S. F. McLean1, A. H. Tyroch1, C. Ricci1, A. H. Tyroch1 1Texas Tech University Health Sciences Center At El Paso,Surger,El Paso, TX, USA
Introduction: Case—based learning (CBL)is an inquiry-based learning paradigm requiring some type of inquiry by the student, based on actual or simulated cases, discrete learning objectives, and with mentorship to achieve the objectives. A literature search was completed in order to assess its use in critical care education.
Methods: A literature search was completed using OVID and Pubmed.gov. Key word searches used “Critical Care” and separately Emergency Medicine, Medicine and Surgical Critical Care and “Case-Based” and “learning”. Abstract total was 595. Abstracts were discarded due to not critical care topics, no data, not CBL, no English or Spanish translation. Method of teaching was assessed and categorized based on main teaching method. Chi-square testing was used for categorical variables.
Results: 595 Abstracts were retrieved, out of these 39 articles were kept. Key disciplines were Surgical Specialties (8, 20%), Medicine (26, 67%), and Anesthesia (2, 6%). 5 continents were represented, with North America having 30 papers (77%). Methods of delivery were live (27, 69%) and live plus online (6, 15%), live plus written (4, 10%), online only (2, 5%). Method of teaching was of 9 categories, the most common was simulation plus didactics (10, 26%), then simulation cases only (9, 23%), case-based non-simulation only (5, 12.8%), written materials followed by CBL (4, 10%). 19 (49%) of studies listed CBL as part of the course. Learners were students to post-graduates. Student numbers were 3-413, 14 papers (36%) reporting on practitioners, 25 (64%) were in-training or students.
Primary assessments were categorized into 5 types: written tests, 13 (33%),observed skills clinical exam OSCE), 10 (26%), survey of learners, 6 (15%), review of practice behaviors, 4(10%), review of patient outcomes, 3 (7.7%). Post course learner’s survey was used in 24 (62%), this was the sole course evaluation in 6 (15%).
Learners who were still in training for their specialty had more written tests (13 studies vs. 0 in practitioner level courses) as primary course evaluations, and fewer review of patient outcomes ( 0 in trainees vs. 3 in practitioners), (p=.008). In training studies used OSCE (6) more often than practitioner studies (4).
Conclusion: CBL is used throughout the world to teach critical Care topics to students in training and practitioners. Simulation is the most common way to deliver CBL. Evaluations differ significantly depending on learner education level. .