Collaborative Case-based Learning Research Articles

Case-Based Learning: An Analysis of Student Groupwork and Instructional Design that Promotes Collaborative Discussion

The use of small-group collaborative case-based learning methodologies has been growing both in interest and implementation across veterinary college curriculums in recent years. The ability of this pedagogical approach to solidify and deepen learning outcomes is well-established in the broader education literature. However, to achieve this positive impact, students must interact in productive discussions that expand the scope of their understanding. The present study focused on analyzing the ways in which professional veterinary students interact as they work collaboratively through clinical cases, in the context of a Team-Based Learning intensive curriculum. This data was used to draw connections between the questions posed in the clinical case activities and the resulting intragroup collaborative outcomes, which can assist veterinary educators in sparking more robust student discussions through facilitation and instructional design. Fourteen participants formed two student groups that worked on 49 case questions across 5 sessions, providing 98 episodes of collaboration for analysis. The findings of this study revealed how professional veterinary students negotiated perspectives to come to consensus on in-class case-based learning tasks, including eight primary types of statements they made and seven overall patterns of group collaboration. This study highlighted specific elements of instructional design that influenced student collaboration including: allowing for multiple perspectives, sparking disagreement, perceived difficulty, learning outcome level, and the level of consensus required by the question structure. We present specific recommendations for veterinary educators to consider while designing questions for veterinary student groups.

Increasing Collaborative Discussion in Case-Based Learning Improves Student Engagement and Knowledge Acquisition

BackgroundIn the transition from academic to clinical learning, the development of clinical reasoning skills and teamwork is essential, but not easily achieved by didactic teaching only. Case-based learning (CBL) was designed to stimulate discussions of genuine clinical cases and diagnoses but in our initial format (CBL’10) remained predominantly tutor-driven rather than student-directed. However, interactive teaching methods stimulate deep learning and consolidate taught material, and we therefore introduced a more collaborative CBL (cCBL), featuring a structured format with discussions in small breakout groups. This aimed to increase student participation and improve learning outcomes.MethodA survey with open and closed questions was distributed among 149 students and 36 tutors that had participated in sessions of both CBL formats. A statistical analysis compared exam scores of topics taught via CBL’10 and cCBL.ResultsStudents and tutors both evaluated the switch to cCBL positively, reporting that it increased student participation and enhanced consolidation and integration of the wider subject area. They also reported that the cCBL sessions increased constructive discussion and stimulated deep learning. Moreover, tutors found the more structured cCBL sessions easier to facilitate. Analysis of exam results showed that summative assessment scores of subjects switched to cCBL significantly increased compared to previous years, whereas scores of subjects that remained taught as CBL’10 did not change.ConclusionsCompared to our initial, tutor-led CBL format, cCBL resulted in improved educational outcomes, leading to increased participation, confidence, discussion and higher exam scores.

Collaborative case-based learning with programmatic team-based assessment: a novel methodology for developing advanced skills in early-years medical students

BackgroundImperial College London launched a new, spiral undergraduate medical curriculum in September 2019. Clinical & Scientific Integrative cases (CSI) is an innovative, flagship module, which uses pioneering methodology to provide early-years learning that [1] is patient-centred, [2] integrates clinical and scientific curriculum content, [3] develops advanced team-work skills and [4] provides engaging, student-driven learning. These aims are designed to produce medical graduates equipped to excel in a modern healthcare environment.MethodsCSI has adopted a novel educational approach which utilises contemporary digital resources to deliver a collaborative case-based learning (CBL) component, paired with a team-based learning (TBL) component that incorporates both learning and programmatic assessment. This paper serves to explore how first-year students experienced CSI in relation to its key aims, drawing upon quantitative and qualitative data from feedback surveys from CSI’s inaugural year. It provides a description and analysis of the module’s design, delivery, successes and challenges.Results Our findings indicate that CSI has been extremely well-received and that the majority of students agree that it met its aims. Survey outputs indicate success in integrating multiple elements of the curriculum, developing an early holistic approach towards patients, expediting the development of important team-working skills, and delivering authentic and challenging clinical problems, which our students found highly relevant. Challenges have included supporting students to adapt to a student-driven, deep learning approach.ConclusionsFirst-year students appear to have adopted a patient-centred outlook, the ability to integrate knowledge from across the curriculum, an appreciation for other team members and the self-efficacy to collaboratively tackle challenging, authentic clinical problems. Ultimately, CSI’s innovative design is attractive and pertinent to the needs of modern medical students and ultimately, future doctors.

