Case Based Learning (CBL)
CBL is a trend in most of the medical colleges and especially with the newer colleges. It helps them to market the school. What is CBL? Is it just a trend or better way of teaching? Is it more clinically oriented than having strong basics? These are a few of the questions that crop up for the parents, students and even to the professors.
Follow up:
CBL was first introduced in some of the medical schools like McMaster University in Canada and Kingston University. Later on many universities including Harvard have implemented CBL. Some universities went for hybrid education that combined traditional lectures with case based learning. Few well known universities went one step ahead where students were given option to select the curriculum.
CBL is a student oriented teaching or in other words self directed learning. CBL helps the students to learn independently, to gather relevant information and encourages the students to share their knowledge with their fellow students. It also empowers the students for critical reasoning to arrive at a diagnosis.
Many people involved in medical field ask me whether CBL is a better way of teaching. I have been baffled by this question. Is there any program better than the other? Not really! The most appropriate program is what best suits our students and the infrastructure. If you are recruiting students who are having GPA less than 3 and these students are not self- motivated, of course CBL is going to fail. Definitely in any American medical college or in any other premiere medical college, CBL or hybrid education (traditional teaching plus CBL) is the right approach. So the curriculum committee should be able to decide what is good for that college.
CBL is not standardized. Each college has its own method of teaching.
There are no regular lectures in case based learning or huge class strength. Instead, students are divided into group of 8 to 10. Each group is handled by a tutor. Selection of tutor is very important. He is the one who gels with group, keeping them together, assisting in studies and motivating them.
In most colleges, all the groups will be given a case where in the tutor acts as a patient and the group as a whole will elicit the history, request for the lab works and will arrive at provisional diagnosis. At the end of the session, students will be provided with the questions which arose while case taking and pre-prepared objectives that will be discussed in the following sessions.
Example of hybrid education (traditional teaching plus CBL) structure follows:
Daily 4-6 hours of regular lecture and laboratory plus 2 to 3 hours of CBL sessions
Group Session One
Consists of 2 hours of learning in which students elicit history and come up with a near diagnosis. Lab works and imaging are given on request. Problems evolved in the case will be taken as one of the objectives to the leader. At the end of the session, facilitator gives the prepared objectives to the group.
Group Session Two
Consists of two hours. This session will be 3 days after the group session one. In these 3 days, students work on the objectives and present their topic to the group in the session. The group discusses each objective in length and pin points the deficiency, organizes the material and integrates them.
Group Session Three
Consists of two hours. The students present their objective to the group in presence of the facilitator. The facilitator helps in refining their information and guides the group.
Group Session Four
This is the final session of the case where teachers from all the departments and all the small groups will be present. Only one of the groups will present the topic and the remaining groups will be challenging them. At this point teachers can give the extra information if needed.
These sessions will ultimately lead to a more effective way of instituting CBL as a program. The scheme provides a way of gaining more knowledge, integrating basic concepts with what is observed in the clinic and hopefully can make a good physician out of the student.