introduction The ageing population means all doctors, regardless of specialty, will need knowledge, skills, and attitudes to care for older people with complex health conditions. An essential component of preparing the medical workforce to best care for older people is by including teaching on ageing and geriatric medicine in undergraduate medical curricula. Here we present results of the British Geriatrics Society (BGS) national curriculum survey 2021–22, highlighting progress made in undergraduate teaching in geriatric medicine. Methods All 35 UK GMC-registered medical schools at the time of data collection were invited to participate in an online survey on content, methodology, timing, and duration of teaching in ageing and geriatric medicine. The survey was structured around the 2013 BGS recommended undergraduate curriculum, for consistency with previous surveys. Results 30/35 of UK medical schools responded (83% response rate). Most teaching occurred in the fourth year of study (21/30, 70%). The majority (15/30, 50%) reported a discrete module for geriatric medicine lasting 4–8 weeks, an increase on previous surveys. However, several programmes have reduced the amount of in-person teaching since the COVID-19 pandemic. Notably, three schools reported geriatric medicine exposure lasting >12 weeks. Of these, two were integrated clerkships and one a dedicated geriatric medicine module. There is increasing focus on multidisciplinary education, with emphasis on combining virtual or simulated teaching with other healthcare professions (n = 7). Every school (n = 30) taught at least one topic as small-group or case-based learning. Conclusion There is a trend towards increasing exposure to geriatric medicine compared to previous surveys in 2008 and 2013. However, several of the programmes reporting greater exposure incorporate geriatric medicine in an integrated clerkship rather than as a dedicated module. Programmes demonstrated a move from didactic teaching towards small-group and case-based learning, employing a wider variety of assessment methods than previous.

Case-based Learning in Obstetric Hemorrhagic Emergencies

Abstract Background: Our institution’s obstetrics and gynecology course for final-year students traditionally relied solely on theoretical lectures. To bridge the gap between theory and real-world scenarios, we implemented case-based learning (CBL) that incorporates case discussions and other practical activities. This study aimed to assess the impact of these changes on students’ performance and perceptions of their learning experience. Materials and Methods: CBL was introduced for the teaching of a final year students about atonic postpartum hemorrhage. Comparisons were made with the two groups of the same batch. The students were assessed for the content retention and analytical skills. Students and faculty members were asked to rate their satisfaction with the teaching program. Results: The mean pretest score for the MCQs improved from 5 to 7.52–7.89, showing an improved content retention in both the groups. The mean score for analytical skills in CBL group was 7.96 as compared to 4.5 in the lecture group. Conclusion: CBL is helpful in improving the analytical skills of the undergraduate medical students.

Case-based learning for cybersecurity leaders: A systematic review and research agenda

Increasingly, large organisations are turning to cybersecurity leaders to protect their information resources against attack. However, because cybersecurity leadership roles are new, educational literature and practice targeting this role are nascent. In this systematic review, we assess the value of case-based learning (CBL) in educating cybersecurity leaders. We also aim to discover what gaps, if any, exist in this body of research. We find that cybersecurity leaders’ attitudes and metacognitive abilities are important but overlooked elements of their competence, and that CBL has potential to develop these competencies. The article concludes with a competency matrix and agenda for further research.

Perspectives of a non-medically and a medically qualified early career anatomy academic on facilitating case-based learning sessions for undergraduate medical students.

Case-based learning (CBL) is a student-centered pedagogy where medical students are given a real-world clinical problem. At St George's University of London (SGUL), anatomy academics can volunteer to facilitate CBL sessions for pre-clinical undergraduate medical students. The major benefits of facilitating CBL sessions from the perspective of a non-medically qualified early career anatomy academic (ECAA) include exposure to clinical cases that help the academic develop an understanding over key clinical cases at the context of clinical anatomy and other disciplines including physiology, pathology, and pharmacology. Furthermore, facilitating CBL sessions assists in the acquisition of basic knowledge over history taking, the conduction of clinical examinations, the investigations performed for the diagnosis of a condition as well as how it is managed. The major benefits of facilitating CBL sessions from the perspective of a medically qualified ECAA include staying in touch with the clinical aspect of medicine and becoming familiar with the country's healthcare system and its professional standards. Perceived benefits shared by both the non-medically and medically qualified ECAA include the opportunity to become familiar with the structure and key elements of the pre-clinical medical curriculum as well as gain experience in facilitating small group teaching sessions. Overall, facilitating CBL sessions can help non-medically and medically qualified ECAAs in different contexts that may help them with their individual career goals, can encourage collaborative discussions between clinical and non-clinical anatomy academics as well as help bridge the gap between the anatomy teaching approaches employed by non-medically qualified and medically qualified anatomy academics.

