Abstract:

Evidence suggests that case-based learning may have a role in supporting health professional students to improve self-confidence in applying theory to practice and in self-perceived preparedness for clinical placements. However, student feedback during the initial stage of an action research study identified that second year BSc occupational therapy students found case-based learning particularly challenging when aiming to acquire complex knowledge and skills. The students reported that they felt that working on case-studies was inauthentic and that this approach required them to make assumptions about individuals, deviating from the person-centred approach, central to the occupational therapy profession. To address this, the use of student-developed cases, in place of case-studies developed by lecturers, was introduced into the module delivery. Student-developed or self-led case studies within case-based learning is a developing area of research. This action research study explored the impact of case-based learning using both tutor-developed and student-developed cases on student confidence in applying clinical skills. Surveys were used to collect numerical and textual data after students had worked on each of three case studies, one of which was student-developed. Likert scales were used to measure confidence in clinical skills in both academic and practice placement contexts. Open-ended questions were used to identify the elements of the case-based learning approach that students felt had the greatest positive and negative impact on their confidence. Significant improvement in confidence were found in interpreting assessments in academic (p<0.001) and clinical contexts (p<0.005) following the student-developed case study. A large proportion of students cited developing and working on their own case study as a key factor in improving confidence. The findings suggest that case-based learning may have a positive impact on student confidence in applying clinical skills in practice and that student-developed cases have a role to play in this. It is hypothesised that by developing their own case to work upon, students are able to build complex knowledge and skills upon a familiar base, thus allowing confidence to build gradually. By creating an individual to work with, students draw on their own experiences and appear to connect more effectively with the case-study, demonstrating a deeper consideration of the person’s strengths, needs and goals.

Keywords:

Case-based learning, student-led case studies, higher education, confidence, student health professionals, occupational therapy, clinical skills.