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Curriculum Innovation: Integrating Case-Based Learning With Seminar and Journal Club to Enhance Critical Thinking

Sulena Sulena1,2, Anil Kapoor3, Ashwin Kulkarni4

  • 1Division of Neurology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.

Neurology. Education
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Summary

An integrated case-based learning (I-CBL) curriculum significantly improved internal medicine residents' critical thinking and knowledge retention in neurologic assessments. This approach enhances clinical reasoning and satisfaction, despite some implementation challenges.

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Area of Science:

  • Medical Education
  • Neurology
  • Internal Medicine

Background:

  • Traditional postgraduate medical education often lacks structured methods for developing critical thinking and clinical reasoning skills essential for complex neurologic cases.
  • Effective management of neurologic conditions necessitates robust critical thinking and clinical reasoning abilities.
  • Current educational frameworks may not adequately prepare residents for advanced neurologic patient assessments.

Purpose of the Study:

  • To develop an integrated case-based learning (I-CBL) curriculum aimed at enhancing critical thinking skills in postgraduate internal medicine residents during neurologic patient assessments.
  • To evaluate the effectiveness of the I-CBL curriculum from the perspective of faculty members.
  • To assess and improve residents' acceptance and satisfaction with the implemented I-CBL curriculum.

Main Methods:

  • A prospective mixed-method study with a pretest-post-test design was conducted involving internal medicine residents and faculty in an Indian tertiary-care hospital.
  • The I-CBL curriculum incorporated systematically planned seminars, journal presentations, and in-depth case-based presentations tailored to postgraduate year levels.
  • Assessments included pre/post-tests, Likert scale surveys, the Holistic Critical Thinking Scoring Rubric, and concept map evaluations to measure knowledge, critical thinking, and satisfaction.

Main Results:

  • Residents demonstrated significant knowledge gains from pretest to post-test, with retention sustained at 6 months (p < 0.05).
  • Critical thinking skills showed notable improvement across seminars (75%), case presentations (40%), and concept mapping (40%).
  • High satisfaction rates were reported: 96% of residents and 92% of faculty experienced positive outcomes, appreciating enhanced engagement and clinical reasoning.

Conclusions:

  • The I-CBL curriculum effectively integrated theoretical knowledge with clinical practice, improving residents' critical thinking, diagnostic skills, and teamwork in neurology.
  • While satisfaction was high, challenges such as time constraints and faculty workload were identified, suggesting areas for curriculum refinement.
  • I-CBL holds significant potential to transform postgraduate neurology education by fostering critical thinking and clinical competence, ultimately producing more effective practitioners.