Ilana Harwayne-Gidansk,NewYork Presbyterian Hospital/Weill Cornell,New York,NY,TJ Jirasevijinda,Weill Cornell Medical College,New York,NY
Are students learning what educators intend them to learn: A mixed-methods comparative analysis of lessons reported on student case logs from live vs. CLIPP cases.
Experiential learning is an important component of undergraduate medical education. Learning from real patients provides authenticity; however, ensuring a diverse caseload is not always feasible at all clinical sites. Online, virtual cases such as CLIPP have been designed to fill this gap. While online cases are designed to cover core objectives, it is unclear if students learn the intended lessons. Nor is it known if lessons from live encounters align with corresponding CLIPP case objectives.
This study aims to 1) examine lessons learned by students from live and CLIPP cases as compared to stated objectives in corresponding CLIPP cases; 2) explore types and scope of lessons students learn that are not covered by the corresponding CLIPP case objectives.
In addition to submitting an online case log for live encounters and CLIPP cases, students at our institutions were asked to respond to this prompt: List 3 things you learn from this case. Investigators extracted data from the 2010-2012 academic years and examined them for degree of overlap with corresponding CLIPP case objectives. Degree of overlap was examined using frequency analysis. For lessons that did not match the stated objectives, investigators analyzed them using Grounded Theory to identify emerging themes. This pilot study examined four of the 19 required cases: Well Child (Newborn), Fever, Jaundice and Developmental Delay.
Of the 191 medical students rotating through the clerkship during the study period, a mean of 154 or 80.6% (range = 149-160) made complete entries for each of the four cases. Almost all students (mean = 92.9%, range = 90-98.8%) relied on live encounters to satisfy the case log requirement. Students logging CLIPP cases reported lessons that overlap corresponding CLIPP case objectives by a mean of 87.5% (mean = 50-100%); whereas those logging live encounters reported overlap by 33.3% (mean = 0-100%). Ongoing qualitative analysis of lessons from live encounters not overlapping with CLIPP case objectives identified the following preliminary themes: medical knowledge and skills, professional responsibilities, approach to learning, communication, psychosocial dimensions, and system-based issues.
Lessons students reported to have learned from live patient encounters overlapped with only one-third of those stated in corresponding CLIPP cases. Many of these were related to the psychosocial aspects of care and students’ personal growth/professional development. The findings can potentially help educators enhance existing CLIPP cases.