Case-Based Collaborative Learning in Undergraduate Radiology Teaching-Are Essential Conditions for Group Discussions Met?

BACKGROUND

Delivering case-based collaborative learning (cCBL) at scale using technology that both presents the clinical problem authentically and seeks to foster quality group discussion is a challenge, especially argumentation which is critical for effective learning. The aim of this study was to investigate the presence of essential conditions to capitalize on a technology-enhanced cCBL scenario for teaching radiology and facilitating quality group discussion.

METHODS

A questionnaire was administered to 114 fourth-year medical students who completed a technology-enhanced cCBL scenario for teaching neuroradiology. It consisted of individual online pre-class work and face-to-face in-class work, where group discussion followed individual work at a workstation. Items from the "Heedful Interrelating in Collaborative Educational Settings" scale and "positive emotional engagement" questionnaire assessed the quality of social-cognitive processes and emotional engagement during the group discussions. Structured interviews were used to explore the teachers' awareness of and engagement with the technology.

RESULTS

The mean scores of most "heedfulness" items were below 3.5 (7-point scale), suggesting that participants did not enter the debriefing with a mindset conducive for argumentation. However, for the affective states "interest" and "enjoyment" the mean scores were above 5. Free text comments suggested participants enjoyed the superficial interactions, but did not necessarily engage in argumentation. Structured interviews revealed teachers were aware of the possibilities of the learning dashboard and used it as a common frame of reference, but did not really succeed to use it as a springboard for discussion.

CONCLUSION

A technology-enhanced cCBL scenario is useful for teaching radiology in undergraduate medical education, but the added value of acquiring in-depth knowledge will only be achieved when students are aware of the importance of an "heedful" mind-set.

Physiology education in China: the current situation and changes over the past 3 decades

OBJECTIVE

As an experimental biological science, physiology has been taught as an integral component of medical curricula for a long time in China. The teaching effectiveness of physiology courses will directly affect students' learning of other medical disciplines. The purpose of this study is to investigate the current situation and changes in physiology teaching over 30 years in Chinese medical schools.

METHODS

National survey was conducted online on the platform SoJump via WeChat and the web. The head of the physiology department in medical school was asked to indicate the information of physiology education from three periods: 1991-2000, 2001-2010, and 2011-2020. The responses of 80 leaders of the Department of Physiology from mainland Chinese medical schools were included in the study for analysis.

RESULTS

The survey showed that the class hours, both of theory and practice, had been decreased. During the past 20 years, the total number of physiology teachers, the number of physiology teachers who had been educated in medical schools, and the number of technicians had been reduced, whereas teachers with doctor's degrees had been increased. In addition to traditional didactic teaching, new teaching approaches, including problem-based learning/case-based learning/team-based learning, integrated curriculum and formative evaluation systems, had been employed, mostly for more than 5 years, in some medical schools.

CONCLUSION

The present study has provided historical data regarding the current status of physiology education in China and that in the past thirty years by showing that physiology education in China has developed quickly,even it faces many challenges.

Application of PRI-E-a combined learning method in oral and maxillofacial oncology education

The traditional lecture-based learning (LBL) method is facing great challenges due to its low efficiency and single proceeding form. We designed a PRI-E learning mode that combined and modified problem-based, case-based, and evidence-based learning with a step-by-step approach. We evaluated the practical learning outcomes of using the PRI-E mode by comparing it with traditional lecture-based learning in oral and maxillofacial oncology education. "PRI-E" consists of the first letters of the English words Passion, Research, Innovation, and Education, and it means "the best Education". This prospective randomized controlled trial included 40 participants. We evenly divided the participants into the PRI-E (n = 20) and LBL group (n = 20) based on the entrance test scores. The same staff group designed and then taught the learning content with different group measures. The evaluation included the final test scores and questionnaire assessments. Without affecting the examination results, the PRI-E teaching method was more satisfactory and popular with participants in terms of ability development and classroom participation. Enacting the PRI-E teaching method required more time, but this did not affect its popularity among the participants. Compared with the LBL learning mode, the PRI-E learning mode was more organized and efficient in oral and maxillofacial oncology education without affecting academic performance. This model has a high degree of satisfaction, which is conducive to training students' comprehensive ability.

Combination of concept maps and case-based learning in a flipped classroom: A mixed-methods study

AIM

This study aimed to evaluate the impact of a hybrid learning method on the academic achievements, learning skills and experiences of undergraduate nursing students.

BACKGROUND

Case-based learning is a student-centered approach that is commonly integrated into the flipped classroom model in nursing education. However, effectively combining the flipped classroom model and case-based learning into a hybrid learning format is challenging. To address this gap, this study integrated concept maps with case-based learning and the flipped classroom and evaluated the impact of this hybrid learning method on the academic achievements, learning skills and experiences of undergraduate nursing students.

DESIGN

A mixed-methods approach, including a quasi-experimental study and semi-structured interviews, was employed.

METHODS

A total of 277 undergraduate nursing students participated, with 136 students in the control group undergoing case-based learning and 141 students in the experimental group taught using the hybrid learning approach, which combined concept maps, case-based learning and a flipped classroom. The study assessed self-directed learning, critical thinking, learning strategy and curriculum grades in both groups before and after the intervention. Additionally, students in the experimental group participated in semi-structured interviews.

RESULTS

The quantitative findings indicated that both case-based learning and the hybrid learning method (combined concept maps, case-based learning and a flipped classroom) had similar impacts on the curriculum grades, self-directed learning, cognitive maturity and learning strategy of nursing students. The qualitative results further demonstrated how the hybrid approach facilitated integrated learning, promoted self-evaluation, aided adaptation to the flipped classroom and enhanced teacher-student interaction.

CONCLUSIONS

Combining case-based learning, a flipped classroom and concept maps is an effective learning approach for undergraduate nursing students. It may improve students' self-directed learning, cognitive maturity and learning strategy. Additionally, concept maps are a beneficial supplement to case-based learning and a flipped classroom in terms of guiding integrated learning, promoting self-evaluation, enhancing adaptation to a flipped classroom and increasing interaction between teachers and students and between classmates.

Pediatric and Adolescent Gynecology WebEd: A Brief Report of an Underutilized Online Learning Module

Pediatric and adolescent gynecology (PAG) is a unique subspecialty for which accessible educational resources and clinical exposure have historically been limited; surveys show that trainees in both obstetrics and gynecology and pediatrics agree. In 2014, the North American Society for Pediatric and Adolescent Gynecology (NASPAG) introduced PAG WebEd, an original and interactive online case-based curriculum designed to bridge this learning gap. As of 2023, there are 35 published PAG WebEd clinical cases with key learning points that present, test, and discuss a variety of current PAG topics. The NASPAG Resident Education Committee (REC) compiled and reviewed administrative data from the module platform to investigate trainee utilization and performance. The activity data and assessment scores for 161 registered users are included and reported in this article. This brief report highlights that a relatively small number of medical trainees use PAG WebEd and aims to raise awareness of this resource through publication. There is potential for many more users to benefit from this resource; its efficacy as an examination and clinical practice tool could also be measured. The NASPAG REC hopes to ultimately show, with increased utilization, that PAG WebEd deserves to be a key piece of PAG-focused medical education. For PAG WebEd information and faculty registration, as well as a link that allows faculty to submit new learners, please visit https://www.naspag.org/pagwebed-information.

Learning Assistants in Flipped-Classrooms: A New Pedagogical Strategy for Pre-Clinical Medical Education

Problem-based learning has been widely incorporated into pre-clinical medical education to increase the applicability of pre-clinical knowledge. However, studies have demonstrated increased learning burden and decreased confidence in learning when adapting to this didactic medium. To the authors' knowledge, limited interventions target these shortcomings in real time. Thus, we adapted and implemented a "Learning Assistants" (LA) program that can be deployed in pre-clinical didactic sessions. In this prospective pilot study, trained LAs were deployed in the classroom to assist students in their clinical case vignettes under instructor supervision. Learning assistants and students completed pre-session and post-session evaluation surveys to assess LA helpfulness, student confidence, and interest in study material. Paired observations were evaluated using Wilcoxon signed-ranks tests, ANCOVA, and paired t-tests. Unstructured responses were evaluated using thematic analysis. A significant improvement in both student interest (p < 0.001) and confidence (p < 0.001) in the course material was observed after each surveyed session. No significant difference was observed in student-perceived LA helpfulness across the sessions (p = 0.12). Thematic analysis revealed common themes in student knowledge gaps, including challenges with understanding drug mechanisms of action and drug interactions. The results suggest that this program may consistently positively impact student interest and confidence. However, further research is needed to evaluate the impacts of this intervention on learning outcomes and standardized assessments. This study highlights the potential for such a program to bolster pre-clinical didactic sessions that utilize the problem-based learning instructional modality.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01958-x.

