Integrating Web-based computer cases into a required clerkship: development and evaluation

To evaluate a five-year experience (1995-2000) developing and integrating computer cases into a required clerkship.

In Study 1, 54 volunteer students were randomly assigned to study articles, a paper case, or a computer case on low back pain/kidney stones. Students were given an exam immediately after the exercise and one week later. In Study 2, 325 clerkship students were asked to select and complete two computer cases or to prepare assignments on unrelated topics. Among the cases offered were two test cases on low back pain/kidney stones and pneumonia. Questions specific to the computer test cases (CC) and other noncomputer cases (NCC) were in the final exam. Exam scores related to CC questions and NCC questions were compared between the groups of students who did and did not complete the computer cases. Students also rated the computer cases on a questionnaire.

In Study 1, reading articles required the most time and received the most negative comments. The students who completed the computer case scored the best on the exam one week later. In Study 2, the students who completed the two computer cases scored significantly higher on the CC questions than did students who studied only one or none of the computer cases (p <.001). There was no difference among groups for the NCC scores (p =.76). Students rated the computer cases with a mean of 6 on a seven-point scale (7 = strongly agree).

Computer cases are effective learning tools, are well-received by students, and can be successfully integrated into existing clerkships.