Introduction: Case-based learning (CBL) is a newer modality of teaching healthcare. In order to evaluate how CBL is currently used, a literature search and review was completed.
Methods: A literature search was completed using an OVID© database using PubMed as the data source, 1946-8/1/2015. Key words used were “Case-based learning” and “medical education”, and 360 articles were retrieved. Of these, 70 articles were selected to review for location, human health care related fields of study, number of students, topics, delivery methods, and student level.
Results: All major continents had studies on CBL. Education levels were 64% undergraduate and 34% graduate. Medicine was the most frequently represented field, with articles on nursing, occupational therapy, allied health, child development and dentistry. Mean number of students per study was 214 (7–3105). The top 3 most common methods of delivery were live presentation in 49%, followed by computer or web-based in 20% followed by mixed modalities in 19%. The top 3 outcome evaluations were: survey of participants, knowledge test, and test plus survey, with practice outcomes less frequent. Selected studies were reviewed in greater detail, highlighting advantages and disadvantages of CBL, comparisons to Problem-based learning, variety of fields in healthcare, variety in student experience, curriculum implementation, and finally impact on patient care.
Conclusions: CBL is a teaching tool used in a variety of medical fields using human cases to impart relevance and aid in connecting theory to practice. The impact of CBL can reach from simple knowledge gains to changing patient care outcomes.

https://journals.sagepub.com/doi/pdf/10.4137/JMECD.S20377

Case-Based Learning and its Application in Medical and Health-Care Fields: A Review of Worldwide Literature

In problem-based learning (PBL), implemented worldwide, students learn by discussing professionally relevant problems enhancing application and integration of knowledge, which is assumed to encourage students towards a deep learning approach in which students are intrinsically interested and try to understand what is being studied. This review investigates: (1) the effects of PBL on students’ deep and surface approaches to learning, (2) whether and why these effects do differ across (a) the context of the learning environment (single vs. curriculum wide implementation), and (b) study quality. Studies were searched dealing with PBL and students’ approaches to learning. Twenty-one studies were included. The results indicate that PBL does enhance deep learning with a small positive average effect size of .11 and a positive effect in eleven of the 21 studies. Four studies show a decrease in deep learning and six studies show no effect. PBL does not seem to have an effect on surface learning as indicated by a very small average effect size (.08) and eleven studies showing no increase in the surface approach. Six studies demonstrate a decrease and four an increase in surface learning. It is concluded that PBL does seem to enhance deep learning and has little effect on surface learning, although more longitudinal research using high quality measurement instruments is needed to support this conclusion with stronger evidence. Differences cannot be explained by the study quality but a curriculum wide implementation of PBL has a more positive impact on the deep approach (effect size .18) compared to an implementation within a single course (effect size of −.05). PBL is assumed to enhance active learning and students’ intrinsic motivation, which enhances deep learning. A high perceived workload and assessment that is perceived as not rewarding deep learning are assumed to enhance surface learning.

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Deep and surface learning in problem-based learning: a review of the literature

Buku Learning To Listen, Learning To Teach: The power Of Dialogue in Educating Adults, layaklah sebagai buku wajib bagi mereka yang berkecimpung di bidang pengembangan masyarakat, pekerja sosial, penyuluh pembangunan (pertanian, sosial, hukum, kesehatan, agama, pajak, politik, kebudayaan) baik di instansi pemerintah maupun swasta. Buku ini menunjukkan cara ampuh untuk lebih memahami teknik mendidik orang dewasa yaitu melalui kekuatan dialog dengan 12 prinsip yang menyertainya.

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Learning to Listen, Learning to Teach: The Power Of Dialogue in Educating Adults

The purpose of this study was to explore the effects of case-based learning on communication skills, problem-solving ability, and learning motivation in sophomore nursing students. In this prospective, quasi-experimental study, we compared the pretest and post-test scores of an experimental group and a nonequivalent, nonsynchronized control group. Both groups were selected using convenience sampling, and consisted of students enrolled in a health communication course in the fall semesters of 2011 (control group) and 2012 (experimental group) at a nursing college in Suwon, South Korea. The two courses covered the same material, but in 2011 the course was lecture-based, while in 2012, lectures were replaced by case-based learning comprising five authentic cases of patient-nurse communication. At post-test, the case-based learning group showed significantly greater communication skills, problem-solving ability, and learning motivation than the lecture-based learning group. This finding suggests that case-based learning is an effective learning and teaching method.

