Case Based Learning
What is CBL?
CBL is a student focussed approach to small group teaching. CBL fosters ‘active learning’, which is proven to enhance retention of knowledge and understanding. This is achieved through:
- Student self-study of case scenarios that are written to prompt consideration of the underlying medical science, related to disease states (and, from Y3, the therapeutics and management of these conditions) onwards
- Group-based exploration of key questions related to the scenario
- Expert facilitator led discussion of the key learning points
Why do we use CBL?
Our course also delivers a considerable amount of didactic learning (e.g. there are over 680 lectures in Yrs 1-3). However, because the cohort size is 300+, such teaching is limited in its capacity to be interactive and therefore to draw on the benefits of ‘active learning’. CBL complements the lecture programme by enabling this through carefully prompted self-exploration of the lecture content, and the ability to identify and address knowledge gaps in a group setting. It enables both a greater depth of understanding and the consolidation of topics covered in lectures.
CBL also encourages students to make full use of the other resources available to them through the library, internet and their peer group and to develop their communication and presentation skills.
Students value working in small groups, the contact with expert clinicians and the sense of why it is important to learn the medical science, as a background to later practice.
How is CBL different from PBL (problem-based learning)?
The content is more orientated to the rest of the taught content
Both CBL and PBL blend student self-exploration of topics with group discussion. However, CBL uses cases specifically chosen to explore in more depth some elements of the lecture materials they have met.
The facilitators are personally skilled in the topics being taught
PBL facilitation does not require expert comment or contribution to the knowledge shared and discussion of points, instead prompting students to find this knowledge themselves. Facilitators are skilled in the art of facilitation but do not need to be personally skilled in the topic area. In contrast, CBL facilitators are encouraged to prompt student discussion but also to serve as a source of expert information when necessary. In 2014, we changed to a CBL approach as we believe it is important that the facilitation of our students’ discussion is based on this strong foundation of experience in medicine and medical science and the ability to address additional questions that may arise, by drawing on this experience.
How does this work in practice?
To support the knowledge transfer of lectures, CBL gives the student ‘real’ case histories that take them beyond their taught material. Prepared CBL questions stimulate their reading to solve the types of clinical problems that they will encounter on wards & in clinics in the future.
Ahead of the teaching session, students have access to the case and a power-point presentation explaining key knowledge related to the scenario.
Sample scenario: “Joe Clarke, age 56 has been a lifelong smoker. He tells his doctor that he has become increasingly short of breath with episodes of wheezing and sometimes a productive cough.”
They can use these and other resources to prepare what their answers to the pre-set structured case questions would be.
The students meet in small groups of 6-8, initially without a facilitator, to discuss their shared answers to the questions.
The groups are then merged into much larger groups, chaired by CBL facilitators, who enable the students to explore their answers in greater depth and provides guidance in respect of any queries or clarification needed. A group session lasting two hours will explore 2 or 3 cases and allow the students to present their answers, to the structured questions and in so doing also improve their communication and presentation skills.
The cases and their questions are not intended to extend the syllabus, but rather in Yr 1 they consolidate their understanding of core medical science topics such as anatomy and physiology e.g.
- Where is breathing controlled from in the brain?
- What are the sensory inputs that control breathing?
- What is the physiological basis of wheezy breathing?
As students move to year 2, where pathophysiology & diseases are introduced, the cases and questions develop e.g.
- What is the relevance of sputum culture & Gram staining?
- How can you differentiate between an obstructive & restrictive lung condition?
- What is the genetic component of emphysema?
Who leads a CBL?
Recognising the emphasis on the Science of Medicine in the earlier years, each facilitated session for Years 1 & 2 pairs a scientist facilitator with a clinician facilitator.
What is involved in facilitating a CBL Session as a clinician?
Our students especially value your clinical experience. During the CBL session you will ask students to present their findings, encouraging discussion of principles and stimulating students to explore topics and situations that bring the cases to life. In so doing, you will help them to appreciate the clinical relevance of the science they are learning.
The emphasis is on facilitating consolidation of the key knowledge related to the topic, rather than on the provision of additional direct teaching. Your role will be to act as an experienced guide, through the material covered by the scenario, rather than to provide a new teaching session or introduce a lot of new material.
Each session is a stand-alone 2 hour event, rather than a regular commitment.
How am I supported as a CBL facilitator?
- You are provided with model answers to the questions.
- You can have contact with the System Lead for the CBL content, to explain the purpose and context for the CBL.
- We will be developing training and a facilitator guide for that CBL module.
- You can have access to the lecture content that has preceded the CBL.
- We can arrange to gather feedback about your teaching
- If you are not on the School of Medicine staff, car parking can be booked, if necessary (on a first-come first served basis).
Why should I take part?
- It is fun! Working with our students is stimulating and rewarding. It can also provide evidence of teaching activity for your appraisal portfolio and support acquisition of Honorary Status.
- Both students & clinicians need each other's engagement to produce excellent doctors for the next generation. We would really appreciate you being part of the team.
To find out more about & register your interest in becoming a CBL facilitator, please contact: Year2Mbchb@liverpool.ac.uk
