Janet Hafler, EdD, Director of the YSM Teaching and Learning Center and Amy Wrzesniewski, PhD, Associate Professor of Organizational Behavior at the Yale School of Management leading a discussion "Facilitating Case Based Discussions".
Cases can be used to enhance a lecture or frame a small group teaching session. Cases can be written in a variety of formats from a short paragraph to a complete write-up. Cases are usually brief stories with one particular focus.
Hafler JP. Case Writing: Case Writer’s Perspectives. In Boud D and Feletti G (eds.). The Challenge of Problem Based Learning, London: Kogan Page, 1991.
Questions to Consider in Designing Small Group Learning Experiences
The Teaching and Learning Center (TLC) can provide support to faculty interested in designing case-based small group learning experiences. Assistance is available in creating and implementing cases, planning teaching exercises, providing feedback through observation and evaluating the outcomes.
Case-based learning can encourage:
- Application of basic science knowledge,
- Linkage of knowledge between the basic and clinical sciences,
- Deeper understanding of content,
- Development of clinical reasoning skills, and
- Development of social intelligence.
Research in medical education suggests that the more medical students work through a variety of case discussions with appropriate feedback, the better their clinical reasoning abilities.
How long should small groups remain together? The longer that students work together within their small groups, the more time they have to achieve goals regarding working in a team and developing cohesiveness and trust. Therefore it would be appropriate for groups to remain together with the same faculty depending on the learning goals. Students in a small group learn group dynamics as well as content, including the important ability to take on different roles in a group setting. Groups need time to form, understand how to identify and move through conflicts to accomplish their goals. Dysfunctional groups usually require intervention from the faculty member. The TLC is available to consult with faculty on effective group formation and how to work through conflicts.
Case-based workshops can have sessions with the facilitator having a range of expertise in the case content.
- “Expert facilitators” have a thorough understanding of the case, with specialized knowledge in the case content.
- “Non-expert facilitators” have a thorough understanding of the case and guide the discussion as needed.
Each type of facilitator has strengths and weaknesses. The literature has reported that sessions run by “expert” facilitators:
- Tend to be more directive.
- Generate fewer student-led discussions,
Non-expert facilitators have been found to elicit more student-student dialogue in small group sessions. The outcomes of studies with advanced medical students as facilitators are mixed and show faculty experts to be superior in encouraging effective learning, or advanced students to be just as effective as faculty. The use of trained tutors who are facilitators and have an in-depth knowledge of the case (such as advanced medical students or faculty) can also be considered.
In general, being explicit to the students about “why” different types of facilitators are guiding workshops will help students understand the underlying rationale behind the teaching methodology.
Albanese MA, Mitchell S. Problem-based learning: A review of the literature on its outcomes and implementation issues. Academic Medicine 1993; 68(1): 52-81.
Papa FJ, Aldrich D, Schumacker RE. The effects of immediate online feedback upon diagnostic performance. Academic Medicine 1999;74S: 16–8.
Thistlethwaite JE, Davies D, Ekeocha S, Kidd JM, MacDougall C, Matthews P, Purkis J, Clay D. The effectiveness of case-based learning in health professional education: A BEME systematic review. Medical Teacher 2012; 34(6): e421-44.
University of New Mexico School of Medicine. Constructing Tutorial Cases. Retrieved from: http://som.unm.edu/omed/_docs-dev/tools_constructing_wkbk.pdf
a. Descriptive Case
- Unfolds over two or three tutorials. (Problem Based Learning) Azer SA, Peterson R, Guerrero APS, Edgren G. Twelve tips for constructing problem-based learning cases.
- In a short story in one session Ferguson KJ. Problem-based learning: let’s not throw the baby out with the bathwater.
Online Web-based Cases
Digital video (YSM Created Videos, YouTube, Vimeo),DVD
Trained actors who assume the role of a patient for the purpose of education, e.g., medical students’ history taking and physical examination skills. Contact Tracie Addy for more information.
Real patients can be incorporated into the curriculum for educational purposes.