CBL on FHIR: A FHIR-Based Platform for Health Professional Education

A FHIR based platform for case-based instruction of health professions students has been developed and field tested. The system provides a non-technical case authoring tool; supports individual and team learning using digital virtual patients; and allows integration of SMART Apps into cases via its simulated EMR. Successful trials at the University of Queensland have led to adoption at the University of Melbourne.

Effect of the case-based learning method combined with virtual reality simulation technology on midwifery laboratory courses: A quasi-experimental study

Objective

This study aimed to evaluate the effect of case-based learning (CBL) method with virtual reality (VR) simulation technology (CBL-VR) on midwifery laboratory courses.

Methods

A quasi-experimental design was employed. A total of 135 midwifery students were recruited from Nursing College of Guilin Medical University in China from September 2020 to January 2022. Intervention group recruited students from the Class of 2019 (n = 59) and control group recruited students from the Class of 2018 (n = 76). The intervention group students received the CBL-VR method based on traditional laboratory teaching, the contents of course included four sections: eutocia (6 class hours), dystocia (6 class hours), umbilical cord prolapse (2 class hours), and neonatal asphyxia and resuscitation (4 class hours), 40 min per class hour. The control group students received the traditional laboratory teaching. Students' academic performance, Self-Directed Learning (SDL) Ability Questionnaire, and the education satisfaction questionnaire were used to evaluate the teaching efficacy between two groups.

Results

After intervention, the intervention group students achieved higher scores than the control group in individual operation ability (90.88 ± 2.14 vs. 89.24 ± 3.15), team operation ability (90.97 ± 2.33 vs. 81.28 ± 5.45), and midwifery case analysis ability (88.64 ± 3.19 vs. 86.70 ± 2.56) (P ＜0.01). Prior to the implementation of the course, there was no difference in the SDL ability scores between the two groups of students (P ＞ 0.05). However, following the course intervention, the SDL ability scores of the intervention group were higher than those of the control group (94.78 ± 6.59 vs. 88.12 ± 8.36), and the scores in all dimensions of the intervention group were also higher (P < 0.05). Additionally, more than 94% of the students indicated that CBL-VR method developed comprehensive abilities, including independent-study enthusiasm, independent thinking, collaboration, and communication.

Conclusion

Using the CBL-VR method in midwifery lab courses improved students' course performance, SDL ability, and comprehensive ability. Students highly recognized the effectiveness of this approach.

Application of the BOPPPS-CBL model in electrocardiogram teaching for nursing students: a randomized comparison

BACKGROUND/AIM

Interpreting an electrocardiogram (ECG) is a vital skill for nurses in cardiology. This study aimed to evaluate the efficacy of the bridge-in, objective, preassessment, participatory learning, post-assessment, and summary (BOPPPS) model, when combined with case-based learning (CBL), in enhancing nursing students' ECG interpretation capabilities.

MATERIALS & METHODS

Nursing students were randomly divided into two groups: one utilizing the BOPPPS model combined with CBL (BOPPPS-CBL), and the other employing a traditional lecture-based learning (LBL) model. All participants underwent training and completed pre- and post-course quizzes.

RESULTS

The BOPPPS-CBL model significantly improved nursing students' abilities in ECG interpretation compared to the traditional LBL model group. The BOPPPS-CBL model proved to be a comprehensive and effective method for enhancing students' attitudes towards teaching and learning.

DISCUSSION

Our study demonstrated for the first time that the BOPPPS-CBL model is an innovative and effective method for promoting nurses' accuracy in ECG interpretation. It highlights the potential of this approach as a superior alternative to traditional learning methods.

Three-Dimensional Multimodality Image Reconstruction as Teaching Tool for Case-based learning among medical postgraduates: a focus on primary pelvic bone Tumour Education

BACKGROUND

Postgraduate medical education in oncology orthopedics confronts obstacles when instructing on pelvic tumors, primarily due to their intricate anatomy and the limitations of conventional teaching techniques. The employment of Three-dimensional multimodality imaging (3DMMI) can be considered a valuable teaching tool, as it gracefully elucidates the intricacies of pelvic anatomical structures and the interactions between tumors and surrounding tissues through three-dimensional imaging, thereby providing a comprehensive and nuanced perspective. This study aimed to assess the feasibility and effectiveness of incorporating 3DMMI in combination with a Case-Based Learning (CBL) approach for postgraduate education.

METHODS

The study encompassed a 10-week course involving 90 surgical postgraduates, focusing on common pelvic tumor diseases. Students were assigned representative clinical cases, and each group created a PowerPoint presentation based on these cases. The core educational content included fundamental knowledge of pelvic anatomy, as well as clinical presentations, radiological features, and treatment principles of common pelvic tumor diseases. The research compared two groups: a traditional CBL group (n = 45) and a 3DMMI-CBL group (n = 45). The 3DMMI-CBL group had access to advanced imaging technology for better visualization. Various evaluations, including image interpretation, theoretical knowledge, and questionnaires, were used to assess the learning outcomes.

RESULTS

The 3DMMI-CBL group outperformed the CBL group not only in the imaging diagnosis of common pelvic diseases but also in their mastery of the related theoretical knowledge. Student questionnaires indicated higher scores for the 3DMMI-CBL group in basic pelvic anatomy knowledge (8.08 vs. 6.62, p < 0.01), image interpretation (8.15 vs. 6.69, p < 0.01), learning efficiency (8.07 vs. 7.00, p < 0.01), clinical reasoning (7.57 vs. 6.77, p < 0.01), and learning interest (8.46 vs. 7.00, p < 0.01). Teacher questionnaires revealed that 3DMMI technology enhanced teachers' clinical knowledge, facilitated instruction, and increased overall satisfaction and interest in teaching.

CONCLUSION

Our study introduced an enhancement to the conventional Case-Based Learning (CBL) model by incorporating 3DMMI technology for visualizing pelvic anatomy. In contrast to pure CBL, this adaptation improved teacher instruction, substantially heightened student engagement, ignited greater interest in learning, and boosted overall efficiency, ultimately leading to positive learning outcomes. Consequently, our study demonstrated the potential feasibility and acceptability of the 3DMMI-CBL teaching method for postgraduates in pelvic bone tumor education.

Modelling the case-based learning preferences of undergraduate nursing students using a discrete choice experiment in China

PURPOSE

To investigate the preferences for case-based learning programmes among undergraduate nursing students.

METHOD

A questionnaire was designed based on a discrete choice experiment, and 227 undergraduate nursing students were investigated. In STATA 15.0 software, the data were statistically analysed using a mixed logit model.

RESULT

All attributes in our study were found to have a significant influence on undergraduate nursing students' preferences for case-based learning programmes. The students' preference for the CBL programme was influenced by the clinical internship experience and type of university. Furthermore, the most ideal scenario was found to be video case modality, unfolding delivery, provided by academic experts and clinical instructors, group size 9-11, adequate feedback, and fragmented case content.

CONCLUSION

The undergraduate nursing students' preferences for case-based learning programmes were affected by the provider, case modality, modality, group size, feedback, and case content. Our results can provide useful information for nursing educators to gain insight into student preferences and formulate case-based learning programs.

Exposing the disability-related hidden curriculum in case-based learning: A qualitative study

BACKGROUND

People with disabilities face significant health disparities. Studies show that healthcare professionals harbor negative attitudes towards disability, compromising the quality of care. These attitudes, in unwritten, unofficial, and even unintended ways can be passed from providers to learners in the medical education setting.