Virtual Interdisciplinary Collaboration in Statewide Implementation of the MIND at Home Dementia Care Program

MIND at Home, a well-researched holistic, family-centered dementia care coordination program, provides collaborative support to community-dwelling persons living with dementia (PLWD) and their informal care partners (CP). Through comprehensive home-based assessment of 13 memory-care domains covering PLWD and CPs, individualized care plans are created, implemented, monitored, and revised over the course of the illness. Non-clinical Memory Care Coordinators (MCCs) working with an interdisciplinary team provide education and coaching to PLWD and their identified CP, and serve as a critical liaison and resource and between families, medical professional, and formal and informal community resources. This paper will describe a statewide pilot implementation of the program within a health plan across diverse sites in Texas and will present qualitative and quantitative descriptions of a key component of the program's effective translation to practice, the virtual collaborative case-based learning sessions. Health plan teams completed online interactive training modules and an intensive in-person case-based training with the Johns Hopkins team prior to program launch, and then engaged in weekly, hour-long virtual collaborative sessions that included health plan teams (site-based field teams, health plan clinical supervisory and specialty personnel [RNs, pharmacists, a geriatric psychiatrist, behavioral health specialists] and Johns Hopkins MIND program experts and geriatric psychiatrists. To date, the program has enrolled 350 health plan members, conducted 65 virtual collaborative sessions, and provided 423 CME/CEU units to team members. We will provide an overview of virtual collaborative session structure, participant contributions and discussion topics, case complexity, as well as didactic learning topics covered.

Scaffolding Collaborative Case-Based Learning during Research Ethics Training

As development of research ethics competencies is in the focus in higher education (HE) institutions, it is crucial to understand how to support the learning process during such training. While there is plenty of research on how to scaffold children’s learning of cognitive skills, there is limited knowledge on how to enhance collaborative case-based learning of research ethics competencies in HE contexts. Our aim was to identify whether, how and when scaffolding is needed with various expertise levels to support development of ethics competencies. To identify and evaluate scaffolding during collaborative case-based ethics training we synthesised a scaffolding framework consisting of three levels: techniques, mechanisms and process. We organised 5 training sessions where 46 participants (including bachelor, master and PhD students as well as junior and senior academics) were involved. Data was collected as part of action research from group-work recordings and transcribed verbatim. Deductive qualitative analysis was implemented on transcripts based on the scaffolding framework. Our analysis revealed that structural scaffolding alone (learning material) is not always efficient with bachelor level students, they also require oral scaffolding when the need becomes apparent. Master’s level students benefited most from wording the issues they needed to focus on. Doctoral students and senior academics needed scaffolding to maintain goal orientation. We end our article with some recommendations for facilitators of ethics education, and encourage using the scaffolding framework also in complex problem-solving beyond ethics training.

Collaborative case-based learning process in research ethics

The increasing concern about ethics and integrity in research communities has brought attention to how students and junior academics can be trained on this regard. Moreover, it is known that ethical behaviour and integrity not only involve individual but also group norms and considerations. Thus, through action research and participant observation, this research investigates the learning processes through which 64 students collaboratively develop research ethics and integrity competencies. The aim was to understand how bachelor, master and PhD students approach ethical dilemma cases through a collaborative process. The data consisted of recorded group work on ethics cases, student group reports, and post-training questionnaires. Later, the analyses considered groups as the unit of analysis. These data were analysed through content analysis utilizing the SOLO taxonomy to identify levels of understanding and assess evolvement of ethical sensitivity during a case-based training session. The results show that all groups reached the level of understanding where the groups demonstrated that concepts had been understood appropriately, but occasionally struggled to make connections between them. Students perceived working collaboratively as beneficial. The results help teachers of research ethics and integrity to make pedagogically justified choices in their teaching. Drawing on the results of this study, we propose a tool for the formative assessment of student learning of research ethics and integrity.

