Presented By: Laurel Gorman, Temple University School of Medicine

Purpose
Evidence shows effective healthcare education small-group case-based learning (SG-CBL) can promote collaboration, active learning, and integration. The design of the activities and outcome deliverables contribute to deep and collaborative learning. However, the literature is lacking on how to best design outcomes to promote integrative thinking. For this pilot study, the outcomes from assigned critical thinking cases were compared with self-selected group project outcomes to determine if SG-CBL performance impacts the deliverable quality for future self-selected projects. A secondary purpose was to share SG-CBL process and outcome design strategies to improve SG-CBL practices. 

Methods
Twenty groups of second year medical students were assigned SG-CBL with a required creative whiteboard deliverable. A rubric (0-3 points per criteria; anchor 3=outstanding; 2=meets expectations; 1=developing/needs improvement; 0=insufficient) scored product performance on concept understanding, creativity, integration, and organization. Feedback was provided after each CTC. Groups were later allowed to self-select neurological disease group projects using any method; their self-selected deliverables were evaluated for collaboration, creativity, and complexity. 

Results 
Mean rubric scores for the SG-CBL demonstrated different cohorts: Low-scoring (LS, below 2.5), Medium scoring (MS: 2.5-2.8), and High scoring (HS: 2.9-3.0). The LS group tended to score lower for collaboration and creativity of deliverable (LS 1.75 vs MS 2.75 vs HS 2.6). The LS cohort was more likely to self-select lists (low creativity/complexity) and to divide tasks in lieu of group brainstorming; MS and HS cohorts were more likely to work together to create Cmaps or original patient cases. 

Conclusions 
Results suggest the differences in SG-CBL performance were associated with different collaborate and creative outcomes on future projects. This study was not set-up to ascertain underling reasons for differencing group experiences but it suggests effective small group processes, feedback, and selection of deliverables that promote collaboration, critical thinking, and creative end-products may impact future performance on group tasks.