Case-Based Studies and Clinical Reasoning Development: Teaching Opportunities and Pitfalls for First Year Veterinary Students

Cased-based studies (CBS) is defined as a student-centered approach that prepares students for clinical practice using real clinical cases in the pre-clinical curriculum. CBS supports development of students’ clinical reasoning skills, which requires knowledge, understanding and integration of basic sciences and clinical information using a problem-solving approach. Ross University School of Veterinary Medicine (RUSVM) offers CBS I-IV in semesters 2 through 5, respectively. This study compared CBS in developing clinical reasoning skills through assessment and time spent between two cohorts of first year veterinary students. Thirty-one students enrolled in CBS, and 46 students served as the control. All students processed a clinical case and individually submitted three clinical reasoning assignments. A seven-item rubric was used to grade each assignment and these were scored overall using a scale from 0 to 4 with a maximum result of 28. Descriptive statistics for clinical reasoning assignment scores based on the rubric for enrolled students in CBS versus the control cohort were [m = 13.3; SD = 3.8], [m = 14.6; SD = 4.5], respectively. The control cohort had a significantly higher score on the explanation of the diagnosis (p = 0.02). Additionally, time spent for both cohorts resulted in higher scores of specific rubric items of prioritizing patient’s problems (r = 0.27, p = 0.02), identifying differential diagnoses (r = 0.23, p = 0.04) and ranking differential diagnoses (r = 0.23, p = 0.04). Lastly, the total rubric score of both cohorts was significantly associated with the time spent completing assignment 2 (r = 0.22, p = 0.05). Overall, the outcomes for the intervention cohort did not reflect the predicted effectiveness of CBS. Study outcomes reinforced the importance of student engagement that is pivotal in adult learning theory and self-directed learning. © 2018, International Association of Medical Science Educators.