OBJECTIVE

Using a Critical Disability Studies (CDS) paradigm, the authors uncovered the disability-related hidden curriculum within Case-Based Learning (CBL) and proposed guidelines for promoting a disability-conscious medical education that resists ableism.

METHODS

The study team conducted a qualitative analysis of all CBL cases from the pre-clerkship curriculum (n = 53) at Sidney Kimmel Medical College. The authors employed a directed content analysis approach to develop a codebook based on case examination, literature review, and CDS concepts. Two researchers coded all cases and assessed intercoder reliability. The results informed the development of an explanatory model.

RESULTS

Only four of 53 cases overtly mentioned disability, none of which defined disability according to CDS. Coding did not identify content challenging stereotypical views of disability. Additionally, two cases included content fueling negative attitudes of disability.

CONCLUSION

By inadequately addressing disability from a CDS perspective, harmful assumptions of disability may go unchallenged, driving a hidden curriculum within CBL. This phenomenon leaves medical students ill-prepared to care for people with disabilities and creates physicians ill-equipped to teach the next generation. Since many health professions utilize CBL to educate students, these cases provide an untapped opportunity to resist ableism and better prepare students to address the negative attitudes driving health disparities experienced by people with disabilities.

Small-Group Teaching: Should It Be Recorded?

Background

Recording large-group lectures is commonplace in higher education, allowing students to access content asynchronously and remotely. With the move towards online learning during the COVID-19 pandemic, recording of small-group teaching sessions has also become increasingly common; however, the educational value of this practice is unknown.

Methods

All medical students rotating through the Acute Medicine Department of a large teaching hospital were invited to enrol in the study. Consenting students were recorded for the second half of an online case-based learning (CBL) session. The recording was available for 6 months; viewing patterns were analysed. Students were sent a questionnaire after the session, asking them to reflect on the recorded and unrecorded halves of the session.

Findings

Thirty-three students underwent recording in 12 separate groups; 31 students (94%) completed the questionnaire. All 31 respondents (100%) described the session as "useful" or "very useful". Twenty-four respondents (77%) recommended continuing to record small-group sessions and 17 (55%) reported being "likely" or "very likely" to watch the recording. Six respondents (19%) reported a negative impact of being recorded. During 6 months of follow-up, no students returned to view the recording for more than 1 minute.

Conclusion

Despite positive feedback for the session and high student demand for ongoing recording, no students viewed the recording for any significant duration. One-fifth of students reported a negative impact of being recorded. The findings from this study do not support routine recording of small-group CBL sessions, even where demand for this may exist.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01837-5.

Application of case-based learning in psychology teaching: a meta-analysis

BACKGROUND

Case-based learning (CBL) has been found to be effective for many subjects, but there is currently a lack of evidence regarding its utility in psychology education. The present study investigated whether CBL pedagogy can improve students' academic performance in psychology courses compared to the traditional teaching methods.

METHODS

A systematic review and meta-analysis were conducted to investigate the effectiveness of CBL in psychology teaching. Databases including PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), the VIP database, and Wanfang data were searched to find eligible randomized controlled trials. Pooled effect estimates were calculated using Hedges' g under the random effects model, and a subgroup analysis was carried to investigate the heterogeneity among studies.

RESULTS

Fifteen studies with 2172 participants, 1086 in the CBL group and 1086 in the traditional lecture-based teaching group, were included in the meta-analysis. Students in the CBL group scored significantly higher on exams than those in the lecture-based group [Hedges' g = 0.68, 95%CI (0.49, 0.88), p < 0.00]. Relatively high heterogeneity was noted among the included studies. Publication bias was examined by the funnel plot and Egger's test, but did not significantly influence the stability of the results. A subsequent evaluation using the trim-and-fill method confirmed that no single study was skewing the overall results. A qualitative review of the included studies suggested that most students in the CBL group were satisfied with the CBL teaching mode.

CONCLUSIONS

This meta-analysis indicated that the CBL pedagogy could be effective in psychology education, and might help increase students' academic scores, while encouraging a more engaging and cooperative learning environment. At present, the application of CBL in psychology education is in its initial stage. Problems related to the curriculum itself, research methodology, and challenges faced by both teachers and learners have confined its practice. Fully tapping into the strengths of CBL in psychology teaching will require additional work and advancing research.

Understanding competency of nursing students in the course of case-based learning in Cambodia: a convergent mixed method study

BACKGROUND

In the last decade, nursing education has begun to reform to competency-based education worldwide, including in low-and middle-income countries. Case-Based Learning (CBL), an approach to delivering competency-based education, contributes to acquiring critical thinking competency, problem-solving, higher knowledge, professional value and attitude. However, it needs to be taught in a culturally appropriate manner. In Cambodia, CBL was initiated in a classroom and clinical practicum by faculty and preceptors who graduated from the upgrading course. This study examined the factors associated with the competency level of nursing students, explored the practice and perceptions of teaching-learning activities among students, faculty members and preceptors and assessed the coherence of qualitative and quantitative findings.

METHODS

This was a convergent, mixed methods study. Data were collected from eight educational institutions for quantitative and qualitative studies and seven hospitals for qualitative studies. From June to September 2019, a cross-sectional survey of nursing students in the third year of the three-year programme (n = 719), eight focus group discussions (FGDs; n = 55) with 6-8 members and 15 FGDs with faculty (n = 38) and clinical preceptors (n = 37) with 4-7 members were conducted to elicit the teaching-learning experience and perceptions. Multiple linear regression was performed to investigate the factors associated with student competency. Moreover, the study conducted thematic content analysis on the qualitative data. The integrated analysis was presented as side-by-side joint displays.

RESULTS

First, the quantitative and qualitative findings confirmed each other 's CBL learning experiences. Students had higher levels of nursing competencies if they had CBL experiences, both in the classroom and clinical practicum, both in a group manner. Next, the quantitative and qualitative findings complemented students' academic satisfaction with the teaching by faculty members and preceptors. Finally, the quantitative and qualitative findings were expanded to explain students' academic satisfaction with the programme.

CONCLUSIONS

The finding of CBL experiences in a group and students' satisfaction with faculty members' and preceptors' teaching improved nursing students' competency development. Meanwhile, students' satisfaction with the design and delivery of the educational programme provides implications for policy level to narrow the theory and practice gaps in low- and middle-income countries.

Developing Research-Informed Guidance on Preparing Pharmacy Students to Care for Diverse Populations

OBJECTIVE

The purpose of this study was to develop research-informed guidance on how to better prepare students for working with diverse populations through exposure to diversity representation within case-based learning materials.

METHODS

This was a qualitative interpretive phenomenological study using audio-recorded semi-structured interviews for data collection. Interviews were conducted virtually with 15 recent program alumni from Dalhousie University and 15 members from underrepresented communities in Nova Scotia, Canada. Audio-recordings were transcribed verbatim and framework analysis was used to code and categorize data. Themes were interpreted from categorized data and a conceptual model was developed based on the results.

RESULTS

The conceptual model highlighted that awareness of diversity and health equity paired with practice and application of learning were perceived to be important for preparing graduates for practice. It was found that awareness could be best achieved through exposure to diversity within cases. To effectively expose students, programs must deliberately identify diverse populations to include, seek perspectives and engagement from those populations when writing cases, ensure conscientious representation of diversity without reinforcing stereotypes, and provide resources for discussion and further learning.

CONCLUSION

Through the development of a conceptual model, this study provided research-informed guidance representing diversity within case-based learning materials. Findings support the notion that representation of diversity must be deliberate, conscientious, and collaborative with those offering diverse perspectives and lived experiences.

Evaluating the effectiveness of a new student-centred laboratory training strategy in clinical biochemistry teaching

BACKGROUND

The error-proneness in the preanalytical and postanalytical stages is higher than that in the analytical stage of the total testing process. However, preanalytical and postanalytical quality management has not received enough attention in medical laboratory education and tests in clinical biochemistry courses.

METHODS/APPROACH

Clinical biochemistry teaching program aim to improve students' awareness and ability of quality management according to international organization for standardization 15,189 requirements. We designed a student-centred laboratory training program, according to case-based learning that included 4 stages: "establish an overall testing process based on the patient's clinical indicator, clarify principles, improve operational skills, and review process and continuous improvement". The program was implemented in our college during the winter semesters of 2019 and 2020. A total of 185 undergraduate students majoring in medical laboratory science participated in the program as a test group, and the other 172 students were set up as the control group and adopted the conventional method. The participants were asked to finish an online survey to evaluate the class at the end.

