Using design-based research to aid the development of a case-directed learning pedagogy for the preclerkship medical curriculum

This study showcases the use of Design-Based Research (DBR) applied to the development of Case-Directed Learning (CDL), a new, clinically contextualized teaching method designed to better support critical thinking, clinical relevance, and self-directed learning. CDL uses small groups to work through cases over several days, using open-ended prompts to guide their learning. Students take the lead in exploring the material and meeting learning objectives, followed by a faculty-led debrief to reinforce key science concepts. The purpose of this study was to use a DBR approach to enhance the effectiveness and design of CDL sessions. First-year medical students at the University of Central Florida College of Medicine participated in CDL during a 20-wk “Structure and Function” module focused on anatomy and physiology. According to DBR principles, the iterative development of CDL cases was guided by the concurrent collection of data from stakeholders. Student feedback was collected via surveys based on the Attention, Relevance, Confidence, and Satisfaction (ARCS) model of motivation and focus groups. Faculty involved in CDL design and facilitation were interviewed, and student performance on a CDL assignment was evaluated to assess achievement of learning objectives. The use of DBR produced findings that showed students responded positively to CDL and demonstrated a strong understanding of foundational science content. Feedback from both students and faculty helped to guide improvements to CDL design and delivery during the trial by identifying examples of emerging best practices. The results suggested that CDL is a promising, adaptable approach to integrating clinically relevant, active learning into the preclerkship curriculum, with potential for broader application in Undergraduate Medical Education (UME).NEW & NOTEWORTHY This study uses Design-Based Research to guide the development of Case-Directed Learning (CDL), a fresh approach to teaching basic sciences in preclerkship medical education. Designed to strike a balance between traditional lectures and fully self-directed learning, CDL helps students build a strong foundation in anatomy and physiology while developing the skills they will need to think critically, learn independently, and succeed in clinical settings.