The Effectiveness of Gamebook Teaching-Learning Approach in Undergraduate MBBS Course in Comparison with the Conventional Teaching-Learning Approach

Among various methods of learning and teaching, educational games are tools that engage students for both educational purposes and entertainment. This study aimed to evaluate the effectiveness of game-based learning (GBL) for undergraduate obstetrics and gynecology students in the form of a gamebook. A quasi-experimental study was conducted to compare the outcomes of two different teaching methods, conventional case-based learning (CBL) and GBL, on undergraduate medical students from Taylor’s University, Malaysia. A statistical analysis was performed to compare the performance between the control and intervention groups. Single-best-answer multiple-choice questions (MCQs) were used to assess students’ knowledge and understanding of the clinical subject content, and a 5-point Likert scale was used to assess students’ perception of the new teaching method. Chi-squared tests were used to compare the mean academic performance of the two groups of 128 participants. There was no significant difference in the post-intervention MCQ scores. Students in the GBL group found that learning is more enjoyable and felt more confident in managing patients both theoretically and in real world situations. In conclusion, GBL is comparable to conventional CBL in achieving the desired knowledge and understanding of the topics with a more positive perception towards GBL.

A national education program for rapid genomics in pediatric acute care: Building workforce confidence, competence, and capability

PurposeTo develop and evaluate a scalable national program to build confidence, competence and capability in the use of rapid genomic testing (rGT) in the acute pediatric setting. MethodsWe used theory-informed approaches to design a modular, adaptive program of blended learning aimed at diverse professional groups involved in acute pediatric care. The program comprised 4 online learning modules and an online workshop and was centered on case-based learning. We evaluated the program using the Kirkpatrick 4-level model of training evaluation and report our findings using the Reporting Item Standards for Education and its Evaluation (RISE2) guidelines for genomics education and evaluation. ResultsTwo hundred and two participants engaged with at least 1 component of the program. Participants self-reported increased confidence in using rGT, (P < .001), and quiz responses objectively demonstrated increased competence (eg, correct responses to a question on pretest counseling increased from 30% to 64%; P < .001). Additionally, their capability in applying genomic principles to simulated clinical cases increased (P < .001), as did their desire to take on more responsibility for performing rGT. The clinical interpretation of more complex test results (such as negative results or variants of uncertain significance) appeared to be more challenging, indicating a need for targeted education in this area. ConclusionThe program format was effective in delivering multidisciplinary and wide-scale genomics education in the acute care context. The modular approach we have developed now lends itself to application in other medical specialties or areas of health care.

Using a Template to Develop Clinical Judgment Skills in Case-Based Learning.

Using a Template to Develop Clinical Judgment Skills in Case-Based Learning.

The effect of the case-based learning approach on the level of satisfactions and learning of nursing students in Iran: A randomized controlled trial

IntroductionNurses must have sufficient knowledge and skills in the field of medications and medication management. This study was designed to investigate the effect of the case-based learning (CBL) approach on the level of satisfaction and learning of nursing students. Materials and methodsThis study was conducted using a randomized controlled trial on 70 Iranian third-semester nursing students during a pharmacology internship in 2023. After considering the inclusion criteria, the samples were entered into the study by census method and then they were placed in either the control (35 people) or intervention (35 people) groups by simple random method. Pharmacology training was done in the control group by the usual method (lectures by the instructor and conferences with students) and in the intervention group by the Kaddoura case-based learning method. Data collection tools included a demographic questionnaire, satisfaction of educational approach questionnaire, and exam scores before and after the internship. SPSS version 26 software was used for statistical analysis. ResultsThere was no statistically significant difference (P = 0.88) in the mean scores of the pharmacology pre-test in the control (10.54 ± 2.74) and intervention groups (10.6 ± 3.49) before the intervention. Also, there was no statistically significant difference (P = 0.19) between the pharmacology post-test scores in the control (17.7 ± 1.15) and intervention groups (18.07 ± 0.91). A comparison of pre-test and post-test scores in both control and intervention groups showed that the post-test scores in both groups increased significantly (P < 0.001). The results showed that the intervention group was significantly (P = 0.008) more satisfied with the learning method. ConclusionThe case-based educational approach resulted in improved satisfaction among students in the pharmacology course. It is recommended to incorporate this learning method alongside traditional teaching methods, in nursing education, particularly in pharmacology instruction.

Application of combined teaching method of case-based-learning and clinical pathway in practical gynecological teaching.

