Modified case-based learning as supplement to bedside teaching-why, how and what next?

Jyoti G. Mannari; Punam V. Bhende; Sarmishtha Ghosh

doi:10.18203/2320-6012.ijrms20252387

Authors

Jyoti G. Mannari Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Gujarat, India
Punam V. Bhende Department of Medicine, Pramukhswami Medical College, Bhaikaka University, Gujarat, India
Sarmishtha Ghosh Department of Health Professions Education, Bhaikaka University, Gujarat, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20252387

Keywords:

Case based learning, Clinical competence, CBME, Medical education, Modified CBL

Abstract

Background: Competency based medical education requires the teaching learning methods and assessment to conform to the framework of competencies. The pandemic disrupted medical education; but led to modifications and innovations in teaching methodologies. We adopted modified CBL for third year part 2 students, alongside bedside teaching to explore its efficacy in terms of improving clinical reasoning, group dynamics, summarizing, presentation and to highlight perceptions of students regarding CBL and its adoption as a regular teaching learning activity.

Methods: CBL sessions were taken every afternoon by faculty from department of medicine, trained by department of Health Professions Education; who used real life authentic cases. At the end of each posting, evaluation was planned based on Kirkpatrick hierarchy. Google form, focussed group discussions and content analysis, OSCE stations, bedside case presentation and MCQ based tests were used.

Results: Learning assessment tools showed that CBL enhanced learning. Feedback from students revealed that CBL encouraged discussions and critical thinking and through FGDs they suggested the need for advance topic information, more pre-reading time, blending CBLs with lectures when relevant and selecting specific topics to be taught through CBL.

Conclusions: Our study demonstrates that modifying CBL-based teaching and including it in clinical postings as a substitute/ supplement to bedside teaching during times when there is lack of clinical material is feasible and effective, as shown by the performance of students in the MCQs. It also appeals to the students and the clinical case scenarios mirror real-world situations, enhance learning and facilitate the clearing of concepts.

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References

Alsoufi A, Alsuyihili A, Msherghi A, Elhadi A, Atiyah H, Ashini A, et al. Impact of the COVID-19 pandemic on medical education: Medical students’ knowledge, attitudes and practices regarding electronic learning. PLoS One. 2020;15(11):242905. DOI: https://doi.org/10.1371/journal.pone.0242905

Kivunja C. Do You Want Your Students to Be Job-Ready with 21st Century Skills? Change Pedagogies: A Pedagogical Paradigm Shift from Vygotskyian Social Constructivism to Critical Thinking, Problem Solving and Siemens’ Digital Connectivism. International J High Edu. 2014;3(3):81–91. DOI: https://doi.org/10.5430/ijhe.v3n3p81

Burgess A, Matar E, Roberts C, Haq I, Wynter L, Singer J, et al. Scaffolding medical student knowledge and skills: team-based learning (TBL) and case-based learning (CBL). BMC Med Edu. 2021;21(1):238. DOI: https://doi.org/10.1186/s12909-021-02638-3

Miller GE. The assessment of clinical skills/competence/performance. Acad Med. 1990;65(9):63-7. DOI: https://doi.org/10.1097/00001888-199009000-00045

Heydari MR, Taghva F, Amini M, Delavari S. Using Kirkpatrick’s model to measure the effect of a new teaching and learning methods workshop for health care staff. BMC Res Notes. 2019;12(1):388. DOI: https://doi.org/10.1186/s13104-019-4421-y

Vaca-Cartagena BF, Quishpe-Narváez E, Cartagena Ulloa H, Estévez-Chávez JP. Differences in medical education before, during and in the post-peak period of the COVID-19 pandemic—exploring senior medical students’ attitudes. BMC Med Edu. 2023;23(1):506. DOI: https://doi.org/10.1186/s12909-023-04489-6

Guldner G, Wells J, Ayutyanont N, Iyengar R, Sprenger S, Siegel JT, et al. COVID-19 related disruptions to medical education and perceived clinical capability of new resident physicians: a nationwide study of over 1200 first-year residents. Medical Education Online. 2023;3;4407. DOI: https://doi.org/10.1080/10872981.2022.2143307

Clark E, Freytag J, Hysong SJ, Dang B, Giordano TP, Kulkarni PA. Impact of the COVID-19 Pandemic on Bedside Medical Education: A Mixed-Methods Study. Open Forum Infect Dis. 2021;8(1):574. DOI: https://doi.org/10.1093/ofid/ofab466.1159

Zhang Y, Xu X, Wang F, Tu L, Deng Q, Xu M, et al. The use of bedside case-based learning in the clinical practice of midwifery education in China. BMC Med Educ. 2024;24:1308. DOI: https://doi.org/10.1186/s12909-024-06251-y

Duan Y, Li Z, Wang X, Gao Z, Zhang H. Application of online case-based learning in the teaching of clinical anesthesia for residents during the COVID-19 epidemic. BMC Medical Edu. 2021;21(1):609. DOI: https://doi.org/10.1186/s12909-021-03047-2

Sivanjali M, Arulpragasam AN. Why include Case-based Learning in the medical curriculum? – A review. SE Asian Jnl Med Educ. 2023;17(2):10–3. DOI: https://doi.org/10.4038/seajme.v17i2.555

George T, Carey RonaldAB, Abraham O, Sebastian T, Faith M. Trainee doctors in medicine prefer case-based learning compared to didactic teaching. J Family Med Prim Care. 2020;9(2):580. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1093_19

Sangam MR, Praveen K, Vinay G, Bokan RR, Deka R, Kaur A. Efficacy of case-based learning in anatomy. Cureus. 2021;13(12):76. DOI: https://doi.org/10.7759/cureus.20472

Zinski A, Blackwell KTCPW, Belue FM, Brooks WS. Is lecture dead? A preliminary study of medical students’ evaluation of teaching methods in the preclinical curriculum. Int J Med Edu. 2017;8:326–33. DOI: https://doi.org/10.5116/ijme.59b9.5f40

Nishal A, Patel J, Balvalli R, Yadav PP, Jayani P, Singh R, et al. A comparative study of case-based learning vs. traditional teaching method in pathology in Indian medical graduates. J Med Educ. 2022;21(1):127188. DOI: https://doi.org/10.5812/jme-127188

Shrivastava S, Shrivastava P. Implementing case-based learning in medical colleges in India. Muller Journal of Medical Sciences and Research. 2018;9:98. DOI: https://doi.org/10.4103/mjmsr.mjmsr_18_18

Sartania N, Sneddon S, Boyle JG, McQuarrie E, de Koning HP. Increasing Collaborative Discussion in Case-Based Learning Improves Student Engagement and Knowledge Acquisition. MedSciEduc. 2022;32(5):1055–64. DOI: https://doi.org/10.1007/s40670-022-01614-w

James M, Baptista AMT, Barnabas D, Sadza A, Smith S, Usmani O, et al. Collaborative case-based learning with programmatic team-based assessment: a novel methodology for developing advanced skills in early-years medical students. BMC Medical Edu. 2022;22(1):81. DOI: https://doi.org/10.1186/s12909-022-03111-5

McLean SF. Case-based learning and its application in medical and health-care fields: a review of worldwide literature. J Med Edu Curr Dev. 2016;3:20377. DOI: https://doi.org/10.4137/JMECD.S20377