Here are some choices:
1. Guided independent student learning: provide some or all of a case to a student working on his/her own. Students work at their own pace through an online module with activities and tasks, and adjust their process due to feedback received through electronic means. This could include: “high tech” options such as Open Labyrinth software where students make decisions and follow their own diagnostic path (similar to “Choose your own adventure.”). A less complex choice would be offering students feedback on online MCQ’s at different stages in a diagnostic process. Still more basic, the entire case is done on paper, but feedback is provided through faculty written comments, in-class sessions, etc.
Cases may be conducted through blogs and online discussion boards too.
2. Small group learning: students work in class with a tutor or instructor in small groups to proceed through different stages of the task. At each decision point, they commit to a solution after considering all the data together, and receive immediate feedback as the groups debrief from each other and the instructor. A final summary by the instructor allows students to look back and see the process in its entirety. Problem Based Learning (PBL) assumes 1 tutor/group; Team Based Learning (TBL) assumes 1 instructor for many groups,
3. Independent or small group tasks: Some tasks for case solution include providing students with opportunities to organize knowledge. You may want students to fill in a “diagnostic tree” as a task that leads to making a final decision. Other graphic organizers such as Venn Diagrams, or Comparison Tables (T charts) help students compare different entitites. Students may be asked to develop a genetic history, or provide a pathological pathway, describe the mechanism behind a condition or other tasks that link foundational science to presentations. Using “real world” forms such as admission forms, discharge forms, charts, orders, patient plans, referral letters and responses, etc. are helpful tools.
4. Role Play: some parts of a case may come to life if students are given different roles suited to their future professions, or in alternate situations, and asked to solve dilemmas. This may include “secret instructions” to add to the complications and realism. Role playing a patient with frustrations, and challenges will add to learning about the perspective of the patient. A good example is role-playing taking a history with hidden instructions for all.
5. Independent learning after in-class session. Often faculty will provide further cases for students to assess their learning. These may be done in an iterative fashion online, or they may simply be paper cases, with solutions provided after.
6. Linked to lectures and reading tasks: Students solve cases that synthesize the material they have learned immediately after a lecture or reading task. OR Some schools have the “Case of the Week” or the “Case of the Month” which are offered as challenging and complex cases that allow students to synthesize learning from over a period of time and make decisions using that learning.
7. Faculty Modelling: faculty may model the solution of a case as the introduction to case-based learning. This gives students the opportunity to see an expert at work, listening and observing the critical decisions that are made. Some schools have “Stump the Prof” sessions where students present cases so that the clinical instructor can demonstrate her/his thinking process. (Usually done as a “think aloud”)
8. Linked to assessment: Building cases into assessment processes is critical if they are to have meaning for students in the learning.
- Thus, MCQ’s after a case scenario may appear on a mid-term or final examination. Following the diagnostic or management processes that students learned as well as the content links the assessment to the learning.
- Other assessment activities include collecting group (or individual) case reports for feedback (and grading), or assessment of the understanding and recall of key foundational facts (online quizzes, RATs, clicker review).
NOTE: The key to this type of assessment is providing feedback as soon as possible to influence the student learning. Any student activity may be assessed—that is feedback provided—either through instructor debriefing, or written comments. Grading too may become a part of this process, especially after students have had experience.
Author: Sheila Pinchin, Educational Developer, Office of Health Sciences Education (all rights reserved)