Getting Started with Cases

1. Getting Started with Cases Deborah Allen Steering Committee The Science Case Network deallen@udel.edu ASMCUE: Twenty Years of Vision, Change and Leadership May 16, 2013  Denver, CO

2. Problem-Based Learning & Case Study Method: What’s the Difference? Problem-Based Learning • Student-centered • Small group • Problems before concepts Case Study Method • Instructor-centered • Whole class • Cases as extension, application of concepts The Early Models

3. The Modern Synthesis • It starts with a story….. based on complex, real-world situations • Students work in groups. • Students gain new information through self-directed learning. • Instructors act as facilitators and designers of learning experiences and opportunities. • Learning is active, integrated, cumulative, and connected. Still a difference? Case as application versus case as means to launch new learning?

4. Perceived ‘Problems’with Medical Education Problem-based learning was devised > 30 years ago to address the following perceptions: • Medical students had difficulty transferring basic science knowledge to clinical applications • Expanding knowledge base was leading to ‘information overload’ Solutions: Learn content in context, and learn how to learn

5. Degradative Cycle (Futile Cycle?) Energy and Raw Materials Teachers Teach hot air Students Forget Students Remember waste cellulose midnight oil Students Pass Exam Source: E. J. Wood, Department of Biochemistry & Molecular Biology, University of Leeds, Leeds, UK

6. What Is Case-Based Learning? “The principal idea behind PBL [case-based learning] is not new, indeed it is older than formal education itself. It is that the starting point for learning should be a problem, a query, or a puzzle that the learner wishes to solve.” Boud, D. (1985) PBL in perspective. In “PBL in Education for the Professions,” D. J. Boud (ed); p. 13.

7. Experience It Yourself: ELVIS Meltdown • Using light microscopy, you examine the soil samples and the “goo” from the degraded polyurethane. Will this approach allow you to observe all microorganisms present in the samples? Why or why not? What are the limitations of this approach? • You use phase contrast microscopy to observe a wet mount of a soil sample (the first picture) and a “goo” sample (the second image below) from the ELVIS. In what ways are the potential ET microbes similar to microbes previously characterized on Earth? In what ways are they different? How could you determine whether the microbes present in the soil or goo samples are phylogenetically similar or distant from known microorganisms on Earth?

8. More ELVIS • Part II—Suspicious Minds • Culture methods and reconciling results • Part III—All Shook Up • Choosing the best media • Part IV—A Little Less Conversation • Decision-making - What physical and/or chemical treatments should be required prior to liftoff to minimize the opportunity for contamination by Earth microbes?

9. What Students Do Presentation or formulation of problem Resolution of problem; (How did we do?) Next stage of the problem Integrate new Information; Refine questions Organize ideas and prior knowledge (What do we know?) Reconvene, report on research; Pose questions (What do we need to know?) Research questions; summarize; analyze findings Assign responsibility for questions; discuss resources

10. Medical School Model A good choice for: Motivated, experienced learners? Small seminar classes? Dedicated faculty tutor Groups of 8-10 Very student-centered environment Group discussion is primary class activity

11. Typical Medical School Case: High Degree of Authenticity Patient arrives at hospital, ER, physician’s office presenting with symptoms X, Y, Z What questions should you ask? What tests should you order? Physician interviews patient, receives results of tests Differential diagnosis Preferred therapy

12. The Instructor As Facilitator • Questions/probes the thinking and reasoning process • Guides/directs/intervenes to keep the teams/ on track • Provides information when appropriate • Promotes the use of appropriate resources • Sets high standards for the group • Involves all students in the process • Supports good interpersonal relationships • Serves as a model for giving and receiving feedback

13. A Typical Day in an Undergraduate PBL Course

14. PBL Models for Undergraduate Courses Floating Facilitator Model Small to medium class, one instructor, up to 75 students Peer Facilitator Model Small to large class, one instructor and several peer tutors Large Class Models

15. Floating Facilitator Model Instructor moves from group to group • Asks questions • Directs discussions • Checks understanding Group size: ~4 More structured format: greater degree of instructor input into learning issues and resources

16. Floating Facilitator Model • Class activities besides group discussions: • Groups report out • Whole class discussions • Mini-lectures

17. Instructor roles • Establish learning goals • Create great cases • Keep teams on track • Present information as needed • Evaluate outcomes • Encourage reflective learning and transfer

18. “Hybrid” Case-Based Learning • Non-exclusive use of case-driven learning in a class • May include separate lecture segments or other active-learning components • Floating or peer facilitator models common Often used as entry point into using cases

19. General Chemistry: Course Background First-year students in life sciences, engineering (non-majors): required course 2-4 lecture sections (20 max) MWF 50-minute lecture schedule 5-7 TA-led weekly 3-hr. lab sections (12-16) Four to six groups of 4  1 per section …...Novice, less-motivated learners…….

20. General Chemistry: Course Format Problem-based group work 40% Lecture/whole-class discussion 50% Demonstrations 7% Other (Exam, lab review) 3%

21. How Class Time is Used

22. General Chemistry: PBL Sequence • Problems introduce concepts prior to any discussion in class. • Guiding questions are used to focus learning. • Groups work in class (texts); meet to finish outside before next class meeting. • Group report out via overheads. • Summary sheets prepared from/based on reports • Problem followed by fuller discussion of related issues, connections to earlier work

23. Factors in Choosing a Model • Class size • Intellectual maturity of students • Student motivation • Course learning objectives • Instructor’s preferences • Availability of peer facilitators

24. Effective PBL Cases… • relate to real world, motivate students • require decision-making or judgments • are designed for group-solving • pose questions that encourage discussion • incorporate course content objectives, higher order thinking, other skills

25. But I have to cover content… • Good cases meet content and process learning objectives. • Good cases require learning and applying content. • Cases provide a meaningful context, making concepts more memorable. • Deep understanding is preferable to wide exposure.

26. Assessment of Learning • Written exams, quizzes • Oral exams • Term papers • Reflective journals • Projects • Oral reports • Lab reports • Essays • Group work • Observation • Peer or self-assessments • One-minute papers • Concept maps • Dialogues • Portfolio analyses • Letters • Reflective journals • In general, a shift towards more • opportunities for feedback, • particularly formative

27. Course Transformation: A Balancing Act