Evaluation of a case-based computerized learning program (CASUS) for medical students during their clinical years

Background: Clinical undergraduate medical education at the Ludwig-Maximilians University in Munich (LMU) is supplemented by computerized case presentations. This educational strategy teaches problem-solving abilities and differential diagnostic reasoning, thus preparing the students for the management of actual clinical situations with real patients. This study describes the use of a case-based learning system and its acceptance in internal medicine from the students' perspective. Effects of age and gender were taken into account. The results are used for continually improving the system and the offered contents (cases). Methods: By means of qualitative and quantitative methods data on the integrated concept of the students' perceived learning success, their motivation and acceptance were assessed during 1999 to 2002. Connections between the different factors were evaluated and the reasons for not using the learning program were given particular attention. Data were obtained from on-line and printed questionnaires as well as electronic protocols. Results were obtained from 380 fourth year medical students, aged between 20 and 34 years. 47% of all registered students during the academic year 2001/2 were female, but they were 58% of those completing the written questionnaire part of the study. Results: The study showed a good acceptance rate and broad utilization of cases by the students. Case-based learning improved study motivation. Voluntary use of cases increased from 11% in 1999 to 31% in 2002. Male and older students were more motivated than female and younger students. In free comments the students pointed out the close link between this new learning method and real life and the chance of a useful learning experience. Conclusion: Case-based computerized learning programs adapted to concurrent lectures assists in the self-assisted learning. Thus the integration concept contributes to the learning process.