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A study of the impact of cooperative small group facilitated case studies on student learning outcomes



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A cooperative small group facilitated case-based learning method has been used in the medical college at the researcher’s educational institution since the 2003-2004 academic year. They were designed to be a supplement to a primarily lecture-based curriculum where it was believed that these cooperative cases helped students to develop a better understanding of the material taught in the lectures, although no rigorous investigations had been completed. The purpose of this study was to investigate the impact of these cooperative facilitated small group cases on five specific outcomes which included: 1) achievement, 2) knowledge confidence, 3) student satisfaction, 4) student’s perceived time on task, and 5) the student’s perceptions of the degree to which they believed a facilitator helped them to learn the material. These outcomes for cooperative learning (CL) were compared with individual learning (IL) outcomes. Quantitative data on student achievement and knowledge confidence were collected using a pre-test post-test 10 multiple choice question quiz. A brief questionnaire was also distributed to students to collect data regarding student satisfaction, time on task and perceived helpfulness of the facilitator.Fifty-nine medical students were randomly assigned to either the CL or IL cohort (cooperative cohort, n = 32; individual cohort, n = 27). All students were blinded to the purpose of the study until all data were collected at the end of the investigation. Students completed the 10 multiple choice question pre-test. After each question they rated their level of confidence (on a scale from 1 to 10) that they had chosen the correct answer. Immediately after completion of the pre-test, they worked on the case, either cooperatively or individually. One week after the pre-test and case, the students completed the post-test quiz with the same questions, as well as the questionnaire.A repeated-measures MANOVA was used to compare achievement and confidence in the CL (n =19) and IL (n =13) cohorts. An alpha level of .05 was used for all statistical tests. Effect sizes (d) were calculated for within-group and between-groups comparisons for achievement and confidence. Descriptive data on student satisfaction, time on task and facilitator helpfulness were gathered from the questionnaire and compared between groups. Within-group results from the study showed that CL had a greater impact on student achievement and confidence than IL (achievement, d = 0.57 vs. 0.16; confidence, d = 0.52 vs. 0.14). The results for the statistical analysis did not reach significance for achievement or confidence. Between-groups effect sizes were calculated for average pre- to post-test change for achievement and confidence (achievement, d = 0.35; confidence, 0.40). Students in the CL cohort reported spending more time on task before and during the case session and less after the session. They also reported greater levels of satisfaction with the learning experience than IL group. The majority of students (90.5%) in the CL cohort felt that the facilitator helped them to learn.The findings from this study showed that this CL method had a greater impact on the five outcomes outlined above compared to the IL method. Students made greater gains in achievement and confidence. They also spent more time on task, and had higher levels of satisfaction with the learning experience. Students in the CL cohort also believed that the facilitator helped them to learn. Implications of the study include possible expanded use of the cases within the curriculum of this medical college although the demands of resources and curriculum content would have to be carefully considered.



Case Based Learning, Medical Education, Student Achievement, Time on Task, Student Satisfaction, Confidence, Cooperative Learning, Small Group Learning



Master of Education (M.Ed.)


Educational Administration


Educational Administration


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