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  • Writer's pictureEllie Bates

Overcoming the Challenges of Implementing Case-Based Learning in Healthcare Education


Gif with women giving a lecture entitled case based learning

In healthcare, professionals are faced with complex and unpredictable problems that require critical thinking and problem-solving skills. These "messy problems" can be difficult to replicate in an e-learning environment, making it a challenge for e-learning designers and technologists to create designs and technologies that support the development of these skills.


Case-based learning (CBL) is a teaching method that has a strong history in healthcare education and uses real-world scenarios to provide context for learning new knowledge and skills (Sturdy, 2007). At EL Learning Design, we believe that encountering the complexities of real-world problems is crucial for healthcare professionals who must be able to apply their learning to these problems. Our approach often involves combining case-based learning with other methods to create dynamic learning experiences that engage and motivate healthcare professionals. By starting with a real-life case early in the learning design, learners can immediately see how their new knowledge and skills can be applied in their work.


Despite its effectiveness, implementing case-based learning (CBL) into continuing education courses can present various challenges, including coordinating with subject-matter experts, budget limitations, strict timelines, and technological limitations. In this blog, we'll delve into these challenges and offer strategies to overcome them.


Working with Subject Matter Experts


Healthcare professionals and educators may have experience in writing case-studies, but creating them for e-learning may be a new challenge, especially if the aim is to incorporate branching narratives, interactive videos, and other learning types such as discussion and collaboration. Efficient collaboration between learning designers and subject-matter experts is key, as experts' time is often limited. To streamline the process, it is recommended to share the overall learning design and co-develop learning outcomes before writing the case-studies, and to use templates to ensure all necessary information is included.


To minimise the use of subject-matter experts' time, tasks such as writing video scripts, alternative outcomes, and prompt questions should be kept to a minimum. Instead, a robust quality assurance process should be in place to allow the subject-matter expert to review the characterisation of the learning. To maximise their input, it is important to agree on the amount of time available for their involvement in advance, so that the best decisions can be made about where their expertise will have the greatest impact.



Budget Limitations and Strict Timelines


Screen shot of interactive case study with text and graphics
Screen shot from: Assessment and Diagnosis of Dementia: A personalised approach 2021

Developing an elaborate interactive case-study game filled with animations and professionally produced videos is often not feasible within budget constraints and project timelines. However, this doesn't mean that learning designers and commissioners should limit their aspirations. The key to creating a successful case-study is to prioritise the learning objectives. In some cases, a written case-study may be adequate and focusing more on facilitating reflective learning may be the best approach. Alternatively, a deep understanding of the complexities and different perspectives involved in the case may be more crucial.


At EL Learning Design, we have utilised various strategies to develop case-studies, including interactive patient videos, animated contextual videos, and active learning exercises that challenge learners to apply specific skills such as identifying safeguarding concerns in video consultations. The choice of approach is always guided by the learners' needs and the limitations of the project. These limitations can often drive innovation and help us select the most appropriate tool for the job.


Technological Limitations


Screen shot of reflection and planning page from e-learning course with reflections from other learners and a lightbulb character
Reflection and Planning page from Green Light Learning project 2022

The cornerstone of case-based learning (CBL) is discussion, where learners can articulate their thoughts to peers, weigh pros and cons, and engage in a reflective learning process. However, virtual learning platforms can sometimes limit this type of engagement. To address this challenge, EL Learning Design has come up with strategies to simulate discussion-based learning and collaboration in CBL.


One approach is to link to discussion-based tools such as Twitter conversations or web-based discussion boards like Padlet, but only if the course is partially facilitated. If not, these assets could potentially compromise the module, as ownership might be lost or learners might become disengaged if the design interactions do not happen. An alternative could be to link with professional bodies that have an active social media presence.


If the course is designed as asynchronous and non-facilitated, opportunities for discussion might not be feasible. In such cases, simulating discussion-based interactions is crucial. EL Learning Design has utilised techniques such as creating videos of healthcare professionals or other learners discussing their perspectives to foster a sense of community and discourse. Providing opportunities for learners to reflect and articulate their understanding through text inputs can also help deepen their reflective abilities.


Additionally, EL Learning Design has employed the use of engaging characters that accompany learners on their learning journey, embodying the learning aims. Another strategy is to develop games that encourage replay and allow learners to take on different roles, providing a safe environment for learners to test out different strategies and simulate opposing views.


Conclusion


Case-based learning (CBL) is an effective teaching method for healthcare professionals to develop critical thinking and problem-solving skills. However, its implementation into e-learning environments presents challenges, EL Learning Design has overcome these challenges through a combination of efficient collaboration with subject-matter experts, prioritising learning objectives, and utilising various strategies to simulate discussion-based learning and collaboration. By overcoming these challenges, EL Learning Design is helping to provide healthcare professionals with the skills they need to tackle complex and unpredictable problems.


Sturdy, S., 2007. Scientific method for medical practitioners: the case method of teaching pathology in early twentieth-century Edinburgh. Bulletin of the History of Medicine, pp.760-792.


McLean SF. Case-Based Learning and its Application in Medical and Health-Care Fields: A Review of Worldwide Literature. J Med Educ Curric Dev. 2016 Apr 27;3:JMECD.S20377. doi: 10.4137/JMECD.S20377. PMID: 29349306; PMCID: PMC5736264.

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