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

Susan F McLean, Susan F McLean

Abstract

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.

Keywords: case-based learning; graduate medical education; medical curriculum; medical education.

Conflict of interest statement

Competing Interests:Author discloses no external Funding sources.

Figures

Figure 1
Figure 1
CBL use worldwide.
Figure 2
Figure 2
Fields of study.
Figure 3
Figure 3
Mode of delivery of CBL.
Figure 4
Figure 4
Method of evaluation.
Figure 5
Figure 5
Differences in CBL and PBL.

References

    1. Knowles M.S., Holton E.F., Swanson R.A. The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development. St. Louis: Elsevier; 2005.
    1. Eisenstein A., Vaisman L., Johnston-Cox H. et al. Integration of basic science and clinical medicine: the innovative approach of the cadaver biopsy project at the Boston University School of Medicine. Acad Med. 2014; 89(1): 50–52.
    1. Thistlewaite J.E., Davies D., Ekeocha S. et al. The effectiveness of case based learning in health professional education. A BEME systematic review. BEME guide number 23. Med Teach. 2012; 34: E421–E444.
    1. Srinivasan M., Wilkes M., Stevenson F., Nguyen T., Slavin S. Comparing problem-based learning with case-based learning: effects of a major curricular shift at two institutions. Acad Med. 2007; 82(1): 74–82.
    1. Frengley R.W., Weller J.M., Torrie J. et al. The effect of a simulation-based intervention on the performance of established critical care unit team. Crit Care Med. 2011; 39(12): 2605–2611.
    1. McLean S.F., Horn K., Tyroch A.H. Case based review questions, review sessions, and call schedule type enhance knowledge gains in a surgical clerkship. J Surg Educ. 2012; 70: 68–75.
    1. Guarner J., Amukele T., Mehari M. et al. Building capacity in laboratory medicine in Africa by increasing physician involvement: a laboratory medicine course for clinicians. Am J Clin Pathol. 2015; 143: 405–411.
    1. Ilgüy M., Ilgüy D., Fişekçğlu E., Oktay I. Comparison of case-based and lecture based learning in dental education using the SOLO taxonomy. J Dent Educ. 2014; 78: 1521–1527.
    1. Braeckman L., Kint L.T., Bekaert M., Cobbaut L., Janssens H. Comparison of two case-based learning conditions with real patients in teaching occupational medicine. Me d Teach. 2014; 36: 340–346.
    1. Mitruka K., Thornton K., Cusick S. et al. Expanding primary care capacity to treat hepatitis C virus infection through an evidence-based care model— Arizona and Utah 2012–2014. MMWR Morb Mortal Wkly Rep. 2014; 63(18): 393–398.
    1. Armor B.L., Bulkely C.F., Truong T., Carter S.M. Assessing Student Pharmacists’ ability to identify drug related problems in patients within a patient centered medical home. Am J Pharm Educ. 2014; 78(1): 1–6. [Article 6].
    1. Arora S., Thornoton K., Komaromy M., Kalishman S., Katzman J., Duhigg D. Demonopolizing medical knowledge. Acad Med. 2014; 89: 30–32.
    1. Gade S., Chari S. Case-based learning in endocrine physiology: an approach toward self-directed learning and the development of soft skills in medical students. Adv Physiol Educ. 2013; 37: 356–360.
    1. Malau-Aduli B.S., Lee A.Y.S., Cooling N., Catchpole M., Jose M., Turner R. Retention of knowledge and perceived relevance of basic sciences in an integrated case-based learning (CBL) curriculum. BMC Med Educ. 2013; 13(139): 1–8.
    1. Du G.F., Shang S.H., Xu X.Y., Chen H.Z., Zhou G. Practising case-based learning in oral medicine for dental students in China. Eur J Dent Educ. 2013; 17: 225–228.
    1. Nadershahi N.A., Bender D., Beck L., Lyon C., Blaseio A. An overview of case-based and problem-based leaning methodologies for dental education. J Dent Educ. 2013; 77(10): 1300–1305.
