Application of Case-Based Readiness Assurance Process as a Model for Case-Based Pedagogy and Collaborative Learning in Physiology

The preclinical phase of the undergraduate medical curriculum has to embed clinically relevant learning experience to bridge basic sciences with clinical disciplines. Student-centric educational methods like the readiness assurance process of team-based learning promote active learning. In this study, we report our implementation of the case-based readiness assurance process (CBRAP) as a case-based strategy for introducing early clinical exposure in the preclinical phase of the undergraduate medical curriculum in India. Four CBRAPs with individual and group readiness assurance tests (IRAT and GRAT) were conducted in four different systems taught in physiology (hematology, muscle physiology, cardiovascular physiology, and renal physiology). The multiple-choice questions for CBRAP were specifically designed to test application and problem-solving by incorporating clinical vignettes with pathophysiology and lab findings. This study was designed to involve all 250 students from the first professional year. The GRAT scores were significantly more than mean IRAT scores in all four CBRAPs (p value < 0.001). The GRAT scores in the second, third, and fourth CBRAPs were significantly better than the GRAT score of the first CBRAP (p value < 0.001). The GRAT scores correlated significantly with mean IRAT in three out of four CBRAPs and with the highest IRAT in two out of four CBRAPs. Based on the student feedback of CBRAP and other case-based strategies, it was found that students preferred CBRAP and the majority of students reported that discussion of CBRAP questions with team members was useful. In conclusion, innovative case-based teaching methods with active student involvement can be incorporated in the preclinical curriculum for improving learning outcomes.