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Student perception of Case Based Learning at a medical school in New York before and during the COVID-19 pandemic
Bhurtyal, K. K. [1]
Kung-Lau, S. [1]
Pino, M. A. [2]

Journal: Journal of Osteopathic Medicine Date: 2024/12, 124(12):Pages: A127-A128. doi: Subito , type of study: retrospective study

Full text    (https://www.degruyter.com/document/doi/10.1515/jom-2024-2000/html)

Keywords:

case-based learning [1]
covid-19 [98]
medical students [587]
osteopathic medicine [1938]
perception [119]
retrospective study [283]
USA [1517]
virtual learning [16]

Abstract:

Context: Many medical schools in the US include case-based learning (CBL) for preclinical students to prepare them for clinical rotations. At the New York Institute of Technology College of Osteopathic Medicine - Long Island Campus (NYITCOM- LI), CBL was switched from an in-person to a virtual platform in spring 2020 due to the COVID-19 pandemic restrictions on mass gathering. Because of the importance of CBL in preclinical education, we evaluated student perception of CBL before and during the pandemic. Objectives: i) To assess perception of CBL among preclinical medical students through a self-reported survey ii) To compare student perception of CBL before and during the COVID-19 pandemic. Methods: This is a retrospective exploratory study of osteopathic medical students in year I (OMS-I) and II (OMS-II) at the NYITCOM-LI campus. All students who attended at least one CBL module from 2019-23 were sent a survey. Each CBL module consisted of a weekly two-hour session delivered over 8 to 12 weeks per semester. Student perception was collected using a Likert-like rating scale with four response categories (satisfied to a large extent, moderate extent, small extent, or not at all). Descriptive statistics were used to summarize student perception of CBL in four domains - case presentation, clinical reasoning, differential diagnosis formation, and overall experience. Using spring 2020 as the reference point for the pandemic restrictions on mass gathering, we aggregated students’ responses into two groups to compare perceptions before and during the COVID-19 pandemic. Results: 12 modules of CBL were delivered from 2019-2023. 1962 out of 2959 students completed the survey (mean response rate = 66.3%). Overall, 1328 (83%) OMS-I and 1472 (92%) OMS-II respondents reported satisfaction to a large or moderate extent in all 4 domains of CBL across all four years from 2019 to 2023. Only less than 1.5% respondents had a strong negative perception (not satisfied at all) in three or more domains. Clinical reasoning (84%) and Formation of differential diagnosis (81%) were rated as skills that improved most among OMS-I and OMS-II students respectively. Students who participated in in-person CBL reported nominally higher satisfaction for case presentation (94.65%) compared to the students who participated in virtual sessions (90.9%). For other domains, the difference in satisfaction rates were less than 2%. The most frequent complaints students had about CBL remained the same between the in-person and virtual groups: cases not aligned to lectures (28% vs 26.6%), inconsistencies in vignettes (18% vs 17%), and vague questions (13% vs 14.3%). 55% of survey respondents who participated in virtual CBL commented that they would prefer in-person sessions, 30% respondents preferred the virtual format, and 15% preferred a combination of in-person and virtual CBL. Overall, 68% respondents stated that CBL would be better for reinforcing already learned concepts rather than introducing new ones. With 2 hours of CBL sessions and several hours of preparation time each week, more than 75% students in the both groups (in-person and virtual CBL) suggested that there should be fewer learning objectives and shorter focused sessions. Conclusion: Overall, students had a positive perception of CBL in both in-person and virtual formats. Almost two-thirds of virtual CBL participants preferred an in-person or a combination of in-person and virtual format. Because CBL requires significant student time and effort, medical schools should explore ways to optimize the delivery of CBL modules. Future studies should investigate the impact of skills learned during CBL on student outcomes during clinical rotations.

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