Michael Rowe

Trying to get better at getting better

Abstract for a project I submitted earlier this week for ethics clearance. During 2012 – 2014 we converted one of our modules that runs in the 2nd, 3rd and 4th year levels from a lecture-based format to a case-based learning format. We are now hoping to have a closer look at whether or not the CBL approach led to any changes in teaching and learning behaviours in staff and students.

Case-based learning (CBL) is a teaching method that makes use of clinical narratives to create an authentic learning activity in which students navigate their way through complex patient scenarios. The use of CBL in a health professions undergraduate curriculum attempts to convey a multidimensional representation of the context, participants and reality of a clinical situation, allowing students to explore these concepts in the classroom. While the implementation of CBL has a sound theoretical basis, as well as a strong evidence base for use in health professions education, there are challenges in its effective use that are not easily resolved. However, if it can be shown that the approach leads to changes in teaching and learning practice, which enhance student learning, providing additional resources to resolve the challenges can be more strongly justified. This project therefore aims to determine staff members’ and students’ perceptions of CBL as a teaching method, and to find out how it influenced their teaching and learning behaviours.

This study will make use of a mixed method research design in which the experiences and perceptions of student and staff members are used to determine whether or not there was a change in their teaching and learning practice. Qualitative and quantitative data will be gathered using a survey of all students in the population, focus group discussions of students and in-depth interviews of all staff in the department. The survey will determine if the design of the CBL approach led to a change in what the students did. The focus group discussions will gather data on the nature of the changes and the underlying rationale for those changes. The interviews with lecturers will be conducted in order to delve more deeply into whether or not lecturers’ teaching behaviours changed, and again, to explore the underlying rationale of those changes.

The survey will make use of a self-developed questionnaire that will gather quantitative data using Likert scales and other closed-ended questions. The survey will be sent to all 3rd and 4th year students in the 2015 academic year. The same students will be invited to participate in the focus groups, and the researchers will make use of purposive sampling to allocate volunteers into two focus groups in each year level. All lecturers in the department (n=10) will be invited to participate in the in-depth interviews, including those who were not directly involved in the implementation of CBL. In addition, we will also invite ex-staff members who were involved in the process, as well as postgraduate students who assisted with student facilitation.

Qualitative data will be gathered during the focus groups and interviews. This data will be interpreted via the theoretical frameworks used in the design of the CBL cases. The focus group discussions and interviews will be conducted in English and recorded using a digital audio recorder. The audio files will be sent for verbatim transcription and the anonymised, transcribed documents will then be sent to participants for verification. The transcripts will be analysed thematically, coding the data into categories of emerging themes. Trustworthiness of the analysis will be determined through member checking and peer debriefing and participants will be given the opportunity to comment on whether or not the data was interpreted according to what they meant. The transcribed verbatim draft will be given to colleagues who were not involved in the study for comment.


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