The use and evaluation of case-based collaborative learning to teach basic sciences at HMS

Awardees: Edward Krupat (HMS), David Roberts (HMS), Amy Sullivan (HMS), Richard Schwartzstein (HMS), Jeremy Richards (HMS)

Summary: Awardees plan to implement and evaluate a new instructional method that utilizes pre-class preparation, the case method, collaborative learning, and peer instruction.

Edward Krupat of the Center for Evaluation, and David Roberts, Amy Sullivan, Jeremy Richards, and Richard Schwartzstein, of The Academy at Harvard Medical School, designed a new pedagogical approach, Case-Based Collaborative Learning (CBCL), to teach medical students to think critically, apply the basic sciences, and work in teams. They devised this pedagogy after researching existing methods such as Problem-Based Learning, Case-Based learning, Team-Based Learning, and Peer Instruction, with the goal of incorporating the most relevant features for science education: pre-class preparation; exploration of key case-based issues in groups of 16; self-reflection and individual responses to challenging questions; comparison of responses in groups of 4; and cross group comparison and discussion.

In “Human Physiology,” they assigned 32 first-year HMS student volunteers randomly to two 16-person sections of CBCL, and 32 additional students to four 8-person sections using their traditional Problem-Based Learning (PBL) tutorial model. They video recorded and coded student behavior in addition to collecting measures of student performance and perception.

Overall exam performance in the course did not differ between PBL and CBCL students. However, CBCL students whose prior exam performance had been below the median received significantly higher scores than their below-median PBL peers, suggesting that the new method may be particularly valuable for students who are having academic challenges. Student ratings of their CBCL experience were generally more positive, and video analyses of individual behavior, and individual and group affect provided strong evidence of greater student engagement and positivity in the CBCL small group discussions.

Case-Based Collaborative Learning Word CloudThey also asked students in both groups to state the two adjectives that best described their tutorial experience: twelve percent of the control students described their tutorial using negative terms (e.g., “inefficient,” “frustrating,” “scattered”), but there was only a single negative term (“indecisive”) among the 31 CBCL students who described their tutorial. CBCL students’ most frequently used descriptors for this new method were: “engaging,” “thought-provoking,” and “fun.”

The team concluded that CBCL is a valuable alternative to the traditional HMS tutorial, deserving further exploration and implementation (they plan to extend the model into other courses). Their pilot study, “Assessing the Effectiveness of Case-Based Collaborative Learning via Randomized Controlled Trial,” was published in Academic Medicine in May, 2016.