    1. Baeten M., Dochy F., Struyven K. The effects of different learning environments on students’ motivation for learning and their achievement. Br J Educ Psychol. 2013; 83: 484–501.
    1. William J.H., Huang G.C. How we make nephrology easier to learn: computer-based modules at the point-of-care. Med Teach. 2014; 36: 13–16.
    1. Distlehorst L.H., Dawson E., Robbs R.S., Barrows H.S. Problem-based learning outcomes: the glass half-full. Acad Med. 2005; 80(3): 294–299.
    1. Palter V.N., Orzech N., Reznick R.K., Grantcharov T.P. Validation of a structured training and assessment curriculum for technical skill acquisition in minimally invasive surgery. Ann Surg. 2013; 257(2): 224–230.
    1. Ellman M.S., Schulman-Green D., Blatt L. et al. Using online learning and interactive simulation to teach spiritual and cultural aspects of palliative care to interprofessional students. J Palliat Med. 2012; 15(11): 1240–1247.
    1. Keeve P.L., Gerhards U., Arnold W.A., Zimmer S., Zöllner A. Job requirements compared to dental school education: impact of a case-based learning curriculum. GMS Zeitschrift für Medizinische Ausbildung. 2012; 29(4): 1–14.
    1. Woelber J.P., Hilbert T.S., Ratka-Krüger P. Can easy-to-use software deliver effective e-learning in dental education? A randomized controlled study. Eur J Dent Educ. 2012; 16: 187–192.
    1. Bogoch I.I., Frost D.W., Bridge S. et al. Morning report blog: a web-based tool to enhance case-based learning. Teach Learn Med. 2012; 24(3): 238–241.
    1. Karpa K. Development and implementation of an herbal and natural product elective in undergraduate medical education. BMC Complement Altern Med. 2012; 12(57): 1–10.
    1. Nordquist J., Sundberg K., Johansson L., Sandelin K., Nordenstrom J. Case-based learning in surgery: lessons learned. World J Surg. 2012; 36: 945–955.
    1. Persky A.M. The impact of team-based learning on a foundational pharmacokinetics course. Am J Pharm Edu. 2012; 76(2): 1–10. [Article 31].
    1. Alcota M., Muñoz A., González F.E. Diverse and participative learning methodologies: a remedial teaching intervention for low marks dental students in Chile. J Dent Educ. 2011; 75(10): 1390–1395.
    1. Begley K.J., Coover K.L., Tilleman J.A., Haddad A.M.R., Augustine S.C. Medication therapy management training using case studies and the MirixaPro platform. Am J Pharm Educ. 2011; 75(3): 1–6. [Article 49].
    1. Kourdioukova E.V., Verstraete K.L., Valcke M. The quality and impact of computer supported collaborative learning (CSCL) in radiology case-based learning. Eur J Radiol. 2011; 78: 353–362.
    1. Parmar S.K., Rathinam B.A.D. Introduction of vertical integration and case-based learning in anatomy for undergraduate physical therapy and occupational therapy students. Anat Sci Educ. 2011; 4: 170–173.
    1. Zimmerman S.C., Short G.F.L., Hendrix E.M., Timson B.F. Impact of interdisciplinary learning on critical thinking using case study method in allied health care graduate students. J Allied Health. 2011; 40(1): 15–18.
    1. Wittich C.M., Lopez-Jimenez F., Decker L.K. et al. Measuring faculty reflection on adverse patient events: development and initial validation of a case-based learning system. J Gen Intern Med. 2010; 26(3): 293–298.
    1. Layne K., Nabeebaccus A., Fok H., Lams B., Thomas S., Kinirons M. Modernising morning report: innovation in teaching and learning. Clin Teach. 2010; 7: 77–82.
    1. Marshall L.L., Nykamp D. Active-learning assignments to integrate basic science and clinical course material. Am J Pharm Educ. 2010; 74(7): 1–5. [Article 119].