RESULTS/OUTCOMES

The test group had significantly better examination scores not only in experimental operational skills (89.27 ± 7.16 vs. 77.51 ± 4.72, p < 0.05 in 2019 grade, 90.31 ± 5.35 vs. 72.87 ± 8.41 in 2020 grade) but also in total examination (83.47 ± 6.16 vs. 68.90 ± 5.86 in 2019 grade, 82.42 ± 5.72 vs. 69.55 ± 7.54 in 2020 grade) than the control group. The results of the questionnaire survey revealed that the students in the test group better achieved classroom goals than those in the control group (all p < 0.05).

CONCLUSIONS

The new student-centred laboratory training program based on case-based learning in clinical biochemistry is an effective and acceptable strategy compared with the conventional training program.

WeChat as a platform for blending problem/case-based learning and paper review methods in undergraduate paediatric orthopaedics internships: a feasibility and effectiveness study

BACKGROUND

Paediatric orthopaedics is a significant and difficult for undergraduate students to master. During the COVID-19 pandemic, we used the WeChat platform to combine the advantages offered by problem-based learning (PBL), case-based learning (CBL) and paper review teaching methods to establish a new blended online teaching model and demonstrated its feasibility and effectiveness.

OBJECTIVE

This study aims to demonstrate the feasibility and effectiveness of a new blended pedagogical method that uses the WeChat platform and combines PBL, CBL and paper review.

METHODS

We enrolled 22 students participating in the Department of Paediatric Orthopaedics. They participated in the WeChat blended pedagogy mode. Their departmental rotation examination scores were compared with those of 23 students who participated in the traditional teaching method. Moreover, an anonymous questionnaire was used to evaluate students' perceptions and experiences.

RESULTS

The total average scores of students who participated in the WeChat blended pedagogy mode and the traditional teaching method were 47.27 and 44.52, respectively. There were no statistically significant differences between the online teaching mode and the traditional teaching method in terms of possessing professional accomplishment, gaining knowledge and promoting interpersonal skills (P = 0.07, P = 0.12 and P = 0.65, respectively). In terms of independent clinical thinking, self-improving capability and improving clinical skills, the scores associated with the WeChat blended pedagogy mode were 8.00, 8.00 and 6.00, whereas those associated with the traditional teaching method were 6.70, 6.87 and 7.48. The overall satisfaction with the WeChat blended pedagogy mode reached 100%. A total of 64%, 86%, 68%, 64% and 59% of students chose very large or large in response to the items concerning professional accomplishment, knowledge absorption, independent clinical thinking skills, English reading and literature exploring capacity, as well as interpersonal skills, respectively. Fifteen participants claimed that the WeChat blended pedagogy mode was less helpful to them with regard to promoting the improvement of their clinical skills. Nine students claimed that the WeChat blended pedagogy mode was time-consuming.

CONCLUSIONS

Our study verified the feasibility and effectiveness of the WeChat blended pedagogy mode for undergraduate paediatric orthopaedics internships.

TRIAL REGISTRATION

Retrospectively registered.

The PEST (Pathology, Epidemiology, Severity, Treatment) approach to optimizing antimicrobial therapy

BACKGROUND

Selecting an empiric antimicrobial regimen can be difficult for early learners and misuse of antibiotics can lead to adverse events and antimicrobial resistance. There have been few interventions that have focused on improving antibiotic decision making, as a form of therapeutic reasoning, for post-graduate trainees. We describe here an approach to aid internal medicine interns in their therapeutic reasoning, particularly when it comes to diagnosing and empirically treating infections.

METHODS

The PEST (pathology, epidemiology, severity, treatment) model was created as a four-step approach to therapeutic reasoning and choosing an appropriate antimicrobial regimen for a given infectious disease syndrome. In February 2020, we conducted two independent teaching sessions for interns on the PEST approach. We assessed pre-and post-teaching responses to five clinical vignette-based questions. Results were presented as a percentage of interns who chose an appropriate antibiotic and provided sufficient therapeutic reasoning as defined by using at least three out of the four PEST criteria. Statistical analysis occurred via Fischer's exact test to determine the level of statistical significance between responses.

RESULTS

Twenty-seven interns participated in the activity. At baseline, several interns had incorporated aspects of the PEST approach in their pre-teaching responses. Ten interns commented on the usefulness of such a systematic approach. While there was no statistically significant difference in antibiotic selection, the teaching session demonstrated a trend towards significance in improving therapeutic reasoning as defined by the PEST strategy.

CONCLUSION

Our results suggested an improvement in using a structured cognitive tool such as the PEST approach to reinforce therapeutic reasoning, but the method did little to improve antibiotic selection. Some interns used select "PEST" concepts prior to the intervention suggesting that the PEST approach may enhance prior knowledge or clinical reasoning skills. Continued incorporation of the PEST approach using a case-based framework may solidify conceptual and practical knowledge of antimicrobial selection. Further studies are needed to assess the impact of such teaching interventions.

Evidence-based teaching in contact lenses education: Teaching and learning strategies

INTRODUCTION

Contact lens (CL) practice is an ever-changing field with clinical knowledge, techniques and equipment continuously evolving. These new developments are backed with clinical trials and research to ensure that practitioners feel confident that there is an evidence base to support these advances. Evidence-based practice is now a crucial part of CL practice, and its importance also filters down to CL education. For example, lectures are one of the most popular tools for an educator but, is standing at the front of a lecture theatre full of students a more effective way of teaching than providing the same material for students to read by themselves? What evidence exists specific to CL education?

METHOD

An expert panel of educators completed a comprehensive literature review of current evidence of teaching methods in CL training, or if not available then what can be learnt from other health care professional training that could be potentially applicable to CL education.

RESULTS

Due to the amount of evidence available in the overall subject area relating to healthcare education, the initial plan of compiling evidence into one narrative review paper was discarded in favour of producing two linked papers. Here, the first paper details definitions of terminology, and also teaching methods. The second paper focuses on assessment and specific clinical training required to attain CL practice competency. In this first paper, no direct evidence of the spreading and benefit of new education strategies evidence such as flipped classrooms, spaced learning, test-enhanced learning, group work, CBL, PBL, TBL, and reflective practice in CL education was found. The only technique that was widely used in the CL field was case reports and the group discussion of them. Nevertheless, the authors found a consensus of opinion from other disciplines that are transferable to CL teaching and could help students meet the intended learning outcomes.

CONCLUSION

There is a small amount of evidence supporting CL education, but most of this seems to be related to the practical element of the training. However, there is a lot of evidence in the field of healthcare education from related disciplines which provides additional but important learning tools that may be effectively implemented in CL education.

"Starting from the Image": A Tele-pathology Pre-graduate Course Aimed at Motivating Medical Students

In the tele-course entitled "Starting from the image", medical students are confronted with practical tasks in relevant professional contexts. Initially, a macroscopic or microscopic image of a patient case is presented to learners who then receive relevant information on the patient's history, clinical findings, and other laboratory tests. A pathologist actively discusses the pathological findings; then, a clinician explains their implications for the patient's individualized treatment and prognosis. In this way, pathology's interaction with other medical specialties is highlighted. Students declared that through these simulated professional practice experiences, they strengthened their decision-making skills. Educators should consider upgrading from information-based teaching to practice-focused instruction.

A Virtual Patient Encounter to Promote Integration in a Preclinical Case-Based Learning Session

In medical education, virtual patients increase the realism of learning in a safe environment. We added an integrated learning event using a virtual patient to integrate patient history taking into a preclinical basic science course. Herein, we describe the process and our overall satisfaction with the virtual patient encounter.

Evidence for commonly used teaching, learning and assessment methods in contact lens clinical skills education

INTRODUCTION

Evidence based practice is now an important part of healthcare education. The aim of this narrative literature review was to determine what evidence exists on the efficacy of commonly used teaching and learning and assessment methods in the realm of contact lens skills education (CLE) in order to provide insights into best practice. A summary of the global regulation and provision of postgraduate learning and continuing professional development in CLE is included.

