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Assessing the Effectiveness of Case-Based Collaborative Learning via Randomized Controlled Trial

Krupat, Edward PhD; Richards, Jeremy B. MD; Sullivan, Amy M. EdD; Fleenor, Thomas J. Jr MEd; Schwartzstein, Richard M. MD

doi: 10.1097/ACM.0000000000001004
Research Reports

Purpose Case-based collaborative learning (CBCL) is a novel small-group approach that borrows from team-based learning principles and incorporates elements of problem-based learning (PBL) and case-based learning. CBCL includes a preclass readiness assurance process and case-based in-class activities in which students respond to focused, open-ended questions individually, discuss their answers in groups of 4, and then reach consensus in larger groups of 16. This study introduces CBCL and assesses its effectiveness in one course at Harvard Medical School.

Method In a 2013 randomized controlled trial, 64 medical and dental student volunteers were assigned randomly to one of four 8-person PBL tutorial groups (control; n = 32) or one of two 16-person CBCL tutorial groups (experimental condition; n = 32) as part of a required first-year physiology course. Outcomes for the PBL and CBCL groups were compared using final exam scores, student responses to a postcourse survey, and behavioral coding of portions of video-recorded class sessions.

Results Overall, the course final exam scores for CBCL and PBL students were not significantly different. However, CBCL students whose mean exam performance in prior courses was below the participant median scored significantly higher than their PBL counterparts on the physiology course final exam. The most common adjectives students used to describe CBCL were “engaging,” “fun,” and “thought-provoking.” Coding of observed behaviors indicated that individual affect was significantly higher in the CBCL groups than in the PBL groups.

Conclusions CBCL is a viable, engaging, active learning method. It may particularly benefit students with lower academic performance.

E. Krupat is director, Center for Evaluation, Harvard Medical School, and associate professor of psychology, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

J.B. Richards is assistant professor, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina. At the time of the study, J.B.R. was assistant professor of medicine, Harvard Medical School, Boston, Massachusetts.

A.M. Sullivan is director for research, The Academy at Harvard Medical School, and assistant professor, Department of Medicine, Harvard Medical School, and director for education research, Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

T.J. Fleenor Jr is project coordinator, Center for Evaluation, Harvard Medical School, Boston, Massachusetts.

R.M. Schwartzstein is Ellen and Melvin Gordon Professor of Medicine and Medical Education and faculty associate dean for medical education, Harvard Medical School, vice president for education, Beth Israel Deaconess Medical Center, and executive director, Carl J. Shapiro Institute for Education and Research, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Funding/Support: The project was supported by a grant from HILT.

Other disclosures: None reported.

Ethical approval: The protocol was deemed exempt by the Harvard Medical School IRB.

Previous presentations: A presentation about CBCL was made at the Innovations in Medical Education Conference, Los Angeles, California, February 21, 2015.

Correspondence should be addressed to Edward Krupat, Harvard Medical School, 384 MEC, 260 Longwood Ave., Boston, MA 02115; telephone: (617) 432-1689; e-mail: ed_krupat@hms.harvard.edu.

© 2016 by the Association of American Medical Colleges