Effects of case-based learning on communication skills, problem-solving ability, and learning motivation in nursing students

Medical school mentoring programs incorporate a wide range of objectives. Clinical mentoring programs help to develop students' clinical skills and can increase interest in under-subscribed specialties. Those that focus on teaching professionalism are integrated into medical school curriculums in order to overcome the "hidden curriculum". Positive mentoring plays a part in reversing the decline of academic medicine, by sparking interest through early research experiences. It also has an important role in encouraging recruitment of under-represented minority groups into the medical profession through widening access programs. The aim of our review of the literature, is to analyze current trends in medical student mentoring programs, taking into account their objectives, execution, and evaluation. We outline the challenges encountered, potential benefits, and key future implications for mentees, mentors, and institutions.

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Medical student mentoring programs: current insights.

Melaka Manipal Medical College (Manipal Campus; Manipal, Karnataka, India) conducts the Bachelor of Medicine and Bachelor of Surgery program, for which the admission intakes are during the months of March and September. The present study was undertaken to study the differences in learning approaches to physiology of undergraduate medical students in a partially problem-based learning (PBL)- and non-PBL-oriented curriculum. PBL was introduced as a curricular reform for the September 2006 batch of students (partially PBL group), whereas it was not incorporated for the March 2006 batch of students (non-PBL group). Learning approaches to physiology of both groups of students were compared using the short inventory of approaches to learning. Mean scores for deep and strategic approaches were found to be significantly higher for the partially PBL group compared with the non-PBL group. The results of the present study support the earlier observation that PBL promotes a deep approach to learning.

Learning approaches of undergraduate medical students to physiology in a non-PBL- and partially PBL-oriented curriculum.

Background: Case-based learning (CBL) is an interactive student-centered exploration of real life situations. This paper describes the use of CBL as an educational strategy for promoting active learning in microbiology. Materials and Methods: CBL was introduced in the microbiology curriculum for the second year medical students after an orientation program for faculty and students. After intervention, the average student scores in CBL topics were compared with scores obtained in lecture topics. An attempt was also made to find the effect of CBL on the academic performance. Student and faculty perception on CBL were also recorded. Results: In a cross sectional survey conducted to assess the effectiveness of CBL, students responded that, apart from helping them acquire substantive knowledge in microbiology, CBL sessions enhanced their analytic, collaborative, and communication skills. The block examination scores in CBL topics were significantly higher than those obtained for lecture topics. Faculty rated the process to be highly effective in stimulating student interest and long term retention of microbiology knowledge. The student scores were significantly higher in the group that used CBL, compared to the group that had not used CBL as a learning strategy. Conclusion: Our experience indicated that CBL sessions enhanced active learning in microbiology. More frequent use of CBL sessions would not only help the student gain requisite knowledge in microbiology but also enhance their analytic and communication skills.

Enhancing active learning in microbiology through case based learning: experiences from an Indian medical school.

Assessment is the process by which the teacher and the student gain knowledge about student progress. Assessment systems should aim at evaluating the desired learning outcomes. In Melaka Manipal Medical College, (Manipal Campus), Manipal, India, the TEMM model (consisting of 4 assessment methods: Triple Jump Test, essay incorporating critical thinking questions, Multistation Integrated Practical Examination, and multiple choice questions) was introduced to 30 refresher students in the fourth block of the academic year. At the end of the block, a questionnaire was distributed to ask the students to rank the different assessments in the order of their preference with respect to seven items. Analysis of the results showed that not a single type of assessment was ranked highest for all the seven items, proving the earlier observation that a single assessment does not fulfill all aspects of assessment and that there is a need for an evaluating system with multiple ways of assessment.