METHOD

An expert panel of educators was recruited and completed a literature review of current evidence of teaching and learning and assessment methods in healthcare training, with an emphasis on health care, general optometry and CLE.

RESULTS

No direct evidence of benefit of teaching and learning and assessment methods in CLE were found. There was evidence for the benefit of some teaching and learning and assessment methods in other disciplines that could be transferable to CLE and could help students meet the intended learning outcomes. There was evidence that the following teaching and learning methods helped health-care and general optometry students meet the intended learning outcomes; clinical teaching and learning, flipped classrooms, clinical skills videos and clerkships. For assessment these methods were; essays, case presentations, objective structured clinical examinations, self-assessment and formative assessment. There was no evidence that the following teaching and learning methods helped health-care and general optometry students meet the intended learning outcomes; journal clubs and case discussions. Nor was any evidence found for the following assessment methods; multiple-choice questions, oral examinations, objective structured practical examinations, holistic assessment, and summative assessment.

CONCLUSION

Investigation into the efficacy of common teaching and learning and assessment methods in CLE are required and would be beneficial for the entire community of contact lens educators, and other disciplines that wish to adapt this approach of evidence-based teaching.

Embracing the continuity of care experience: A new Australian graduate entry master of midwifery course with a student caseload of 15 women per year

BACKGROUND

Women receiving continuity of midwifery care have increased satisfaction and improved outcomes. Preparation of midwifery students to work in continuity models from the point of graduation may provide an ongoing midwifery workforce that meets rising demand from women for access to such care.

AIM OF THE PAPER

The aim of this paper is to describe an innovative midwifery course based on a continuity model, where students acquire more than 50 % of clinical hours through continuity of care experiences. Additional educational strategies incorporated in the course to enhance the CCE experience within the philosophy of midwifery care, include a virtual maternity centre, case-based learning and the Resources Activities Support Evaluation (RASE) pedagogical model of learning.

DISCUSSION

Australian accredited midwifery courses vary in structure, format and philosophy; this new course provides students with an alternative option of study for those who have a particular interest in continuity of midwifery care.

CONCLUSION

A midwifery course which provides the majority of clinical hours through continuity of care may prepare graduates for employment within midwifery group practice models by demonstrating the benefits of relationship building, improved outcomes and the reality of an on-call lifestyle.

Evaluating an interprofessional pharmacy and dental hygiene case-based learning activity with student reflections

BACKGROUND AND PURPOSE

Interprofessional collaboration between dentistry and pharmacy has great value but is often lacking in didactic and experiential education, particularly in dental hygiene programs.

EDUCATIONAL ACTIVITY AND SETTING

A case-based interprofessional assignment was implemented into the dental hygiene curriculum. Students reflected on their experiences and completed the International Collaborative Competencies Attainment Survey (ICCAS) to assess changes in self-reported interprofessional competencies following the activity.

FINDINGS

Reflections revealed knowledge gain themes, with medication-related oral health concerns most frequent (53), followed by systemic adverse effects of medications (31), impact of systemic health on oral health (21), drug-drug interactions (17), and drug information (2). Additionally, students identified both future plans to collaborate with a pharmacist (25) and application of clinical knowledge gained (25). Scores from the ICCAS increased significantly in most of the domain statements following the interprofessional activity.

DISCUSSION

This interprofessional education (IPE) activity increased student knowledge of the pharmacy profession and provided an experience with interprofessional communication. Students identified the impact of medications on oral health, as well as the value of interprofessional collaboration and communication.

SUMMARY

This IPE activity positively impacted student perceptions of interprofessional collaboration with pharmacists.

Beyond Skin Deep: case-based online modules to teach multidisciplinary care in dermatology among clerkship students

BACKGROUND

Canadian medical schools offer limited clinical dermatology training. In addition, there is a lack of educational resources that are designed specifically for clerkship students that focus on the multidisciplinary nature of dermatology.

OBJECTIVES

After developing case-based educational resources to address the lack of clinical exposure and learning of multidisciplinary care in dermatology, this study aimed to evaluate the educational intervention and gather feedback for future module development.

METHODS

Ten online interactive dermatology case-based modules involving 14 other disciplines were created. Medical students (n = 89) from two Canadian schools were surveyed regarding perceptions of the existing dermatology curriculum. Among 89 students, 46 voluntarily completed the modules, and a survey (a five-point Likert scale ratings) including narrative feedback was provided to determine an improvement in dermatology knowledge and understanding of multidisciplinary care.

RESULTS

Among 89 surveyed students, only 17.1% agreed that their pre-clerkship dermatology education was sufficient and 10.2% felt comfortable managing patients with skin conditions in a clinical setting. Among 46 students, 95.7% of students agreed that the modules fit their learning style (4.17 ± 0.73 on Likert scale) with positive narrative feedback. 91.3% agreed or strongly agreed that the modules enhanced their dermatology knowledge (4.26 ± 0.61). 79.6% of students agreed that the modules helped with understanding the multidisciplinary nature of dermatological cases (3.98 ± 0.81). Student comfort to manage skin conditions increased 7.7 times from 10.2% to 78.3% post-module.

CONCLUSIONS

Clerkship students had limited knowledge of dermatologic conditions; the case-based modules were able to successfully address these deficits and assist students in understanding the multidisciplinary nature of dermatology.

Effect evaluation of case-based learning with situated cognition theory on competence training for student nurses in pediatric surgery

Objective

The case-based learning with situated cognition theory (CBL-SCT) approach focuses on teaching over learning, making it suited to student nurse education. However, it is rare in student nurse training in pediatric surgery, and some subjective evaluations of the learning effect are still affected by the assessor. This study investigated the effect of the CBL-SCT approach on improving the nursing quality/safety and comprehensive performance of student nurses, and explored a method for analyzing the reliability of subjective evaluations.

Methods

Thirty-six student nurses were divided into a control group and an experimental group and received seven days of orientation via conventional and CBL-SCT training, respectively. The learning effect was evaluated via examining their implementation of nursing quality criteria within the following month and their comprehensive clinical performance after six months. Among the evaluation indicators, professional skills, job competency, and professional quality were evaluated by assessors, whose scores were tested for consistency using Cronbach's alpha.

Results

Among the 11 nursing quality criteria, the correct implementation of patient identification and communication (t = 2.257, P = 0.031), medication-checking (t = 5.444, P < 0.001), tumbles/bed-falling prevention (t = 3.609, P = 0.001), pressure injury prevention (t = 3.834, P = 0.001), catheter management (t = 3.409, P = 0.002), and nursing record writing (t = 2.911, P = 0.006) in the experimental group were all higher than in the control group. Six months after training, the experimental group was also higher in professional theory (t = 4.889, P < 0.001), professional skills (t = 2.736, P = 0.010), job competency (t = 5.166, P < 0.001), and professional quality (t = 16.809, P < 0.001). Cronbach's alpha test verified that the assessors' evaluations had good internal consistency and reliability for job competency (alpha = 0.847, 95% CI lower limit = 0.769), professional quality (alpha = 0.840, 95% CI lower limit = 0.759), and professional skills (alpha = 0.888, 95% CI lower limit = 0.822).

Conclusions

The CBL-SCT method can help student nurses quickly change their nursing role, and Cronbach's alpha test can verify the reliability of subjective evaluations, thus indirectly reflecting the training effect equitably and objectively.

Curating a Case Catalog: Development and Implementation of a Process for Revising Small Group Teaching Cases for Pre-clerkship Medical Education

Small group, case-based learning (CBL) is an integral component of many pre-clerkship undergraduate medical education (UME) curricula. We report here an institutional process for curating a catalog of CBL cases utilized in a pre-clerkship curriculum, providing a practical guide for faculty. We describe the structured revision process conducted by a team of foundational and clinical science faculty, which incorporates student and faculty feedback. Revisions take into account core attributes of a case catalog, producing a collection of cases that are more relevant and instructional, realistic, challenging, consistent, current, diverse and inclusive, patient-centered, and mission-centered. Measurable outcomes after implementation of this process include increased focus on primary care as well as humanization and diversification of the case patients.

