Moving Case-Based Learning into the 21st Century

Case-based learning is a pedagogical method that is frequently used in education.  There is no consensus on how to define CBL and there are 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 their focus has been on business cases.  Subsequently, CBL has been increasingly used in healthcare education, although in graduate nursing it 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 nurse practitioner and physician assistant programs at our university are in the process of developing a novel model we are calling Integrative Case Based Learning, designed to incorporate social determinants of health into cases used in our clinical graduate programs. As part of the development process, we explored the faculty's feedback with the development of the expanded cases as well as their goals of how the enhanced case based learning process will enhance student learning. We used a doctoral candidate, skilled in qualitative research but not involved with the clinical programs, to conduct a focus group comprised of the faculty involved in the ICBL process. Faculty were overwhelmingly positive about the ICBL to date, but identified a key issues that would improve the process of developing cases.  Faculty outlined student goals and objectives beyond those associated with the previous case based learning process and described how they will incorporate ICBL into future coursework.  Based on faculty feedback, using cases for enhanced clinical learning, will better prepare advanced practice students for the challenges they will face in practice.