Presented By: Brett Szymik, Augusta University/University of Georgia Medical Partnership
Co-Authors: Amy Baldwin, Augusta University/University of Georgia Medical Partnership
Lia Bruner, Augusta University/University of Georgia Medical Partnership
Tresa Chappell, Augusta University/University of Georgia Medical Partnership
Shereen Farooq, Augusta University/University of Georgia Medical Partnership
Janette Hill, University of Georgia
Ellen House, Augusta University/University of Georgia Medical Partnership
Dina Teshager, Atrium Health Carolinas Medical Center
Lia Topper, Duke University School of Medicine

Purpose 
Case-based learning (CBL) is an integral component of many pre-clerkship curricula, and small group learning (SGL) utilizing cases is the cornerstone of our curriculum. The purpose of this study was to investigate faculty and learner perspectives of sample cases before and after major revisions made by a faculty-led case oversight team. 

Methods 
Three focus groups with faculty (n=4) and students (n=5) who had completed their pre-clerkship curriculum were conducted. Participants compared and discussed two SGL cases from the 2016/17 academic year with their revised versions from 2021/22. Cases were randomly selected from a pool of eligible cases utilized in both academic years that underwent significant changes based on specific criteria. A semi-structured protocol allowed focus group participants to openly discuss similarities and differences between the two versions of each case, including how the versions might impact learning and preparedness for clerkships/clinical practice. Data from the focus groups were analyzed by three team members using constant comparative methods to inductively code these data and identify themes. 

Results 
Analysis indicated that faculty and learners generally agreed that the updated cases from 2021/22 were beneficial for learning, better prepared the students for clerkships, and were more useful for future patient care. Both faculty and learners indicated that inclusion of additional information (e.g., media, patient social determinants of health) added to the realism of the cases and therefore, the overall effectiveness for learning. 

Conclusion 
Our faculty-led case oversight team employs feedback, review, and revision for continuous quality improvement of cases in pre-clerkship curricula as a process to ensure an optimal learning experience. Faculty and learner perceptions of case revisions provide valuable insight into changes made over time as well as potential impact on learning. Overall, revised cases were perceived as improved and valuable by both faculty and medical learners.