Introducing Case Based Learning into an Undergraduate Medical Curriculum

In 2020, a new undergraduate medical curriculum (code-named ‘C25’) will be introduced at Queen’s University Belfast. At the heart of C25 is case-based learning (CBL). CBL is an approach by which students apply their knowledge to answer contextualised questions based on ‘real-life’ scenarios. In their first and second years of study, students will spend each two-week period focusing on a multi-faceted case. The cases will form a scaffolding on which other teaching opportunities (such as lectures, tutorials and practical classes) will hang. Each case will feature a clinical scenario, and students will be prompted to explore the material in an integrated and applied manner.
Several meetings were held with relevant staff members (and a summer studentship medical student) to outline the ethos of CBL. Small group discussions were utilised to generate a large selection of scenarios that could potentially have been used for case development. These cases were then grouped into themes and then evaluated by looking at issues such as the flexibility of the scenario to allow coverage of learning outcomes and the relevance of the scenario to future clinical exposure. 22 cases were chosen for further development. These cases were then expanded with the creation of characters, situations, dialogue and memorable taglines. Lists detailing which learning outcomes could be covered in each case were generated. The end result of this process was the framework for cases which together will cover the majority of the learning outcomes for first and second year.
Cases were circulated to all relevant staff members for comment. It was agreed that one further case should be included for training purposes, but otherwise no major changes were required. Module coordinators are now using the cases to plan the delivery of their curriculum content.
For other institutions contemplating a switch to CBL, we recommend engagement with a wide cross-section of teaching staff from the outset. This helps to ensure that everyone feels a sense of ownership of the cases and should help to ease staff uncertainty during a major change to the undergraduate medical curriculum. We also recommend student involvement in the process.