title: Piloting case-based instruction in a didactic clinical immunology course.
abstract: OBJECTIVE
  To assess (1) the effect of case-based instructional modules on student critical thinking, class attendance, and satisfaction and (2) student opinion of case formats.
  
  
  METHODS
  University-based upper division course in clinical immunology and serology. The course was taught by the same instructor for two consecutive semesters with the intervention introduced in the second semester. Sixty-seven students experienced the intervention and 56 students were in the baseline cohort.
  
  
  METHODS
  Nine cases were interspersed between lectures during the semester. Each case took one 50-minute class in which students worked in groups of five or six.
  
  
  METHODS
  Student performance on five critical thinking multiple-choice examination questions and percent student attendance on case days versus lecture days were analyzed using the Mann-Whitney test. Student ratings on course evaluations were analyzed using t-test comparing semesters with and without intervention. Student opinion of cases was obtained through surveys and a focus group.
  
  
  RESULTS
  Student performance on critical thinking exam questions was similar in the two groups. Student attendance was significantly higher on case days (95.6%) versus lecture days (80.3%; p < 0.0001). Only composite ratings for instructor involvement, student-instructor interaction, and course organization were significantly improved in the semester with cases compared to the semester with lecture only (p < 0.0001 for all indices).
  
  
  CONCLUSIONS
  Although case studies did not significantly improve student performance on critical thinking questions, they still proved to be a valuable instructional method. Student attendance, student-instructor interaction, and instructor involvement in the course were all positively affected by incorporation of case studies. Discussion of cases also helped to uncover student misconceptions of course material.
authors.affiliation: Medical Technology Program, College of Natural Science, Michigan State University, East Lansing, MI, USA. hoagk@msu.edu
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hoag
authors.forename: Janet
authors.initials: J
authors.lastname: Lillie
authors.forename: Ruth
authors.initials: R
authors.lastname: Hoppe
mesh_terms: D000486:Allergy and Immunology / Q000193:education*; D004501:Education, Medical; D004504:Education, Medical, Undergraduate; D006801:Humans; D018794:Problem-Based Learning; D015397:Program Evaluation; D013038:Specialization; D013337:Students, Medical; D013663:Teaching / Q000379:methods*