Comparison of Case-Based Learning and Traditional Lectures in an Orthopedic Residency Anatomy Course

The impact of new pedagogical methods such as case-based learning (CBL) rather than traditional lectures in graduate medical education is poorly defined. We hypothesized that using CBL in lieu of lectures in an orthopedic surgery residency anatomy course would lead to increased resident engagement, improved resident satisfaction, and similar knowledge acquisition.

A prospective, observational study design was used. CBL sessions were developed for an orthopedic surgery residency anatomy course. Content was delivered in 6 sessions (3 traditional lecture-based and 3 CBL) taught by the same attending surgeon. Engagement was measured every 10 minutes by 2 trained observers using a standardized protocol. Resident satisfaction was surveyed and knowledge acquisition tested. Data from the course were scored separately for CBL verses lectures and compared statistically.

Orthopedic surgery residency program at the University of California, San Francisco.

Orthopedic surgery interns and residents (n = 35).

No significant differences were measured in resident engagement (83% vs 85%, p = 0.664) or in knowledge acquisition (84% vs 78%, p = 0.056) in CBL verses lecture sessions, respectively. CBL sessions were judged equally valuable compared to lectures with high satisfaction rates across all survey measures.

Residents demonstrated similar engagement and satisfaction with CBL compared to lectures with equivalent knowledge acquisition, suggesting both pedagogical methods are effective for a highly motivated group of learners.