Web-based formative assessment case studies: role in a final year medicine two-week anaesthesia course

Formative Assessment Case Studies (FACS) are an e-learning resource consisting of a case scenario punctuated with decision-making steps (multiple-choice questions) and feedback for wrong answers. FACS was developed to enhance clinical decision-making skills. We wrote six FACS scenarios covering preoperative assessment topics and made them accessible to 149 final year medical students as part of their two-week anaesthesia module. A data management system recorded usage and performance by each student. Eighty-one percent of students attempted FACS (six cases 53%, five cases 17%, one to four cases 9%) and 61 to 70% completed all steps. On average FACS was attempted 1.5 times. Students required 44 to 95% more steps than the minimum to complete each case. There were two patterns of use: some students completed the cases within five to seven minutes (first quartile) focusing on the questions, while others spent over 22 to 35 minutes (fourth quartile) exploring the FACS and feedback. FACS usage correlated (r2 = 0.32: P < 0.01) with written case report marks. The students' evaluation of FACS was high. FACS is an e-learning resource that is interactive and facilitates higher learning. It can be applied successfully to disciplines less well represented in the medical curriculum, such as anaesthesia. FACS facilitated our teaching of preoperative assessment to a group of final year medical students. It was well received and shown to facilitate the learning of decision-making skills. The students' usage of FACS could have been enhanced by making FACS compulsory and using summative FACS for assessment.