A comparative study of student preferences between case-based learning and problem-based learning in Physiology

Objectives: Case-based learning (CBL) and Problem-based learning (PBL), unlike traditional lectures, are innovative student-centred approaches that promote critical thinking, clinical reasoning, collaborative skills and the integration of basic science subjects with clinical disciplines. The present study was conducted to compare the effectiveness and preferences of CBL and PBL as teaching tools in Physiology. Materials and Methods: A crossover educational interventional study was carried out among Phase I undergraduate medical students using PBL and CBL methods on two different topics of Physiology. Pre-test, post-test and retention test scores were analysed to assess the knowledge gain and retention ability. The student perceptions of these two methods were recorded using a feedback questionnaire based on a 5-point Likert scale. Binary logistic regression was performed on the factors identified through exploratory factor analysis (EFA) and academic performance (1 st internal assessment scores) to predict student predilections between PBL and CBL. Results: Of 223 total participants, 172 (77.13 %) preferred CBL, whereas 51 (22.87%) favoured PBL, as students appreciated faculty-guided, actively engaging case discussion within a structured learning framework in comparison to inquiry-driven driven self-directed, time-consuming, open-ended problem solving. CBL showed a higher retention score than PBL as it enhanced an in-depth understanding of core concepts and reinforcement of memory. Four factors identified by EFA were as follows: (I) Faculty-guided structured content, (II) Group discussion related comfort/anxiety/stress, (III) Time management and cognitive workload and (IV) Effectiveness and clinical relevance. Binary logistic regression analysis revealed that Factors I (odds ratio [OR] = 7.47, P < 0.001) and Factor II (OR = 0.43, P = 0.003) predicted CBL preference, whereas academically stronger students were inclined towards PBL (OR = 0.96, P < 0.001). Conclusion: CBL is more suitable for novice Phase I M.B.B.S students, whereas PBL is appropriate in later phases of the curriculum when they have acquired the ability of self-directed learning, iterative thinking and logical reasoning.