Taking CBL to the Lecture Hall: a Comparison of Outcomes Between Traditional Small Group CBL and a Novel Large Group Team-Based CBL Teaching Method

Joann M Gold; Ricardo A Collazo; Gagani Athauda; Vivian T Obeso; Rebecca L Toonkel

doi:10.1007/s40670-019-00871-6

Taking CBL to the Lecture Hall: a Comparison of Outcomes Between Traditional Small Group CBL and a Novel Large Group Team-Based CBL Teaching Method

Med Sci Educ. 2019 Dec 2;30(1):227-233. doi: 10.1007/s40670-019-00871-6. eCollection 2020 Mar.

Authors

Joann M Gold¹, Ricardo A Collazo², Gagani Athauda³, Vivian T Obeso⁴, Rebecca L Toonkel⁴

Affiliations

¹ Herbert Wertheim College of Medicine, Florida International University, Miami, FL USA.
² University of Texas Medical School, Houston, TX USA.
³ Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL USA.
⁴ Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street AHC2 472, Miami, FL 33199 USA.

Abstract

Purpose: Case-based learning (CBL), an important component of medical school curricula, is an effective inquiry-based teaching method associated with high levels of student and teacher satisfaction. However, because traditional CBL requires small groups, its feasibility is limited by faculty and resources. We developed and tested a novel team-based CBL (TB-CBL) method to be implemented in the lecture hall.

Methods: All second-year students at our institution (n = 121) were randomized to either traditional small group CBL or TB-CBL during the Endocrine block and to the other modality during the Renal block. All students were exposed to both methods. Case content was identical, and sessions were run concurrently. This cross-over, non-inferiority study tested the hypothesis that no difference in knowledge acquisition, clinical reasoning, or student satisfaction would be detected between groups.

Results: Based on student performance on case-relevant exam questions, no difference in knowledge acquisition was seen between groups for either block (p = 0.62 Endocrine, p = 0.38 Renal). There was also no difference in overall final exam performance between groups (p = 0.56 Endocrine, p = 0.26 Renal). Case-relevant script concordance testing revealed no difference in clinical reasoning skills between groups (p = 0.87 Endocrine, p = 0.17 Renal). Satisfaction was higher for the TB-CBL format (p = 0.005). Cost analysis revealed that each small group CBL session costs $2654, while each TB-CBL session costs approximately $221.

Conclusions: TB-CBL, a novel case-based teaching method, appears to produce similar learner outcomes and higher student satisfaction when compared with small group CBL. TB-CBL may be used to supplement case-based curricula while optimizing resource allocation.

Keywords: Case method teaching; Case-based learning (CBL); Large group case-based teaching; Problem-based learning (PBL); Team-based learning (TBL).