    1. Ciraj A.M., Vinod P., Ramnarayan K. Enhancing active learning in microbiology through case based learning: experiences from an Indian medical school. Indian J Pathol Microbiol. 2010; 53(4): 729–733.
    1. Telner D., Bujas-Bobanovic M., Chan D. et al. Game-based versus traditional case-based learning: comparing effectiveness in stroke continuing medical education. Can Fam Physician. 2010; 56: e345–e351.
    1. Smith M., Johnson K.M., Seydel L.L., Buckwalter K.C. Depression training for nurses. Res Gerontol Nurs. 2010; 3(3): 162–175.
    1. Dietrich J.E., De Silva N.K., Young A.E. Reliability study for pediatric and adolescent gynecology case-based learning in resident education. J Pediatr Adolesc Gynecol. 2010; 23: 102–106.
    1. O'Connor P.J., Speri-Hillen J.M., Johnson P.E. et al. Simulated physician learning intervention to improve safety and quality of diabetes care: a randomized trial. Diabetes Care. 2009; 32(4): 585–590.
    1. Ryan K., Leonard M., Guerin S., Donnelly S., Conroy M., Meagher D. Validation of the confusion assessment method in the palliative care setting. Palliat Med. 2009; 23: 40–45.
    1. Kulier R., Hadley J., Weinbrenner S. et al. Harmonising evidence-based medicine teaching: a study of the outcome of e-learning in five European countries. BMC Med Educ. 2008; 8(27): 1–10.
    1. Ghosh S., Pandya H.V. Implementation of integrated learning program in neurosciences during first year of traditional medical course: perception of students and faculty. BMC Med Educ. 2008; 8: 44.
    1. Eversmann-Kühne L., Eversmann T., Fischer M.R. Team- and case-based learning to activate participants and enhance knowledge: an evaluation of seminars in Germany. J Contin Educ Health Prof. 2008; 28(3): 165–171.
    1. Dupuis R.E., Persky A.M. Use of case-based learning in a clinical pharmacokinetics course. Am J Pharm Educ. 2008; 72(2): 1–7. [Article 29].
    1. Webb T.P., Duthie E. Geriatrics for surgeons: infusing life into an aging subject. J Surg Educ. 2008; 65(2): 91–94.
    1. Giddens J.F. The Neighborhood: a web-based platform to support conceptual teaching and learning. Nurs Educ Perspect. 2007; 28(5): 251–256.
    1. Landry M.D., Markert R.J., Kahn M.J., Lazarus C.J., Krane N.K. A new approach to bridging content gaps in the clinical curriculum. Med Teach. 2007; 29: e347–e350.
    1. Schwartz L.R., Fernandez R., Kouyoumjian S.R., Jones K.A., Compton S. A randomized comparison trial of case-based learning versus human patient simulation in medical student education. Acad Emerg Med. 2007; 14: 130–137.
    1. Quillen D.A., Cantore W.A. Impact of a 1-day ophthalmology experience on medical students. Ophthalmology. 2006; 113: 2307–2309.
    1. Pearson D., Pandya H. Shared learning in primary care: participant's views of the benefits of this approach. J Interprof Care. 2006; 20(3): 302–313.
    1. Lai C.J., Aagaard E., Brandenburg S., Nadkarni M., Wei H.G., Baron R. Brief report: multiprogram evaluation of reading habits of primary care internal medicine residents on ambulatory rotations. J Gen Intern Med. 2006; 21: 486–489.
    1. Allilson J.J., Kiefe C.I., Wall T. et al. Multicomponent internet continuing medical education to promote chlamydia screening. Am J Prev Med. 2005; 28(3): 285–290.
    1. Hansen W.F., Ferguson K.J., Sipe C.S., Sorosky J. Attitudes of faculty and students toward case-based learning in the third-year obstetrics and gynecology clerkship. Am J Obstet Gynecol. 2005; 192: 644–647.
    1. Shokar G.J., Bulik R.J., Baldwin C.D. Student perspectives on the integration of interactive web-based cases into a family medicine clerkship. Teach Learn Med. 2010; 17(1): 74–79.