To train highly qualified medical talent in 5-year programs and improve students' analytical and problem-solving abilities, it is necessary to change the traditional teaching method. This study introduces the combined teaching method of case-based learning (CBL) and clinical pathway and evaluates its role in practical gynecological teaching. Medical students in a 5-year program who were enrolled in the fourth year were selected as the research subjects; these students were randomized into two groups that separately received either the traditional teaching method or the combined teaching method of CBL and clinical pathway. Before the internship, a questionnaire was administered to explore students' views of internship in gynecology, and after the internship, the questionnaire was administered to assess the two teaching methods. Furthermore, theoretical and skill tests were performed both before and after the internship. A total of 206 medical students in a 5-year program who were in their fourth year were enrolled in the study. Students in the experimental group performed significantly better than those in the control group. They performed significantly better in the postinternship test than in the preinternship test (P < 0.001). The questionnaire showed that more students in the experimental group thought that their learning interests, clinical skills, case analysis ability, clinical communication ability, understanding of theoretical knowledge and clinical thinking ability had improved and significantly differed between the two groups (P < 0.05). Compared to traditional teaching methods, combined teaching method of CBL and clinical pathway can elevate students' academic performance, improve their learning enthusiasm and help promote clinical teachers' teaching quality. Additionally, this novel method is effective in facilitating the achievement of teaching objectives and improving the quality of talent training. Therefore, the combined teaching method of CBL and clinical pathway should be popularized and applied in gynecological practice.

The Efficacy of Case-Based Learning Model Integrated with Critical Thinking Skills to Improve EFL Learners’ Reading Comprehension

The Efficacy of Case-Based Learning Model Integrated with Critical Thinking Skills to Improve EFL Learners’ Reading Comprehension

Creation and Implementation of Cases for Training Students and Advanced Professional Education

In modern medical education, innovative methods are used to increase the effectiveness of training, such as case-based learning. It develops critical thinking, teaches analysis and decision making. The work describes the process of creating and implementing cases for students of additional professional training at a medical college.

Comparison of case-based and lecture-based learning in dental fluorosis diagnostic ability with visual analog scale assessment

ObjectiveThis study aimed to compare the impact of case-based learning (CBL) versus lecture-based learning (LBL) on dental students' clinical decision-making regarding DF severity using Visual Analog Scale (VAS) scoring.MethodsEighty first-year graduate dental students were randomly assigned to either the CBL (n = 38) or LBL (n = 42) groups. Both groups received instruction on DF diagnosis, with CBL involving small group sessions analyzing real cases and LBL involving traditional lectures. Effectiveness was assessed by presenting 32 dental fluorosis cases with Thylstrup-Fejerskov Index (TSIF) scores ranging from 0 to 7 through slide presentations to both groups for VAS assessment. Five evaluators of each group randomly selected were asked to repeat the rating 2 weeks later. Statistical analysis included two-way ANOVA for group and gender differences, intra-class correlation coefficient (ICC) for reliability, and Spearman correlation coefficients for validity.ResultsVariations in VAS scores were observed between CBL and LBL groups, with no significant gender impact. Excellent inter- and intra-evaluator agreement was found for VAS scoring in both groups, indicating its reliability. Validation against established indices (such as DI and TSIF) demonstrated strong correlations, with CBL students exhibiting higher correlations.ConclusionsCBL enhances students' clinical decision-making and proficiency in DF diagnosis, as evidenced by more consistent and accurate VAS scoring compared to LBL. These findings highlight the importance of innovative educational strategies in dental curricula, with implications for improving training quality and clinical outcomes.Trial registration: The study was registered at the Clinical Research Center, Hospital of Stomatology, Wuhan University (Registration code: HGGC-036).

Based case based learning and flipped classroom as a means to improve international students’ active learning and critical thinking ability

BackgroundInternational student education has become an important part of higher education and an important symbol to measure the level of higher education. To change the traditional teaching model, here we introduced a combination of Case-Based Learning (CBL)and Flipped Classroom (FC) into the pathophysiology course for international students. This study aimed to explore whether the active learning ability and critical thinking ability of international students can be improved, based on this new teaching model, improving the innovation ability of teachers’ team and students’ attitude to the reform.MethodsThe two chapters of Cardiac Insufficiency and Apoptosis in Pathophysiology are designed as a CBL + FC teaching method. Distribute the Self-assessment Scale on Active Learning and Critical Thinking (SSACT) and satisfaction questionnaire to international students to evaluate teaching reform based on CBL + FC.ResultsCompared with the traditional classroom, the online flipped classroom based on CBL has significantly improved the learning enthusiasm, as these students are required to independently complete literature review, actively participate in classroom teaching, learn to use multiple learning strategies, and collaborate with other students to complete PowerPoint (PPT)production. At the same time, the students’ ability to raise problems and solve problems has been greatly improved by analyzing clinical cases; By consulting the literature, the theoretical knowledge learned can be better applied to clinical analysis. The results of the satisfaction survey also show that international students are more likely to accept the flipped classroom teaching mode.ConclusionsThis teaching mode will stimulate the learning motivation of international students, enhance teaching attraction and increase teaching interaction; At the same time, the CBL + FC teaching method can strengthen the evaluation of international students’ in and out of class and online learning, enhance students’ active learning ability and critical thinking ability, promote the development of personalized learning, and integrate with international medical education.

