STUDENTS' ATTITUDES AND KNOWLEDGE RESULTING FROM TRADITIONAL CASE-BASED LEARNING

Purpose/Aims  The purpose of this project was to establish baseline data regarding the attitudes of nurse practitioner and physician assistant graduate students toward case-based learning (CBL).  There were two aims: 1) to determine student's attitudes about the existing CBL program, and 2) to identify student's thoughts on the best ways to use CBL in the classroom and testing environments.

Rationale/Background  Case-based learning is a pedagogical method that is frequently used in health professional education.  There is no consensus on how to define CBL and a wide variety of ways that CBL is employed in the classroom.  The Harvard Business School was one of the first institutions to adopt CBL and has a long history of using this method in the classroom, but this has been focused on business cases.   Subsequently, CBL has been increasingly used in healthcare education, although the literature in graduate nursing often focuses on specific skill acquisition and critical thinking skills. The literature on evaluation of CBL indicates that most studies assess student experiences, faculty satisfaction, and knowledge and attitudes of students. The NP/PA program is in the process of developing a novel model of CBL, designed to incorporate social determinants of health into a clinical graduate program. We wanted to evaluate NP/PA students’ attitudes toward their previous experiences with CBL before implementing the the novel model of CBL to establish baseline data and to inform how we implemented the new program.

Approach  We developed a survey that included 30 questions with a Likert scale of 1-5 (strongly disagree to strongly agree) and 5 open ended questions.  Since this was baseline data, we were interested in student's experiences of CBL and whether they thought that CBL enhanced their learning.  We specifically asked whether the existing method of CBL helped them to understand social determinants of health.

Outcomes Achieved  Students rated CBL highly overall. The highest ratings were in supporting problem-solving skills and differential diagnosis, applying knowledge and skills to new situations, identifying areas where they needed to improve knowledge. The lowest rankings were in recognition of how immigration status impacts health, identifying rural health resources, and providing care to patients of diverse cultural backgrounds. Students thought CBL was best used in the classroom versus in simulation and testing.

Conclusions  Students ratings of what they learned best from CBL supports that they gain knowledge on clinical decision making regarding individual patients.  Given the importance of population health and understanding that social determinants of health and health inequities have a huge impact on overall health, educators must find a way to incorporate these issues into CBL in graduate clinical education.