Student-centered case-based teaching and online-offline case discussion in postgraduate courses of computer science

This study explores a student-centered teaching method in postgraduate courses. Teacher-centered classroom teaching cannot fully stimulate learning initiative and enthusiasm of students. Student-centered means that students actively learn and construct knowledge by participating in teaching activities. This study presents a student-centered online-offline hybrid teaching method, which adopts student-centered case-based teaching and online-offline case discussion in the postgraduate courses of computer science. The latest engineering cases are integrated into teaching and a case library is constructed. Taking the digital image processing course as an example, student-centered teaching allows students to choose what to learn and how to learn. Case-based teaching makes students better understand the application of theory of knowledge. It can introduce multiple perspectives, promote understanding and reflection on problems, and help students develop higher-level thinking, analysis, and synthesis skills. This study explores online-offline case discussion method in the student-centered teaching and proposes the principles of case design of postgraduate courses. Revised Bloom's taxonomy is used for teaching assessment. The actual teaching effect shows that student-centered case-based teaching and online-offline case discussion have achieved better teaching effect.

A smarter perspective: Learning with and from AI-cases

Artificial intelligence (AI) has only partially (or not at all) been integrated into medical education, leading to growing concerns regarding how to train healthcare practitioners to handle the changes brought about by the introduction of AI. Programming lessons and other technical information into healthcare curricula has been proposed as a solution to support healthcare personnel in using AI or other future technology. However, integrating these core elements of computer science knowledge might not meet the observed need that students will benefit from gaining practical experience with AI in the direct application area. Therefore, this paper proposes a dynamic approach to case-based learning that utilizes the scenarios where AI is currently used in clinical practice as examples. This approach will support students' understanding of technical aspects. Case-based learning with AI as an example provides additional benefits: (1) it allows doctors to compare their thought processes to the AI suggestions and critically reflect on the assumptions and biases of AI and clinical practice; (2) it incentivizes doctors to discuss and address ethical issues inherent to technology and those already existing in current clinical practice; (3) it serves as a foundation for fostering interdisciplinary collaboration via discussion of different views between technologists, multidisciplinary experts, and healthcare professionals. The proposed knowledge shift from AI as a technical focus to AI as an example for case-based learning aims to encourage a different perspective on educational needs. Technical education does not need to compete with other essential clinical skills as it could serve as a basis for supporting them, which leads to better medical education and practice, ultimately benefiting patients.

Developing a Flipped Classroom for Clinical Anatomy: Approaches to Pre-class Recordings and a Novel Approach to In-Class Active Learning

For centuries the established pedagogy for teaching in academia has been the lecture, in which an expert in a given subject speaks from a pulpit while a collection of students listens and takes notes. In recent decades, however, advances in technology have allowed educators to rethink the way in which they deliver course content. One approach that has been given attention is that of the flipped classroom, in which lectures are delivered outside of the class through video recording, and the class session is dedicated to more interactive activities. This chapter provides a rationale for this approach to learning, provides guidance in the development of pre-recorded lectures, and introduces a novel approach to the classroom sessions using audience response software.

Efficacy of an Introductory Nail Disorder Learning Module to Supplement the Medical School Curriculum: Experience from One United States Medical School

Introduction

Dermatologic and systemic conditions affecting nails are common, but nail pathology education in medical school curricula is limited. We created and evaluated the efficacy of a case-based module on nail pathologies in a medical student cohort from one well-respected US medical school.

Methods

We developed a module consisting of five cases: melanonychia, onychomycosis, nail psoriasis, Beau's lines/onychomadesis, and apparent leukonychia. Participants completed a pre-module questionnaire prior to completing the module and another questionnaire directly following completion.

Results

Sixty-two clinical medical students completed the pre-module questionnaire, the module, and the post-module questionnaire. 59.68% of participants reported they had evaluated 1-5 patients with nail findings. However, 43.55% of study participants denied receiving any lectures on nail pathologies in their medical education. On average, the module took 13.73 min to complete. Student-reported confidence in both identifying and treating common nail disorders significantly increased from to pre- to post-module responses for both identification (p < 0.001) and treatment (p < 0.001) of common nail pathologies.

Discussion/Conclusion

Nail findings are prevalent in all medical specialties, and improved medical student education on nail pathologies is necessary. Our introductory, case-based module on pathologies is an effective way to improve student confidence in identifying and treating nail disorders.

Video Didactic Preparation Augments Problem-Based Learning for First Year Medical Students

Problem-based learning (PBL) utilizes a self-directed strategy. This process relies on group participation to succeed. Students without a background in biology or medicine can feel overwhelmed by the complexity of the subject matter and unable to participate in the group learning process. We incorporated curated educational videos in the PBL curriculum to help address this situation. First year medical students participated in this study in the form of a typical PBL session. They were then assessed on basic and clinical science knowledge and their learning experience. Student basic science and clinical knowledge were similar between the student groups. However, the students given a list of suggested videos scored higher in their learning experience, perception of feeling prepared, and participating in the group PBL experience than students who were not given the video list. Results from this study indicate that videos can be utilized to enhance the PBL process.

Is there an increase over time in the complexity of teacher questions and student responses in case-based clinical seminars? A cross-sectional video study

BACKGROUND

Case-based group discussions (CBGD) are a specific, interaction-focused format dedicated to fostering medical students' skills in applying basic biomedical knowledge to patient cases. Existing conceptions of CBGD suggest that a gradient towards increased opportunities for students to make elaborative verbal contributions is an important element of such seminars. To verify this assumption, we investigate empirically if clinical teachers progress from more basic, knowledge-oriented questions towards more advanced, elaboration-oriented questions in such seminars.

METHODS

We videotaped 21 different clinical teachers and 398 medical students in 32 CBGD-seminars on surgery and internal medicine. We coded closed-reproductive and open-elaborative teacher questions as well as reproductive and elaborative student responses to these questions. Inter-rater reliability was satisfactory. To determine trends regarding the teacher questions / student responses, we compared eight time-segments of equal duration per seminar.

RESULTS

Overall, clinical teachers asked more closed-reproductive than open-elaborative questions. Students gave more reproductive than elaborative responses. Regarding the frequencies of these forms of teacher questions / student responses, we found no significant differences over time.

CONCLUSIONS

Clinical teachers did not deliberately modify the types of questions over time to push students towards more elaborative responses. We conclude that the critical question to which degree promising teaching approaches are actually put into clinical teaching practice should be raised more purposefully in medical education research.

How Am I Doing in Small Group? Student Perceptions of Feedback in Case-Based Learning Sessions

Introduction

Small group case-based learning (CBL) facilitators are content experts that may provide feedback to students on cognitive reasoning skills and knowledge acquisition. However, student feedback-seeking behavior and response toward faculty feedback in CBL sessions are not known, and it is essential to maximize feedback in this setting where it can be a challenge to observe student performance while groups may have varied emphasis on individual versus team performance. We explored student perceptions of the effectiveness of faculty feedback processes during CBL sessions.

Methods

This qualitative study used semi-structured interviews with ten second year medical students enrolled in the Geisel School of Medicine preclinical neurology course. Investigator triangulation was used with interpretation comparisons that included independent content analysis. The constructed themes were discussed and final theme consensus was reached.

Results

Three major themes arose: (1) students value frequent feedback on their understanding of key clinical case concepts; (2) the CBL learning environment is not conducive to individual feedback; and (3) student feedback-seeking behavior and response are influenced by self-perceived level of preparedness for the sessions and overall comfort with the CBL facilitator and learning environment.

Conclusions

Students value content-based feedback from CBL sessions and need more individualized feedback. The style of the facilitator and overall learning environment can vary widely in the small group setting and has direct impact on feedback opportunities and student feedback-seeking behavior.

Effectiveness of online learning in improving optometry student's reflective abilities

PURPOSE

Optometry education strives to develop competencies required for reflective practice in its pupils. The forced changes in academia during COVID-19 pandemic, rapid switching to online methods imposed serious challenges on the training of reflective skills. We hypothesize that the synchronous online sessions of case-based reflections are effective in imparting training for reflective practice in optometry students.

