School of Medicine and Dentistry, Griffith University, Sunshine Coast Health Institute, 6 Doherty St, Birtinya, Qld, 4575, Australia.
School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Qld, 4556, Australia.
BMC Med Educ. 2023 Aug 9;23(1):564. doi: 10.1186/s12909-023-04520-w.
Case-Based Learning (CBL) in medical education is a teaching approach that engages students as learners through active learning in small, collaborative groups to solve cases from clinical patients. Due to the challenges afforded by the COVID-19 pandemic, small group learning such as CBL, transitioned quickly to include technology-enhanced learning to enable distance delivery, with little information on how to apply pedagogical frameworks and use learning theories to design and deliver online content.
To extend understanding of online CBL a scoping review protocol following the PRISMA-ScR framework explored the literature that describes the use of online CBL application in medical education and the outcomes, perceptions, and learning theories. A literature search was conducted in January 2022 followed by a subsequent review in October 2022. After peer review using the PRESS guidelines, the CASP appraisal tool was used to assess the rigor of each study design.
The scoping review identified literature published between 2010 and 2022 (n = 13 articles), on online CBL in the field of medical education with 11 observational studies describing student and facilitator perceptions and two randomized controlled studies. Positive perceptions of online learning included a flexible work-life balance, connection with learners, and improved accessibility. Negative experiences of online CBL included poor internet access, a distracting learning environment, and loss of communication. In the studies that collected student performance data, results showed equivalent or improved outcomes compared to the control. The CASP appraisal tool highlighted the deficiencies in most study designs, lack of framework or learning theory, and poor reproducibility of the methods to answer the research questions.
This scoping review identified literature to describe the academic outcomes, and student and facilitator perceptions of online CBL in medical education. However, the CASP tool uncovered deficiencies in study descriptions and design leading to poor quality evidence in this area. The authors provide recommendations for frameworks and learning theories for the future implementation of online CBL.
基于案例的学习（CBL）在医学教育中是一种教学方法，通过在小型协作小组中进行主动学习，使学生作为学习者参与进来，以解决来自临床患者的案例。由于 COVID-19 大流行带来的挑战，CBL 等小组学习迅速转变为包括增强技术的学习，以实现远程教学，而关于如何应用教学框架和使用学习理论来设计和提供在线内容的信息很少。
为了扩展对在线 CBL 的理解，本研究遵循 PRISMA-ScR 框架制定了一个范围综述方案，探讨了描述医学教育中在线 CBL 应用及其结果、感知和学习理论的文献。2022 年 1 月进行了文献检索，随后于 2022 年 10 月进行了后续综述。在使用 PRESS 指南进行同行评审后，使用 CASP 评估工具评估每项研究设计的严谨性。
该范围综述确定了 2010 年至 2022 年期间发表的文献（n=13 篇），涉及医学教育领域的在线 CBL，其中 11 项观察性研究描述了学生和教师的感知，两项随机对照研究。在线学习的积极感知包括灵活的工作与生活平衡、与学习者的联系以及更好的可及性。在线 CBL 的负面体验包括网络访问不佳、学习环境分散以及沟通中断。在收集学生表现数据的研究中，结果显示与对照组相比，结果相当或有所改善。CASP 评估工具突出了大多数研究设计的缺陷、缺乏框架或学习理论以及回答研究问题的方法的可重复性差。
本范围综述确定了文献，以描述医学教育中在线 CBL 的学术成果以及学生和教师的感知。然而，CASP 工具揭示了研究描述和设计中的缺陷，导致该领域的证据质量较差。作者为未来在线 CBL 的实施提供了框架和学习理论的建议。
