Undergraduate case based discussions: Not just a tick-box exercise

Background Case based discussions (CbDs) are a participant-led teaching initiative, involving a structured discussion of a clinical case with a trainer, focussing on clinical reasoning and personalised feedback. Undergraduate medical students at Queen Mary University of London are required to complete numerous CbDs throughout their degree. The large number of CbDs needing to be completed, risks diminishing their value to just a box-ticking exercise. Most CbDs completed by the students are ad hoc conversations with a junior doctor in the clinical environment. Students report that there is considerable variability in the quality and duration of every CbD. We aimed to improve these learning events by introducing a 'Case Based Discussion Clinic' (CbDC) at Newham University Hospital (NUH). This was a dedicated time and space for students to complete CbDs. Summary of Work We implemented the CbDC for 3rd year undergraduate medical students on placement at NUH in Autumn 2023. The clinic consisted of one-to-one 30 minute appointments in a non-clinical area with a post FY2 clinician. 28 students attended and completed anonymous feedback forms. Summary of Results 96.4% of students reported that the CbDC was more beneficial than their previous CbD experiences. 25% of students reported that they had never received feedback on the wards despite all reporting they had completed a previous CbD. In the CbDC, 100% of the students reported they received personalised feedback. In anticipation of attending the CbDC, 57.1% of students spent more time on the ward and 64.3% spoke to more patients than they would have otherwise. Discussion and Conclusion The feedback suggests that a designated time and space for completing a CbD may create a more beneficial learning experience and ensure the student receives personalised feedback. In addition, results suggest the CbDC resulted in an increase in students' exposure to patients in the clinical environment. The CbDC was also an opportunity to identify students who needed further academic or pastoral support. The feedback suggests that a designated time and space for completing a CbD may create a more beneficial learning experience and ensure the student receives personalised feedback. In addition, results suggest the CbDC resulted in an increase in students' exposure to patients in the clinical environment. The CbDC was also an opportunity to identify students who needed further academic or pastoral support. Take Home Message CbDs are a major component of postgraduate training. Therefore, establishing CbD as a valuable learning tool early in their career, with an initiative such as the CbDC, we can begin to move away from the view of CbDs as a tick-box exercise.