A traditional veterinary curriculum is composed of 2–3 years of didactic instruction, followed by the application of that knowledge in a clinical setting. Discussions with clinicians have revealed concerns over four particular aspects of student performance:
These concerns can be viewed as symptoms of problems with traditional didactic education. The inability of students to recall information or apply it to patient care is at least partially due to the material being learned out of context. Not providing immediate assessment and remediation leads to flaws in clinical reasoning, while insufficient opportunities to practice communication skills during the didactic portion of the curriculum contributes to students who are not properly prepared to work in a team setting.
We developed Collaborative Case-Based Learning (CCBL), a novel team-based approach for teaching veterinary students.
First, the CET team works with the subject matter expert to develop one or more web-based case studies focusing on the diagnosis and management of a patient. Then relevant media is designed and produced.
Using StepStone, a web application tool created by the CET to assemble case studies, all of these elements are brought together into an intuitive, mobile-friendly HTML5 learning experience.
The utilization of case studies alleviates the issue of students learning the material out of context.
In a classroom setting, students are divided into small groups and are asked to make a series of clinical decisions as they work through each case.
Details of the case are revealed through real-world examples of patient history and signalment, physical exam findings and lab test results.
Contextual material is presented through instructional videos and interactive activities.
Students are expected to work together to reach a single consensus answer for each decision, which improves their communication and negotiation skills. After submitting their answers via online polls, groups are asked by the instructor to present their answers and explain the clinical reasoning process they used to arrive at those decisions.
The correct answers are revealed and a brief discussion follows to ensure uniform understanding. This feedback provides students with the ability to immediately analyze their own clinical reasoning abilities, rather than wait for a summative assessment.
Student surveys show that 97% of students preferred the team-based case study approach to a traditional lecture-based teaching. The vast majority of students (93%) feel that they are more prepared for clinics due to the CCBL approach as compared to a traditional lecture approach, and efforts are now underway to measure long-term retention of the material.
"When we first came up with the idea of developing learning modules for our wellness teaching block, we wanted them to be based on real life primary care cases to help the students incorporate material they learned from both didactic teaching and independent study.
The kitten care module accomplishes these goals with a peer reviewed, user-friendly learning tool that lets the students critically think through a patient case at their pace and receive immediate feedback. Additionally, it highlights where the student may have gaps in knowledge and encourages them to research the subject further. The best part of the module is that there is not always a right or wrong answer, which is true of real life cases.
We foresee that these modules could be used to augment both didactic and clinical training. The reality is that a student will be unlikely to encounter every type of medical case during their senior clinical rotations. Case based interactive modules will allow the student to synthesize patient history and physical exam findings to develop a diagnostic plan and communicate information to the client with feedback on their decision-making skills."
Associate Health Sciences Professor
UC Davis School of Veterinary Medicine
Assistant Clincial Professor
UC Davis School of Veterinary Medicine