Second Year Medical Students Perceive In‐person Pathophysiology and Pharmacology Case‐Based Sessions Promote Learning More Effectively than Zoom
Authors: Yitzhak Benjamin , Gorman Laurel 
Published: May 2022

IntroductionCollaborative small‐group case‐based learning (CBL) is essential to active learning and facilitates team building, communication skills, team‐based decision making, and complex problem solving. Evidence showing extensive pathophysiology and pharmacology CBL learning value in preclinical students was derived in the setting of in‐person CBL, but little is known about best practices for virtual zoom CBL. Due to the COVID‐19 pandemic, schools shifted CBL rapidly to virtual modalities, providing an opportunity to study outcomes related to conducting second year medical school (M2) systems pathophysiology and pharmacology CBL by zoom or other virtual learning platforms. At the UCF College of Medicine, we compared M2 cohorts who experienced CBL virtually vs in‐person to evaluate their perceptions of various learning themes. Our objective is to share the outcomes of a survey sent to learners who had experienced both types of CBL as well as to report end‐of‐module evaluation data for cohorts with CBL conducted in‐person versus virtually.MethodsStudents (N=42) who had completed their preclinical education using both zoom and in‐person CBL, volunteered to answer Likert survey items related to the following themes: Learning‐Critical thinking (L‐T), Collaborative‐team learning (Coll‐T), Engagement‐Motivation (E‐M), and Empathy (Emp) for zoom vs in‐person cases. Responses to general end‐of‐module general survey items on CBL (N=116) from an in‐person cohort were compared to responses from a zoom only CBL cohort (N=123) to obtain perceptions from an entire class. Survey items were presented using a Likert scale and the percent affirmative to survey questions was reported for end‐of‐module items. The Likert anchor was as follows: 5:Strongly agree, 4:Mostly agree, 3:Neutral, 2:Mostly disagree, 1:Strongly disagree. Module data percent affirmative combined responses 4 & 5.ResultsData are represented as mean Likert + SD for zoom (Z) vs in‐person (IP), respectively, for the themes: L‐T (Z:3.1+0.6 vs IP:4.3+0.6), Coll‐T (Z:3.0+0.7 vs IP:4.3+0.6), E‐M (Z: 3.2+0.7 vs IP:4.2+0.7), Emp (Z:2.0+0.9 vs IP:3.3+1.2). Results showed zoom CBL was ranked lower than in‐person CBL for all categories; significance was determined by paired t‐tests (p<0.01). Module data comparing a Z cohort with a previous IP cohort showed, reported as % affirmative for Z vs IP, the following by theme: Coll‐L (Z:69% vs IP:75%), L‐T(Z:80% vs IP:84%), preparation for CBL (Z:96% vs IP:88%). When given the option to work as a small group or individual on CBL, 16% of the Z cohort elected group work whereas 69% of the IP cohort elected collaborative work over individual completion.ConclusionThe data show students, when specifically asked to compare 2 methods of CBL on a survey, perceive the in‐person CBL promoted more collaborative team learning, thinking, engagement, and empathy than zoom CBL. At the end of modules, a majority in both cohorts generally agreed that either zoom or in‐person CBL promoted learning, but the in‐person cohort tended to rate their CBL learning experience more highly. After working in‐person, but not by zoom, students were more likely to elect collaborative learning when it was optional, suggesting that the in‐person interactions changed attitudes and behavior about collaborative learning. Given an additional goal of small group CBL is to develop team skills, this finding suggests in‐person CBL has some specific benefits.