Case Based learning at UIWSOM

So, at UIWSOM, the centerpiece of the curriculum is ‘Case Based Learning’ (CBL). Case Based Learning is an off-shoot of Problem Based Learning (PBL). As originally conceptualized, PBL is an adult learning modality that poses contextualized questions that are based on real clinical/non-clinical problems. Where CBL differs from PBL is that CBL allows for some advanced preparation, and the general content of the topic is known by the student. Like PBL, in CBL, the facilitator is NOT the driver of the discovery process. CBL allows the student to engage in the search for and application of knowledge, it promotes collaboration, and allows the student an easy means to assess their knowledge. When I taught undergraduate community health and pathophysiology at Arizona State University-Downtown, I used CBL and my students loved the method as I wasn’t spoon feeding them by reading from a PowerPoint. They were more engaged with the subject matter of the class and their retention of the material was much greater.

At UIWSOM, the process works as such:

On Monday, we receive two cases and as a group, we have about an hour and a half to develop what we call “session objectives” (SO) that are related to the case. While developing the case, we take turns reading each paragraph and then we pause for 30 seconds after the paragraph. Then we discuss what we think are the important points to research from that paragraph and if there is group consensus, that becomes a SO and then we move on. And so it goes until we have completed the two cases. On Wednesday, we meet to review one of the cases and we meet on Friday to discuss the second case. Again, we discuss in a collaborative way and everyone must share. Later on Friday, after 5 PM, the faculty releases the case study and the SO’s that they came up with so that we can compare ours to theirs. The SO’s become the basis of our exams.

Each week, we choose someone to lead the discussion, a scribe, and a timekeeper and we have very strict rules regarding the timing of things. We also have rules regarding the use of technology in the class; essentially, no one is allowed to bring out a computer or iPad. That’s taken me some time to get used to because I hate killing trees. For the last few years, I’ve taken all my notes on my iPad but now, I’ve got to get used to paper and pen. At the conclusion of every week, we get a quiz that tests us on concepts that we should have covered during the case; the quizzes are ungraded and are meant to be a study aid to us. I also forgot to mention that all our quizzes and exams are written, meaning, we get a question, and we write. None of the questions are board-style. To prepare for boards, the school has purchased access to the Kaplan USMLE/COMLEX prep course, and we are to work a minimum of 200 board style questions per course (this is part of the overall course grade). The school has also provided a suggested schedule to help incorporate these board questions into the curriculum. I digress; I’ll talk about this stuff later. Anyway, that is the CBL process. I’m probably leaving out some details and unfortunately, I cannot share any of our cases as they are copywritten by UIWSOM but you get the gist.

I know a lot of medical students who hate CBP/PBL but I personally enjoy it. I am an independent learner and like the ability to learn and study in a way that is best for me. I don’t do well in the rote PowerPoint environment, nor do I do well in a situation where I have to be in class all day long. One thing that may be different with the way that UIWSOM conducts CBL as compared to some schools is that we do have what is called “Large Group Sessions” where, using Socratic methods, we get exactly two hours of lecture/problem solving that is used to assist us with developing a framework of knowledge from which to draw while we work on our cases. DOCS and STRX also support SIGS (the CBL class) with their learning activities so if anything, all aspects of the curriculum across every class supports and reinforces each other.