Table Of ContentIAMSE Manuals
Henrike C. Besche ·
Richard M. Schwartzstein ·
Randall W. King · Melanie P. Hoenig ·
Barbara A. Cockrill
A Step-by-
Step Guide
to Case-Based
Collaborative
Learning (CBCL)
IAMSE Manuals
Editor-in-Chief
Steven M. Crooks, Western Michigan University Homer Stryker
Kalamazoo, MI, USA
Editorial Board
Jongpil Cheon, Texas Tech University
Lubbock, TX, USA
Peter G. M. de Jong, Leiden University Medical Center
Leiden, The Netherlands
David W. Mullins, Dartmouth Geisel School of Medicine
Hanover, NH, USA
Thom F. Oostendorp, Radboud University Medical Center
Nijmegen, The Netherlands
The book series IAMSE Manuals is established to rapidly deploy the latest
developments and best evidence-based examples in medical education, offering all
who teach in healthcare the most current information to succeed in their task by
publishing short “how-to-guides” on a variety of topics relevant to medical teaching.
The series aims to make the best and latest evidence-based methods for teaching in
medical education to educators around the world, to improve the quality of teaching
in healthcare education, and to establish greater interest in the teaching of the
medical sciences.
Henrike C. Besche • Richard M. Schwartzstein
Randall W. King • Melanie P. Hoenig
Barbara A. Cockrill
A Step-by-Step Guide
to Case-Based Collaborative
Learning (CBCL)
Henrike C. Besche Richard M. Schwartzstein
Program in Medical Education Beth Israel Deaconess Medical Center
Harvard Medical School Harvard Medical School
Boston, MA, USA Boston, MA, USA
Randall W. King Melanie P. Hoenig
Department of Cell Biology Beth Israel Deaconess Medical Center
Harvard Medical School Harvard Medical School
Boston, MA, USA Boston, MA, USA
Barbara A. Cockrill
Program in Medical Education
Harvard Medical School
Boston, MA, USA
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA, USA
ISSN 2673-9291 ISSN 2673-9305 (electronic)
IAMSE Manuals
ISBN 978-3-031-14439-4 ISBN 978-3-031-14440-0 (eBook)
https://doi.org/10.1007/978-3-031-14440-0
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Preface
Interviewer:
“For somebody who’s never been in a CBCL class, can you just describe what it is?
Interviewee:
“A CBCL class is basically a time for you to engage actively with and immediately
apply the material that you’ve prepared the night before to solve problems. The
best way to describe it is that it’s very interactive learning. You’ll sit at a table of
four people, in a classroom of 40 students. The general format will be that the
faculty member will present a case or a problem for you to solve and then a num-
ber of questions to consider as you look at that case. Then you divide into your
groups of four people and maybe talk for maybe 5–10 minutes depending on how
hard the question is, come up with some ideas, and then you’ll be brought back
together in a group of 40 at which point the faculty member will facilitate a
broader conversation in which the different groups can share their ideas, their
thoughts and their questions, or even points of confusion with the group as a
whole. It’s interactive on kind of a broader scale - at the larger group level and
then also at the smaller table level.”
Interviewer:
“Can you describe the best aspects of learning in this kind of way?”
Interviewee:
“I think it’s just getting to actually work with your classmates on a daily basis.
Especially since so much of our class had worked before medical school and had
been in this kind of collegial atmosphere where you’re working with colleagues
and you’re talking with colleagues and you’re bouncing ideas off of colleagues,
I would have found it a lot harder to revert back to more of a lecture setting where
you are sitting with your peers and learning the same information but you’re not
really getting to interact in a learning setting as intensely. For me I really loved
that interaction of actually getting to know my classmates a lot better but also
getting to try and simulate the workplace as much as you can in a classroom
setting, I found really helpful and I think it has a lot of really good potential for
team development.”
v
vi Preface
(Excerpts from an interview with a first-year medical student enrolled in the
Pathways MD Program at Harvard Medical School, slightly edited for brevity and
clarity.)