    1. Waydhas C., Taeger G., Zettl R., Oberbeck R., Nast-Kolb D. Improved student preparation from implementing active learning sessions and a standardized curriculum in the surgical examination course. Med Teach. 2004; 26(7): 621–624.
    1. Massonetto J.C., Marcellini C., Assis P.S.R., de Toledo S.F. Student responses to the introduction of case-based learning and practical activities into a theoretical obstetrics and gynecology teaching programme. BMC Med Educ. 2004; 4(26): 1–7.
    1. Nackman G.B., Bermann M., Hammond J. Effective use of human simulators in surgical education. J Surg Res. 2003; 115: 214–218.
    1. Revel T., Yussuf H. Taking primary care continuing professional education to rural areas: lessons from the United Arab Emirates. Aust J Rural Health. 2003; 11: 271–276.
    1. Chew F. Distributed radiology clerkship for the core clinical year of medical school. Acad Med. 2002; 77(1): 1162–1163.
    1. Cook D.A., Thompson W.A., Thomas K.G., Thomas M.R., Pankratz V.S. Impact of self-assessment questions and learning styles in web-based learning: a randomized, controlled, crossover trial. Acad Med. 2006; 81(3): 231–238.
    1. Nackman G.B., Sutyak J., Lowery S.F., Rettie C. Predictors of educational outcome: factors impacting performance on a standardized clinical evaluation. J Surg Res. 2002; 106: 314–318.
    1. Li S., Yu B., Yue J. Case-oriented self-learning and review in pharmacology teaching. Am J Med Sci. 2014; 348(1): 52–56.
    1. Balzora S., Wolff M., Wallace T. et al. Assessing the utility of a pocket sized inflammatory bowel disease educational resource designed for gastroenterology fellows. Inflamm Bowel Dis. 2013; 19: S60.
    1. Herdeiro M.T., Ribeiro-Vaz I., Ferreira M., Polonia J., Falcao A., Figueiras A. Workshop-and Telephone-Based interventions to improve adverse drug reaction reporting. A cluster—randomized trial in Portugal. Drug Safety. 2012; 35(8): 655–665.
    1. Lam A.K.Y., Veitch J., Hays R. Resuscitating the teaching of anatomical pathology in undergraduate medical education: web-based innovative clinicopathological cases. Pathology. 2005; 37(5): 360–363.
    1. Rigby H., Schofield S., Mann K., Benstead T. Education research: an exploration of case-based learning in neuroscience grand rounds using the Delphi technique. Neurology. 2012; 79: e19–e26.
    1. Sturdy S. Scientific method for medical practitioners: the case method of teaching pathology in early twentieth-century Edinburgh. Bull Hist Med. 2007; 81(760): 92.
    1. Williams B. Case-based learning: a review of the literature—is there scope for this educational paradigm in prehospital education? Emerg Med. 2005; 22: 577–581.
    1. Donner R.S., Bickley H. Problem-based learning in American medical education: an overview. Bull Med Libr Assoc. 1993; 81(3): 294–298.
    1. Berkson L. Problem-based learning: have the expectations been met? Acad Med. 1993; 68(10): 579–588.
    1. Kirkpatrick D. Great ideas revisited: revisiting Kirkpatrick's Four-Level Model. Train Dev. 1996; 50(1): 54–59.
    1. Biggs J.B., Collis K.F. Evaluating the Quality of Learning: the SOLO Taxonomy (Structure of Observed Learning Outcome). New York, NY: Academic Press; 1982.
    1. The American College of Surgeons Committee on Trauma; Rotondo, MF, Peterson N. Advance Trauma Life Support Student Manual. 9th ed., American College of Surgeons; 2012.
    1. American College of Surgeons. Surgical Education and Self Assessment Program 15, American College of Surgeons; 2013.
    1. Vansteenkistes M., Sierrens E., Soenens B., Luyckx K., Lens W. Motivational profiles from a self-determination perspective: the quality of motivation matters. J Educ Psychol. 2009; 101(3): 671–688.

Source: PubMed

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