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Case Based Assessment (CBA): What value does it add to the OB anesthesia resident learning experience?
Abstract Number: 45
Abstract Type: Original Research
Introduction: As residency training time contracts, demands for education outcomes evidence increase. Learning interventions must be purposeful, use pedagogies consistent with goals, and their effects must be assessed (Cooke 2010). This study examines resident perceived educational value and effects of a time-intensive case-based learning activity.
Case Based Assessment (CBA) involves selecting a complex case of one’s own, generating detailed learning objectives, collecting & synthesizing relevant evidence, & 1-hour formal presentation to 2 faculty who interact & probe to assess understanding of case management, relevant concepts, alternatives, “what if’s”, etc. Piloted in 2006, CBA was implemented for OB anesthesia residents in 2009. Two modifications: Fall 2009, individual “pre-CBA meetings” to ensure substantive review case choice & ensure substantive learning points; Spring 2010, switch from “solo” to “group” CBAs (sessions conducted with all 3 residents present). 66 CBAs were conducted from Apr 2009 - Dec 2010.
Methods: E-mail request sent to current residents & graduates (with contact info). Anonymous survey evaluating CBA experience: 11 open-ended questions + demographic data. Survey period: Nov 5 - Dec 15, 2010. Data were analyzed after survey period concluded. Analysis included thematic coding of responses & identifying dominant themes. Analysis was facilitated by qualitative data management software (NVivo9, QRS Internat’l).
Results: Survey completion rate: 26/32 (81%). Respondents cited several important roles of CBA in their 1-month rotation experience (table). Additionally, they described numerous effects related to both breadth & depth of learning (table). Nearly all viewed CBA very favorably. Despite acknowledging the time & effort demands, nearly all viewed it as well worth it (worth ALL the effort…every time!; input=output…the output was tremendous; equivalent to any quality self-guided study session”). Many recommended CBA for other rotations, but several voiced caution about the time commitment.
Discussion: Residents’ responses reflected learning processes that were deep & expansive, deliberate, and meaningful. The attributes they valued included reinforcement of learning, opportunity & space to learn, and a complementary learning approach. Despite acknowledging the extra time/effort demands, they viewed this work very favorably.
Ref: Cooke M, et al. Educating physicians: a call for reform of medical school & residency. Josey-Bass, 2010