Student perspectives of assessment by TEMM model in physiology

Background: Participation in research during undergraduate studies may increase students' interest in research and inculcate research essentials in them. Aims: The purpose of this study was to evaluate the effectiveness of the mentored student project (MSP) program. Settings and Design: In the MSP program, students in groups (n = 3 to 5) undertook a research project, wrote a scholarly report, and presented the work as a poster presentation with the help of a faculty mentor. To begin with, the logic model of the program was developed to identify short-term outcomes of the program on students, mentors, and the institution. A quasi-experimental design was used to measure the outcomes. Materials and Methods: A mixed method evaluation was done using a newly-developed questionnaire to assess the impact of the MSP on students' attitude, a multiple-choice question (MCQs) test to find out the impact on students' knowledge and grading of students' project reports and posters along with a survey to check the impact on skills. Students' satisfaction regarding the program and mentors' perceptions were collected using questionnaires. Evidence for validity was collected for all the instruments used for the evaluation. Statistical Analysis: Non-parametric tests were used to analyze data. Based on the scores, project reports and posters were graded into A (>70% marks), B (60-69% marks), and C (<59% marks) categories. The number of MSPs that resulted in publications, conference presentation and departmental collaborations were taken as impact on the institution. Results: Students' response rate was 91.5%. The students' attitudes regarding research changed positively (P = 0.036) and score in the MCQ test improved (P < 0.001) after undertaking MSP. Majority of project reports and posters were of grade A category. The majority of the items related to skills gained and satisfaction had a median score of 4. The MSPs resulted in inter-departmental and inter-institutional collaborations, 14 publications and 15 conference presentations. An area for improvement noted was to have the MSP implemented in the curriculum without increasing students' overall workload and stress. Conclusion: The study identified strengths and weaknesses of the MSP program. Our model of undergraduate research project may be incorporated in undergraduate medical programs to foster positive attitude and knowledge base about scientific research and to instil research skills among students.

Short-term outcomes of a program developed to inculcate research essentials in undergraduate medical students.

Background Medical school faculty in India are challenged to balance teaching and professional development. Melaka Manipal Medical College (MMMC), Manipal Campus, Manipal University, India offers the Bachelor of Medicine and Bachelor of Surgery (MBBS) program. The institution incorporates certain effective practices based on adult learning principles which are aimed at fostering the professional development of faculty members. Objectives The present study was undertaken to explore the perceptions of faculty members regarding the scope for professional development at Melaka Manipal Medical College, Manipal Campus. Methods In September 2009, a questionnaire comprising items (23) focusing on five adult learning principles (active participation, relevant learning, constructive feedback, safe, non-threatening environment and previous experiences) was designed and faculty members (n=23) were asked to respond to it on a 5-point Likert scale. Additionally, a force field analysis was conducted by asking the faculty to identify three factors which facilitated them to consciously get involved in professional development activities. They were also asked to identify three unfavorable factors that hindered their professional development. Results Among the five characteristics, relevant learning was found to have a high mean score. Frequency analysis of responses revealed that at Melaka Manipal Medical College, there was ample scope for relevant self-learning that fosters professional development (91.3%). Force field response analysis revealed Melaka Manipal Medical College offered considerable flexibility and opportunities for continuing professional development along with faculty members’ prevailing role as teachers. Nevertheless, the need for more research facilities and funds was highlighted. Conclusions Adherence to adult learning principles may provide avenues for professional development in medical schools. An organized attempt to make the medical school faculty aware of the scope of these practices appears to be necessary to nurture professional development in settings where there are resource constraints. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10997 Kathmandu Univ Med J 2012;10(4):60-65

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K Ramnarayan

Papers

Learning approaches of undergraduate medical students to physiology in a non-PBL- and partially PBL-oriented curriculum.

Enhancing active learning in microbiology through case based learning: experiences from an Indian medical school.

Student perspectives of assessment by TEMM model in physiology

Short-term outcomes of a program developed to inculcate research essentials in undergraduate medical students.

Avenues for professional development: faculty perspectives from an Indian medical school.