The Relationship Between Engagement Time in Case-based Learning and Performance on Preclinical Medical Education Exams

The Relationship Between Engagement Time in Case-based Learning and Performance on Preclinical Medical Education Exams

Flipped classroom orthodontic education for undergraduate dental students: A factor analysis study.

Dental schools have a primary responsibility to devise a curriculum that enhances students' confidence and knowledge in orthodontic case analysis. This study aims to compare the confidence levels and performance of undergraduate students in orthodontic case screening, moderated by faculty in a lecture-based format against their self-analysis of the same cases 1 year later, using a case-based and flipped learning approach. This study involved 100 fifth-year students. The same group received predoctoral orthodontics training through an instructor-centered, didactic approach in their fifth year and a case-based, student-centered, flipped classroom approach in their sixth year. At the end of each semester, the students completed an orthodontic case analysis and a self-reflection survey. This study found no significant differences in diagnostic capabilities for orthodontic findings between the two methods studied. However, the self-evaluation survey data revealed an increase in students' confidence levels. This was specifically in terms of carrying out independent orthodontic case diagnosis, effectively communicating with orthodontic specialists, and their comfort in approaching orthodontic cases following the flipped classroom approach. Despite increased confidence in case diagnosis, the results showed that final-year students are uncertain about creating initial treatment plans and referring cases at an early stage. Despite no observed improvement in students' orthodontic diagnostic abilities after another semester of student-centered learning, their confidence in diagnosing orthodontic cases was notably enhanced.

Clinical Outcomes of Rural Patients with Diabetes Treated by ECHO-Trained Providers Versus an Academic Medical Center.

Despite clinical practice guidelines prioritizing cardiorenal risk reduction, national trends in diabetes outcomes, particularly in rural communities, do not mirror the benefits seen in clinical trials with emerging therapeutics and technologies. Project ECHO supports implementation of guidelines in under-resourced areas through virtual communities of practice, sharing of best practices, and case-based learning. We hypothesized that diabetes outcomes of patients treated by ECHO-trained primary care providers (PCPs) would be similar to those of patients treated by specialists at an academic medical center. Specialists from the University of New Mexico (UNM) launched a weekly diabetes ECHO program to mentor dyads consisting of a PCP and community health worker at ten rural clinics. We compared cardiorenal risk factor changes in patients with diabetes treated by ECHO-trained dyads to patients treated by specialists at the UNM Diabetes Comprehensive Care Center (DCCC). Eligible participants included adults with type 1 diabetes, type 2 diabetes on insulin, or diabetes of either type with A1c > 9%. The primary outcome was change from baseline in A1c in the ECHO and DCCC cohorts. Secondary outcomes included changes in body mass index (BMI), blood pressure, cholesterol, and urine albumin to creatinine ratio (UACR). Compared to the DCCC cohort (n = 151), patients in the ECHO cohort (n = 856) experienced greater A1c reduction (-1.2% vs -0.6%; p = 0.02 for difference in difference). BMI decreased in the Endo ECHO cohort and increased in the DCCC cohort (-0.2 vs. +1.3 kg/m2; p = 0.003 for difference in difference). Diastolic blood pressure declined in the Endo ECHO cohort only. Improvements of similar magnitude were observed in low-density lipoprotein cholesterol in both groups. UACR remained stable in both groups. ECHO may be a suitable intervention for improving diabetes outcomes in rural, under-resourced communities with limited access to a specialist.

The System Architecture-Function-Outcome Framework for Fostering and Assessing Systems Thinking in First-Year STEM Education and Its Potential Applications in Case-Based Learning

Systems thinking is crucial for understanding and solving complex problems and is considered an important thinking skill in engineering. Active learning is considered an effective approach for fostering STEM students’ systems thinking. However, viable methods for teaching and assessing systems thinking with active learning across STEM disciplines, particularly in first-year undergraduate education, are still under-researched. In this paper, we introduce a research-based framework named System Architecture-Function-Outcome to help first-year STEM instructors both foster and assess students’ introductory systems thinking. To conduct an initial evaluation of the framework’s suitability in active learning settings, we designed a directed case-based learning assignment with an adapted article and a rubric for assessing ‘introductory systems thinking’, as defined in the framework. We deployed the assignment among 84 first-year STEM students and successfully tested its inter-rater reliability, with 75–100% inter-rater agreement across all assessment criteria. We discuss the implications of our results on fostering and assessing first-year STEM students’ systems thinking, and outline examples for potential applications of the framework, pending further validation, in case-based learning settings of varying degrees of learner autonomy, from lecture-based to problem-based learning.