As you may already know I have just completed year 1 at Cardiff University Medical school, and the curriculum here follows a case based learning (CBL) approach from January of year 1, and for anyone who is interested it is an integrated CBL style course with a systems based approach.
Just as a side note, Term 1 at Cardiff goes by the name of platform for clinical sciences and this is delivered in a lecture based traditional format, so I will be doing a separate post on what it is like to follow a lecture based curriculum for those interested in medical schools which follow that method.
This blog post is going to be a complete run down of what its like to follow a CBL course structure, and I will address many aspects which I feel applicants often ask questions on or feel daunted by when starting the course or looking to apply.
What is CBL?
I have already addressed this topic in a previous blog post but this was on more general terms, instead here I will be describing the CBL style course I have personally witnessed at Cardiff medical school.
Case based learning at Cardiff university runs on a 2 week timetable and follows a given clinical case on one of the body systems. The case itself is split into two parts over the two weeks, the first part often addresses a patients complaint to the GP and the second part shows a development of the patients condition as part of the case. For example the first weeks case may see an middle aged gentleman who is suffering with chest pain, and this could escalate the following week to the gentleman being rushed into A&E with a heart attack. The aim of CBL is to discuss in a small group (10 people) the case, devise learning outcomes and brainstorm ideas to learn about the anatomy, physiology, pathology, histology, sociology and psychology linked to the case in question, and be able to apply this to our practice during placements.
As you can see above, there is a clear outline of what CBL entails (this is specific to Cardiff but I’ve heart it is similar at a lot of universities, and even similar to some PBL courses).
What is case group like as a learning environment?
At my university case groups comprise of 10 students and one academic staff member who is named the facilitator. During each CBL session (we have 3 over the 2 weeks), one person of the 10 will be a chair to keep the session organised and one person will scribe everything that we are discussing. The facilitators role is to keep us on track, prevent us from going on tangents and point out some useful topics of discussion if we are struggling, their main aim is to ensure our learning outcomes cover all the learning points we are supposed to cover during this case, so they do guide us when needed (i think this is where CBL differs from PBL).
For me case group was a brilliant environment to learn in, it allowed us a great safe and supportive place to share our ideas, and it allowed people who did not particularly understand one topic or learning outcome to listen to the findings from others who did, hence sharing ideas really does add to your knowledge and means your very unlikely to miss something important.
The cons for me of case group were the lack of formality, this meant that often people showed up without completing the learning outcomes and this meant some individuals in the group were not pulling their weight and piggybacking if you will off the hard work of others. Also if your not a particularly confident person case group can put you in the spotlight which may be slightly uncomfortable until your used to it.
Overall for me it is a great way to learn, and a very supportive and encouraging environment.
How do you cope with the large amount of self directed learning?
Coming from A-levels where all the information needed to pass the exams was handed to me on a plate, CBL was initially incredibly daunting. I remember leaving the first case group session with a load of learning outcomes and thinking “how am I ever going to find the answers to these on my own”, but trust me when I say its really not like that at all!
I found that the lecture material and lab material which we undertook during the 2 week case answered a lot of my learning outcomes without the need for extra reading in great amounts. Yes there were learning outcomes which weren’t covered at all by timetabled teaching, but I did in the end enjoy going to the library or back to my room and opening up my textbook to find the answers. I am a very motivated studier and this probably helped me as I enjoyed the self-directed aspect of CBL a lot more than I expected I would. SD learning is a key skill to have in medicine, and something which you will rely on heavily during the clinical years, so CBL was a great asset for me.
The main struggle is the transition to this style of learning, but over time if you work at it you will perfect the method best for you. Its also about studying smart, not every learning outcome developed by your group will be important, so make sure you spend less time on those.
For me the one big plus at Cardiff was that we received learning outcomes at the end of the 2 weeks, so even if I missed something out I could use the weekend between cases to fill in the blanks and work out what is important and what is less so.
What is integrated clinical placements like during pre-clinical years?
anyone attending a medical school with an integrated curriculum will know placements are a staple in years 1 and 2. At Cardiff we did 1 full day (8-5) of placement with half a day spent seeing real patients in the community/GP clinics who have the same issues as discussed in the case, and the other half spent learning the relevant clinical skills needed to practice on the wards in clinical years (as well as pass the ISCE and OSCE examinations).
I found clinical placements linked very well to the case, and allowed me to develop my clinical knowledge and patient communication early on. It was also really great to see the clinical issues we are learning about on real patients and to develop the key evidence based approach to medicine. I would definetly recommend any medical school with early clinical contact.
- Do you ever feel like you are having to teach yourself?
No not at all, yes self directed learning means sitting down with a textbook and learning the relevant information, but if I am ever stuck I can ask my facilitator, email a lecturer or ask any of the academics overseeing my course to point me in the right direction. Also a lot of our learning outcomes are addressed in timetabled teaching, it really isn’t as self-directed as many people think.
- Do you feel unprepared for exams?
The short answer is no, if you put the work in during the CBL sessions and in your own revision time, you will be able to learn all the relevant information needed for the exams, especially considering we have learning outcomes to follow. Yes there is a lot of content in the course, so its practically impossible to know every last detail like at A2 level, but if you revise smart you will walk into the exams feeling prepared.
Above is my experience with Cardiff’s CBL style course, and hopefully is an insight into anyone who is looking at studying a course with a similar structure. I am so glad I chose this course style because it really does work for me!