Are preprofessional undergraduate students ready for authentic clinical case studies? An empirical study of students'...

Increasingly, the curricula of many clinical programs have been restructured to an integrated model in which foundational sciences such as physiology, pathophysiology, and pharmacology are taught side by side with clinical reasoning. Case studies are an excellent pedagogical strategy for enhancing such integration, especially if such cases are authentic, that is, they include a broad range of information that could influence the individualization and optimization of patient care. However, authentic cases may be too advanced and thereby dissuade preclinical students. We offered an optional semester-long authentic pharmacotherapy case study to undergraduate students in an introductory pharmacology class in a liberal arts college in the United States Midwest and sought to know what might motivate students to complete this challenging task. Connection with and relevance of the case study were assessed with an anonymous survey. Open-ended questions were analyzed qualitatively. Exploratory factor analysis and nonmetric multidimensional scaling were employed to investigate underlying commonalities and patterns in the motivations for participating in and relating to the case study. Students were motivated more by the perceived relevance and transferability of knowledge acquired to their future career than by their current clinical technician jobs or their personal lives. Rather than causing an information overload and dissuading students, this complex pharmacotherapy case assignment harnessed preclinical students' experiences from cognate cocurricular activities, created numerous points of relevant engagement with instructional content, and therefore motivated students to deeper learning.NEW & NOTEWORTHY Early introduction to clinical reasoning is widely advocated. Case studies are frequently used to enhance integration of foundational sciences with clinical reasoning. Preclinical students may be overwhelmed by complex cases because of the higher-order cognitive tasks involved. We find that complex cases permit connection with students' own experiences and aspirations. These preclinical students were motivated to engage in such challenging academic work because of the perceived transferability of knowledge to their future careers.