(e.g. 5th yr Medicine; 2nd yr Nursing)
(with thanks to Peter Stanton and Louise Venter)
OUTLINE OF METHOD
Here you have been given two examples from different schools which follow a similar approach. In both cases the students are presented with a case which they first study on their own. There is pre-reading to do before they meet to discuss the cases in detail.
For the medical case (Thyriod nodule) the students are given a quick pre-test at the beginning of the class discussion to ensure they have gained the required background in anatomy and pathology which will be applied in the following sessions. Stages in the diagnosis and treatment of the condition are clearly laid out, and at the end of the first class session the students are sent away with more information to discover and group tasks to prepare. (Indeed, there may be additional questions eminating from group discussion which need to be answered and these will be allocated to different class groups so all information can be pooled at the time of the next class meeting.) Note that there is an emphasis on role play in this example and that communication skills are highlighted in the objectives.
Case study notes for the nursing case (Musculoskeletal trauma) are not divided into separate work sessions but follow a similar plan. Students complete initial reading before meeting to discuss management options. Additional resources are provided by the lecturer at a group 'workshop', which may include textbooks and interactive media, test results and X-rays, anatomical samples and demonstrations of therapeutic technique where appropriate. Again, students may have more questions to research before the final class meeting where conclusions are discussed.
Note that the nursing case is an adaptation from a published case - a legitimate example of using available resources for case development.
BENEFITS AND LIMITATIONS
What is this method
good for? |
Limitations |
| Makes case the primary problem-solving activity of the week.
Structured to allow individual analysis before groupwork begins giving opportunity for everyone to 'catch up' to baseline knowledge.
Specific questions shape learning and objective attainment.
Students collaborate and discuss in workshops and role play.
Makes for contextual application of theory, which can develop further if scenarios are added in following weeks (e.g. a complication arises in this patient's management). |
Reliant on carefully constructed questions to direct research.
The degree of directive questioning must necessarily vary according to study level of students (questions cannot 'lead' too much at higher levels).
No test on individual achievement/contribution.
Needs room space for workshop activities.
Good facilitation needed at concluding session to ensure appropriate generalisation can be made (i.e. to what degree will methods be appropriate for other patients with similar condition). |
Case example: 'Ms Pitman - Thyroid nodule', 5th yr Medicine (provided by Peter Stanton)
 handout for students
link to Medical Education Unit web page and video of class sessions for this case
Case example: 'Skeletal fracture - Mr Ruskin', 2nd yr Nursing (handout provided by Louise Venter; adapted from JF Giddens (2001) Virtual Excursions for Lewis, Heitkemper & Dirken 'Medical-surgical Nursing: Assessment and management of clinical problems', 5th ed., Mosby-Year Book Inc.)
This model shown as a flow chart
WHAT DOES THE LECTURER THINK OF THIS APPROACH?
From Prof. Peter Stanton, School of Medicine:
| My experience of case based learning as a tutor has been very positive. I have enjoyed planning and running these sessions, especially the opportunities that they provide to deal with areas that are otherwise quite difficult to get into, such as skills and attitude. I have also sensed rather a positive vibe from the students who, I get the impression, also enjoy the release from more didactic teaching sessions.
What I have found to be very challenging is in deciding what type of material is suited to this format. As I’ve gone on with these sessions, I feel more and more that cases are not optimal, and probably not even terribly well suited, to conveying knowledge. I feel that the knowledge component of the cases is better dealt with as a pre-requisite or by parallel self-directed learning, rather than being conveyed within the teaching time itself. I certainly feel that the sessions that involve students giving presentations to each other about the factual material are very stressful for the students presenting and relatively uninformative for those listening. I would therefore repeat, that I think it is better if at all possible to lay out what the knowledge prerequisites are and to have the students read that up before hand. The idea of a pre-test is obviously optimal for trying to encourage them to do this. Having thus freed myself from the need to deliver knowledge content this way I have found it quite stimulating to think up different activities which can try and convey other types of material. Things that I have used include role-plays, debates, production of patient education materials, and quite a lot of group discussion. Using the tasks just referred to as triggers, I found the students become quite involved with the cases and this has led to very stimulating discussions. |
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