METHODS

A prospective study was done with planned, synchronous, online, small group workshops for case-based reflections through the second year of optometry program during 'introduction to patient care' course. The reflective competencies were measured with a modified Groningen Reflection Ability Scale (GRAS) at the beginning and towards conclusion. Data was analysed with Mann-Whitney one tail test and qualitative thematic methods.

RESULTS

Total of 104 students participated in the study. The aggregate score showed significant improvement (p<0.05) in students' reflective ability. A rising trend was seen in each component namely self-reflection, empathetic and communication reflections.

DISCUSSIONS

The results demonstrate that the reflective skills can be developed using virtual patient experiences, case-based reflective practices conducted in synchronous small group workshops in online mode. Students perceived it as useful activity in developing themselves as healthcare professionals.

Integrating social determinants into pharmacotherapy courses: A case-based learning approach

BACKGROUND

The recognition of social determinants as major drivers of health outcomes has important implications for health care providers, including pharmacists. It is therefore imperative that providers have the requisite knowledge, skills, and attitudes to adequately address the contributions of social determinants of health (SDOH) alongside the impact of medical care on health and treatment outcomes. Case-based learning is a common practice in pharmacy education. Patient cases used in pharmacotherapy courses typically highlight clinical parameters and quantitative indices, often to the exclusion of sociocultural contexts. In actual practice, pharmacists (and other health care providers) must consider both clinical information and the context of SDOH in order to deliver responsive and effective patient care.

EDUCATIONAL ACTIVITY AND SETTING

The aim of the project was to build patient cases that reflect both aspects. The intent is to use these cases in the core pharmacy curriculum to teach students how to concurrently consider both clinical and social elements in patient care. Eleven pharmacists and educators participated in three work groups to develop 10 cases for pharmacotherapy courses in cardiovascular disease, diabetes management, and mental health. Two of the cases were facilitated with fourth year students on advanced pharmacy practice experiences.

SUMMARY

Feedback from case developers and students highlights features of the cases that lend them to utility in the pharmacy curriculum. The integration of SDOH in patient cases provides opportunity for students to build the relevant competencies that will enable them to provide holistic patient care.

Peer feedback as a medium to facilitate reflective practice among pharmacy students in a case-based learning environment

INTRODUCTION

The ability to reflect is a key element in preparing pharmacy professionals to meet the challenges of a dynamic health care environment. This mixed-methods study explored the pedagogical benefits of peer feedback by designing, developing, and implementing a peer feedback activity to facilitate reflective practice among pharmacy students.

METHODS

Twenty second-year doctor of pharmacy (PharmD) students in a required pharmacotherapy course participated in a systematic peer feedback activity and five of these students volunteered for semi-structured interviews.

RESULTS

No significant correlation was found between perceived effectiveness of peer feedback and students' reflective thinking skills. Qualitative interview data revealed three major themes regarding PharmD students' perception of peer feedback as an instructional strategy to promote reflective practice: (1) the cognitive process of providing feedback, (2) the cognitive process after receiving peer feedback, and (3) perceptions of peer feedback as a tool to exercise reflective practice.

CONCLUSIONS

Although limited in sample size, important lessons were learned on how to design, develop, and implement a peer feedback activity.

AMSER Rad Path Case of the Month: Effect of Case-based Integration of Radiology and Pathology on Medical Student Education and Interdisciplinary Collaboration

RATIONALE AND OBJECTIVES

Radiology and pathology are often underrepresented in undergraduate medical education. The Alliance of Medical Student Educators in Radiology (AMSER) hosts the AMSER Rad Path Case of the Month, an online archive of radiological case reports with pathology correlations submitted by medical students. The purpose of this study is to assess the value of preparing and submitting a case on medical students' educational experience.

MATERIALS AND METHODS

Students who had cases accepted for publication in AMSER Rad Path Case of the Month from July 2018 to December 2019 were contacted by email to request their participation in a voluntary, anonymous 22-question survey. Surveys were sent to 35 students from seven institutions.

RESULTS

Twenty three of the 35 students (65.7%) responded. Only five (21.7%) of respondents reported having previously followed a patient case through radiology and pathology during medical school, defined as interaction with a clinician in each specialty to discuss the case. When asked about their experience with AMSER Rad Path Case of the Month, most agreed or strongly agreed it was a valuable case-based learning experience (100%). Respondents also reported high satisfaction with improved understanding of disease process, increased understanding and ability to collaborate, and increased likelihood of participating in future academic work.

CONCLUSION

AMSER Rad Path Case of the Month is a valuable case-based educational experience that deepens students' understanding of disease processes while affording them an opportunity for interdisciplinary and scholarly collaboration.

Learning beyond a single field of nursing through a virtual case-based approach to pre-registration nurse education

Ensuring that pre-registration student nurses gain the richness of clinical practice to allow them to feel confident and knowledgeable to care for patients of the 21st century is often a challenge. Clinical practice challenges often mean that students will be strategic learners. This article discusses the development of a virtual case-based learning site to provide a rich experience for students to learn.

Comparative study between "case-based learning" and "flipped Classroom" for teaching clinical and applied aspects of physiology in "competency-based UG curriculum"

Background

The new curriculum is competency-based and revised. The student must be imparted and should have learned these competencies. New teaching-learning methods such as "Case-based learning (CBL)" and "Flipped classroom (FCR)" can help medical students to be competent Indian medical graduates.

Aims and Objectives

This study was aimed to evaluate the effectiveness of "CBL" over "FCR" for teaching clinical and applied aspects of physiology.

Materials and Methods

Faculty and residents of the department of physiology and first-year MBBS students were introduced and oriented to the study and concept of CBL and FCR. Students were divided into two groups; one was taught clinical and applied aspects of cardiovascular physiology by CBL and another group by FCR. Pre- and post-test with a validated questionnaire were conducted for both groups. Feedback from the students was collected on 5-point Likert's scale and the marks obtained by them were analyzed statistically by paired t-test.

Results

Both CBL and FCR improved the post-test marks significantly when compared to pre-test marks (P < 0.0001). CBL and FCR methods showed no significant difference, but the mean post-test marks were higher in FCR. As per the students' feedback, 62% of students strongly agreed that CBL is useful for clinical and applied aspects of physiology.

Conclusion

CBL and FCR both are equally important and complementary to each other. CBL was found to be slightly more effective for later days of clinical practices, whereas FCR slightly more effective for better performance in university examinations.

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

BACKGROUND

In 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.

METHOD

A 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.

RESULTS

Students 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.

CONCLUSIONS

Compared to our initial, tutor-led CBL format, cCBL resulted in improved educational outcomes, leading to increased participation, confidence, discussion and higher exam scores.

Improving medical student recruitment into neurosurgery through teaching reform

OBJECTIVE

This study aimed to determine whether a combination of case-based learning (CBL) and problem-based learning (PBL) methods in teaching can improve the academic performance and recruitment of medical students for neurosurgery.

METHODS

Four classes of fourth-year medical students were randomly divided into two groups. The traditional model group received the traditional teaching method, and the CBL-PBL group received the combined teaching methods of CBL and PBL. After the courses, the differences between the two groups in self-perceived competence, satisfaction with the course, post-class test scores, and clinical practice abilities were compared, and the proportions of neurosurgery major selection in pre- and post-curriculum between the two groups were also analyzed.

RESULTS

Self-perceived competence, post-class test scores, and clinical practice abilities in the CBL-PBL group were better than those in the traditional model group. The students in the CBL-PBL group showed a higher degree of satisfaction with the course than those in the traditional model group (χ2 = 12.03, P = 0.007). At the end of the semester, the proportion of students who chose neurosurgery majors in the CBL-PBL group was 13.3%, more than the 3.4% in the traditional model group (χ2 = 3.93, P = 0.048).

CONCLUSION

Compared with the traditional teaching method, the CBL and PBL integrated method is more effective for improving the performance of medical students and enhancing their clinical capabilities in neurosurgery teaching. The CBL-PBL method effectively improved students' interests in neurosurgery, potentially contributing to increasing medical student recruitment into neurosurgery.

Comparison of case-based learning combined with Rain Classroom teaching and traditional method in complete denture course for undergraduate interns

BACKGROUND

Complete denture, as an important restoration method for edentulism, is difficult to study for beginners, especially in linking the theory with clinical practice.