Boston, MA, USA Henrike C. Besche
Richard M. Schwartzstein
Randall W. King
Melanie P. Hoenig
Barbara A. Cockrill
Contents
1 What Is Case-Based Collaborative Learning (CBCL)? . . . . . . . . . . . . 1
1.1 What Does Case-Based Learning Mean? . . . . . . . . . . . . . . . . . . . . . 3
1.2 How Does CBCL Compare to PBL? . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.3 How Does CBCL Compare to TBL? . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.4 How Does CBCL Foster Active Learning? . . . . . . . . . . . . . . . . . . . . 8
1.5 How Do I Know if CBCL Is Right for My Learners? . . . . . . . . . . . . 10
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
2 Step-by-Step Guide to Creating CBCL Modules . . . . . . . . . . . . . . . . . . 17
2.1 Learning Objectives and Backwards Design . . . . . . . . . . . . . . . . . . . 18
2.2 Taming the Workload: How to Create Preparatory
Resources That Inform, Not Overwhelm . . . . . . . . . . . . . . . . . . . . . . 24
2.3 Not Too Hard and Not Too Easy: Goldilocks’ Principles
of Writing RAEs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
2.4 What Makes for a Good Discussion? Writing CBCL Cases . . . . . . . 29
2.5 The Final Stage: Supporting Students During Consolidation . . . . . . 33
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
3 Leading CBCL Discussions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
3.1 Supporting Students in Forming Healthy Learning Teams . . . . . . . . 38
3.2 How to Facilitate CBCL Case Discussions . . . . . . . . . . . . . . . . . . . . 40
3.3 Teach the Teacher: Why Faculty Guides Are Essential . . . . . . . . . . . 43
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
4 Variations on CBCL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
4.1 Cultivating Independence: How the CBCL Format
Can Be Adapted Developmentally . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
4.2 Virtual CBCL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
vii
About the Authors
Henrike C. Besche is Lecturer in Cell Biology and the Associate Director for
Curriculum Integration in the Program of Medical Education at Harvard Medical
School. In her role she is responsible for various aspects of basic science teaching
in the pre- and post-clerkship HMS Pathways curriculum ranging from curriculum
and faculty development to active teaching. Dr. Besche is an expert in case-based
collaborative learning and works closely with other faculty on case writing and
facilitation.
Richard M. Schwartzstein is the Ellen and Melvin Gordon Distinguished
Professor of Medicine and Medical Education at Harvard Medical School and exec-
utive director of the Shapiro Institute for Education and Research at Harvard
Medical School and Beth Israel Deaconess Medical Center. Dr. Schwartzstein first
piloted the CBCL format in his course Integrated Human Physiology, and chaired
the steering committee that developed the Pathways curriculum at Harvard Medical
School. He is also the chief of the Division of Pulmonary, Critical Care and Sleep
Medicine at Beth Israel Deaconess Medical Center.
Randall W. King is the Harry C. McKenzie Professor of Cell Biology at Harvard
Medical School. He co-chaired the subcommittee on curricular content and organi-
zation as part of the Pathways curriculum redesign. He directs the Foundations
course, which introduces first-year students to ten basic science disciplines in an
integrated format using the CBCL approach. In addition, he directs an advanced
integrated science course on cancer biology, taken by students in the post-clerkship
phase of the curriculum.
Melanie P. Hoenig is Associate Professor of Medicine. She has co-chaired the
steering committee that developed the Pathways curriculum at Harvard Medical
School and is now the course director for the pre-clinical course, Homeostasis II,
which combines endocrine, renal, and gastrointestinal physiology and pathophysi-
ology taught in the CBCL format. Dr. Hoenig practices nephrology at Beth Israel
Deaconess Medical Center, a Harvard-affiliated teaching hospital.
ix
x About the Authors
Barbara A. Cockrill is the George E. Thibault Academy Associate Professor of
Medicine and Associate Dean for Faculty Development in Medical Education for
the MD program at Harvard Medical School. In addition to providing training and
support for HMS teaching faculty in all phases of the curriculum, she is also a
course director for a pre-clinical pathophysiology course taught in the CBCL for-
mat. Dr. Cockrill practices pulmonary and critical medicine at the Brigham and
Women’s Hospital, a Harvard-affiliated teaching hospital.