Evaluating the Learning Experience of Web-Conferenced Case Based Learning

Objective: The objective of this study was to evaluate web-conferenced case-based learning (WCBL) through the student experience across a semester of learning. Learning was also evaluated via unit examination and compared to the previous year’s cohort, which did not include WCBL (F2F). Methods: This study took place over the first semester of the third year of a Bachelor of Physiotherapy program at Monash University, Australia, in 2014. Having experienced two years of weekly face-to-face case-based learning (F2F-CBL) activities since commencing the program, students were transitioned to WCBL for the duration of this study. Primary outcomes included measures of satisfaction, attendance, communication, issues with information technology, and perceived depth of learning, with data collected via a post-unit survey. The secondary outcome was student learning, evaluated with the unit examination results. Results: 76/78 students completed the post-unit survey (non-participation rate 2.6%). Although 95% of participants reported that WCBL was a valuable addition to the teaching activities of the unit, students reported a range of new challenges and rewards from the transition to small-group WCBL activities. Strong themes emerged encompassing adaptation of communication, increased responsibility for learning, technical difficulties, and learning in a remote environment. Overall, 92% of participants agreed that they were satisfied with WCBL. The unit exam result was comparable for the 2013 (F2F-CBL) and the 2014 (WCBL) cohorts (Mean (SD) 2013 (%) 75.97 (9.56) n = 73; 2014 (%) 76.74 (6.57) n = 78, effect size (95% C.I) = 0.09 (-0.23 – 0.41). Conclusion: Web conferencing may be a suitable medium for students to participate in collaborative case-based learning activities. Further study should evaluate the financial implications of implementing WCBL across an entire semester in regard to student and facility costs.

Use of Online Collaborative Case Study Modules for Obesity Education

Nutrition curricula need to comprehensively address obesity management. Course time constraints may limit in‐depth coverage. Added online case studies can provide experiential learning and enhance coverage of learning objectives. Online collaborative case‐based learning modules (CBLM) on obesity management were tested in four nutrition/dietetics classes. Facilitated CBLMs, based on constructivism, included reflective essays, discussion boards, group activities, and self‐evaluation of learning. Students completed pretests one week prior to and posttests one week after modules. CBLM information and activities were released over three weeks, allowing practice of skills over time. This study presents data from an upper level dietetics class. We tested the hypothesis that a CBLM would have a greater impact on students' obesity knowledge and skills than a standard case study. Students were stratified based on first exam performance and randomized to groups of 5‐6 students to complete the CBLM or a standard case study focused on nutrition assessment of obesity. Forty‐five students completed pretests and posttests. Independent t‐tests revealed a greater mean increase in scores for CBLM than standard group (+7.9 and ‐0.6%, respectively, P = 0.03). Two‐way ANOVA showed that students with below‐mean pretest scores had a greater mean score increase with CBLM compared to a standard case study (+19.6 vs. +3.5%, P <0.001). There was no significant difference between standard and CBLM delivery among students with above‐mean pretest scores. In summary, a CBLM increased knowledge and skills of nutrition students compared to a standard case study.Source of Research Support: College of Family and Consumer Sciences, The University of Georgia

Impact of Online Collaborative Case-Based Learning about Pediatric Obesity Management on Students' Intent to Apply Knowledge in Practice

Participants will be able to identify two elements of a constructivist learning approach and describe the impact of self-reflective activity on students’ intention to transfer knowledge about pediatric obesity and treatment to practice.

“It's Not the Child's Fault” – Students' Perceived Learning About Pediatric Obesity in a Collaborative Online Case Study

Objective: The objective of this collaborative online case study was to increase undergraduate students' pediatric obesity management knowledge and skills. Target Audience: The target audience for this case study was undergraduate students in a life cycle nutrition class. Theory, Prior Research, Rationale:Multiple levels of factors impact children's weight status (social ecological model), and parents and community members may be able to change these factors. Undergraduate nutrition programs should include a review of obesity management but time constraints often prohibit covering material in depth. Online collaborative case-based learning (CBL) may overcome these barriers; however, few have evaluated the effectiveness of online CBL in nutrition courses. Description: This online case study module was one of six to be implemented across the curriculum. Students in small groups completed the module consisting of PowerPoint presentations to scaffold learning, self-reflective essays, group discussion boards, and collaborative development of a nutrition care plan consistent with recommended guidelines for the ‘‘case family.’’ Evaluation: Eighty-eight students were included in analyses. The mean difference between pre-tests and post-tests was +10.3% (SEM 1.2%, P< 0.001). Qualitative thematic analyses of students' self-reflective essays indicated that the majority did not previously recognize the extent of the obesity epidemic, the impact of multiple factors on weight status, and the need to involve families in behavior change. Most students intended to apply knowledge gained to their own behavior. Conclusions and Implications: An online collaborative case study including self-reflection was effective in increasing students' awareness of obesity-related factors and need to involve family in nutrition care planning. Funding: College of Family and Consumer Sciences, University of Georgia

Promoting effective collaborative case-based learning at university: a metacognitive intervention