OBJECTIVE

This study was aimed to compare the teaching effects between case-based learning combined with Rain Classroom teaching and traditional lecture method in the clinical course of complete denture prosthesis for undergraduate interns.

METHODS

In a course called "Problems and treatment strategies of complete denture after wearing", interns were divided into two groups: one for traditional lecture-based teaching with PowerPoint slideshow (the control group, n = 28); and the other for case-based learning combined with Rain Classroom teaching, which published information before class, discussed specific clinic cases in class and got real-time interns' feedback via WeChat (the test group, n = 22). Both groups received the same exam and questionnaire survey after class. The Q&A participation of interns in class, theoretical test scores and questionnaire survey responses were used to evaluate the teaching effects. An independent sample t-test and the chi-square test or Fisher's exact test were used for statistical analysis in this study.

RESULTS

The Q&A participation of interns in the test group was much better than that of the control group. The average score on the theoretical test after class in the test group (72.14 ± 12.24) was significantly higher than that in the control group (61.29 ± 20.12) (P < 0.05). In the test group, 94.54% (21/22) of the interns preferred the new teaching mode.

CONCLUSION

Case-based learning combined with Rain Classroom teaching is helpful to enliven the classroom atmosphere, inspire studying enthusiasm, and achieve a good learning effect in both theory and clinical practice related to complete denture prosthesis.

Effect of the BOPPPS model combined with case-based learning versus lecture-based learning on ophthalmology education for five-year paediatric undergraduates in Southwest China

BACKGROUND

To investigate the effect of the bridge-in, objective, preassessment, participatory learning, post assessment, and summary (BOPPPS) model combined with case-based learning (CBL) on ophthalmology teaching for five-year paediatric undergraduates.

METHODS

The effects of the BOPPPS model combined with CBL (BOPPPS-CBL) and traditional lecture-based learning (LBL) on ophthalmology teaching were compared among students in a five-year programme. The questionnaire surveys of the students were collected and statistically analysed after the class. The final examination scores, including on elementary knowledge and case analysis, in the two groups were analysed.

RESULTS

There were no statistically significant differences between the teachers and students in the baseline data. More students agreed that the BOPPPS-CBL model helped develop their problem-solving skills, analytical skills and motivation for learning better than the LBL model. There was no significant difference in learning pressure between the two groups. The final examination scores of the BOPPPS-CBL group were significantly higher than those of the LBL group. The overall course satisfaction of the BOPPPS-CBL group was obviously higher than that of the LBL group.

CONCLUSIONS

The BOPPPS-CBL model is an effective ophthalmology teaching method for five-year paediatric undergraduates.

Lessons learned from a formative study evaluating student pharmacists' experience with a case-based learning "choose your own adventure" activity

BACKGROUND

A case-based learning "Choose Your Own Adventure" (CBL-CYOA) activity was designed to support students in learning to identify drug-related problems and make clinical decisions related to drug therapy management. The purpose of this study was to describe student pharmacists' experiences in order to understand, from their perspective, which design features of the CBL-CYOA activity were valued as useful for developing clinical decision-making skills in an Applied Pharmacy Practice I course. However, several limitations with various features of study design minimized the usefulness of results.

IMPACT

In retrospect, methodological limitations with both the survey and focus group designs negatively impacted the interpretation of results in this study.

RECOMMENDATIONS

Attention to thoughtful survey development with better alignment to the purpose of the study and neutral questions may produce more useful results. Further, additional focus groups and a purposeful sampling strategy may add to increasing the credibility of the findings in this study.

DISCUSSION

Overall, formative studies like this one have the potential to produce insights into how innovative instructional designs operate in real-world contexts. They also have the capacity to output results that provide an evidence base for refining and improving those designs. We hope that our reflections in this paper may be useful to other educators and researchers working to plan similar projects in the future.

Development of an Online Curriculum for Surgeons on the Use of Pelvic Magnetic Resonance Imaging in Rectal Cancer and Results of a Pilot Study

BACKGROUND

High-resolution pelvic magnetic resonance imaging (MRI) is a critical tool in the management of patients with rectal cancer. An on-line curriculum was developed for surgical trainees on the interpretation of pelvic MRI in rectal cancer for clinical staging and surgical planning.

METHODS

The online curriculum was developed using the six-step approach to curriculum development for medical education. The curriculum incorporated case-based learning, annotated videos, and narrated presentations on key aspects of pelvic MRI in rectal cancer. A pilot study was conducted to assess curriculum effectiveness among Complex General Surgical Oncology (CGSO) fellows using pre- and post-intervention assessments.

RESULTS

Of 15 eligible fellows, nine completed the pilot study (60%). The fellows' median confidence score after completing the online curriculum (40, IQR: 33-46) was significantly higher than their baseline median confidence score (23, IQR: 14-30), P = 0.0039. The total practical assessment score significantly increased from a pre-median score of 9 (IQR: 8-11) to a post-median score of 14 (IQR: 13-14), P = 0.0078. A subgroup analysis revealed a significant change in the knowledge assessment with a median score of 7 compared to a baseline median score of 4, Z = 2.64, P = 0.0078. However, the skills assessment showed no significant change.

CONCLUSIONS

The case-based online curriculum had a positive impact on CGSO fellows' knowledge and confidence in the utilization of pelvic MRI for patients with rectal cancer. This unique on-line curriculum demonstrates a mechanism to enhance shared educational collaboration across CGSO fellowships and other surgical training programs.

Application of online case-based learning in the teaching of clinical anesthesia for residents during the COVID-19 epidemic

OBJECTIVE

COVID-19 prevention and control demand a reduction in crowd gathering, which has a significant impact on traditional teaching and offline case-based learning (CBL). In order to mitigate the impact of the COVID-19 outbreak on clinical teaching, we aimed to compare the effects of an online CBL with traditional teaching model on learning outcomes of anesthesia residents.

METHODS

Residents rotated in the Department of Anesthesiology in Beijing Tsinghua Changgung Hospital from January 2020 to February 2021 were included in Group W (n = 19), which implemented the W-CBL teaching model. The performance of residents was evaluated with theory test and 2 survey questionnaires (A and B) were conducted after 1 month of rotating. All 20 residents rotating in the Department of Anesthesiology at our hospital from January 2018 to December 2019 were included in Group C, which implemented the traditional teaching model. Their examination results were acquired through the teaching files and survey questionnaire (A) were administered through WeChat.

RESULTS

During the 1-month rotation, a total of 10 cases were discussed in Group W. The average score for theory test was higher in Group W than that in Group C (84.57 ± 4.87 vs. 79.35 ± 3.70, P = 0.001). The satisfaction rate was also in favor of Group W regarding to clinical thinking, communication skills, learning interest and self-learning ability (P < 0.05).

CONCLUSIONS

Online CBL based on WeChat platform is an effective and acceptable teaching strategy in comparison to lecture-based learning (LBL) among residents embarking on clinical anesthesia courses.

Implementation and justification of a curriculum-wide electronic health record platform

BACKGROUND AND PURPOSE

In order to develop practice-ready pharmacists as mandated by the Accreditation Council for Pharmacy Education Accreditation Standards, exposing students to health information technologies used in clinical practice, like electronic health records (EHRs), is imperative. While the benefits of using EHRs have been described in the literature, limited information or guidance exists on how these tools can incorporate various activities and topics to be implemented throughout an entire curriculum. The purpose of this report is to describe the curriculum-wide implementation of a simulated EHR software, including the novel learning experiences and costs incurred by the college.

EDUCATIONAL ACTIVITY AND SETTING

The EHR was implemented in various courses across the pharmacy school curriculum in the first, second, and third professional years.

FINDINGS

During the final year of implementation, the EHR platform was utilized in each of the three didactic years of the pharmacy program. Twenty-two faculty members created cases using the EHR platform. These cases were used across 16 courses and were accessed by students 7191 times during the implementation process. The cost per use of the EHR platform was approximately half that of the most frequently used electronic learning database used in the program.

SUMMARY

In the three years since its inception, the EHR has been highly utilized as evidenced by the overall number of experiences for students, the variety of experiences, and the number of faculty who used the EHR in their course.