The use of student-led collaborative learning activities at university level has increased dramatically in recent decades. However, whether such activities foster engagement in self-regulated, deep-learning practices remains contentious, with evidence that desirable learning outcomes are often not achieved. A metacognitive intervention was designed to induce groups of students to engage in productive learning from each other, while working on a clinical case-based group assignment. The intervention introduced students to a twofold metacognitive strategy aimed at enhancing learning through meaning making in group interactions and high-level questioning. The research involved a semi-experimental design, with a previous student cohort providing control data. Observation and self-report data converged to show that the intervention led to increased time spent on case content-discussion, but not at the desired deep level. The intervention's positive impact was also evident in self-reports of personal goals, perceived difficulty of the assignment, group and task challenges, and evaluations of learning.

Computer-supported collaborative learning with digital video cases in teacher education: The impact of teaching experience on knowledge convergence

Case-based learning is ascribed high potential with respect to the education of pre-service teachers as well as the further education of experienced in-service teachers, as it can provide opportunities for the application of professional knowledge to authentic classroom situations. In addition to the application and acquisition of knowledge, the aspect of knowledge convergence (i.e., increasing similarity of collaborative learners with respect to their knowledge) should be taken into account when homogeneous benefits are desired for all participants of a case-based training. A field study with 29 pre-service teachers and 24 in-service teachers from adult education was conducted to examine effects of different levels of teaching experience on knowledge application, knowledge acquisition, and knowledge convergence in a computer-supported collaborative case-based learning environment. An innovative approach to measuring knowledge convergence was introduced, using the positions of annotations (i.e., flags placed on the timeline of the case video) made by learners during their case analyses as an indicator of their shared focus of attention. This measure was found to positively correlate with the application and acquisition of professional knowledge. Teaching experience affected both processes and outcomes of case-based learning, suggesting different means of instructional support for pre-service and in-service teachers.

An Instructional Intervention to Encourage Effective Deep Collaborative Learning in Undergraduate Veterinary Students

In recent years, veterinary education has received an increased amount of attention directed at the value and application of collaborative case-based learning. The benefit of instilling deep learning practices in undergraduate veterinary students has also emerged as a powerful tool in encouraging continued professional education. However, research into the design and application of instructional strategies to encourage deep, collaborative case-based learning in veterinary undergraduates has been limited. This study focused on delivering an instructional intervention (via a 20-minute presentation and student handout) to foster productive, collaborative case-based learning in veterinary education. The aim was to instigate and encourage deep learning practices in a collaborative case-based assignment and to assess the impact of the intervention on students' group learning. Two cohorts of veterinary students were involved in the study. One cohort was exposed to an instructional intervention, and the other provided the control for the study. The instructional strategy was grounded in the collaborative learning literature and prior empirical studies with veterinary students. Results showed that the intervention cohort spent proportionally more time on understanding case content material than did the control cohort and rated their face-to-face discussions as more useful in achieving their learning outcomes than did their control counterparts. In addition, the perceived difficulty of the assignment evolved differently for the control and intervention students from start to end of the assignment. This study provides encouraging evidence that veterinary students can change and enhance the way they interact in a group setting to effectively engage in collaborative learning practices.

Collaborative Case-Based Study of Genetic and Infectious Disease via Molecular Biology Computer Simulations and Internet Conferencing

Case It! is a National Science Foundation-sponsored project to promote collaborative case-based learning in biology education, via free molecular biology computer simulations and Internet conferencing. In this session, we will demonstrate how Case It! Software can be used to enhance understanding of molecular biology techniques for analyzing casesbasedongeneticandinfectiousdiseases,aswellasawarenessofethicalissuesassociatedwiththesediseases.Students first use the Case It! simulation to analyze DNA and protein sequences for cases involving genetic diseases or infectious diseases such as SARS, HIV, West Nile, and influenza, among others. Simulated tools for case analysis include DNA and protein electrophoresis, Southern blotting, Western blotting, dot blot, PCR, and ELISA. After analyzing the cases, students construct web-page posters using the Case It! Web Editor. They then play the roles of counselors, medical personnel, family members, and others as they ask and answer questions about the case results using a custom Internet conferencing systemhostedonourwebsite.Class-testinginvolvingstudentsintheU.S.,theU.K.andAfricahavevalidatedthisapproach to case-based learning - see http://www.uwrf.edu/caseit/caseit.html for details. Workshop participants will discuss how the Case It! system can be adapted to their home institutions.