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    Using Cases in the Case-Based Collaborative Learning Classroom

    When disciplinary knowledge is presented only in the abstract, students miss a critical opportunity to understand how this knowledge can be applied to solve professional dilemmas. In Barbara Cockrill’s Case-Based Collaborative Learning (CBCL) classroom, students study key medical concepts on their own and then work together in class to apply this knowledge to realistic scenarios they are likely to see in future practice. As a result, students gain a storehouse of contextual knowledge, real-world clarifications of concepts, and practice solving professional puzzles...

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    Designing a Case-Based Collaborative Learning Case

    Crafting a strong case requires not only selecting a problem for students to solve but also thinking through how students will solve this problem. Effective cases require a certain level of productive struggle from students. Effective CBCL case solutions are not merely fill-in-the-blank or, as Barbara Cockrill says, “Google-able.” Instead, instructors may strategically bury key information or include potentially relevant details to add complexity to the case. Often the hardest part of crafting a case is achieving, in Cockrill’s words, “desirable difficulty.”

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    Structuring the Case Discussion

    Well-designed cases are intentionally complex. Therefore, presenting an entire case to students all at once has the potential to overwhelm student groups and lead them to overlook key details or analytic steps. Accordingly, Barbara Cockrill asks students to review key case concepts the night before, and then presents the case in digestible “chunks” during a CBCL session. Structuring the case discussion around key in-depth questions, Cockrill creates a thoughtful interplay between small group work and whole group discussion that makes for more systematic forays into...

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    Experiencing the case as a student team

    Student collaboration is instrumental in effective CBCL classrooms. In contrast to impersonal lecture settings, small groups provide students with supportive, low-stakes environments to wrestle with course concepts and test out solutions before sharing their responses with the wider group. In Barbara Cockrill’s CBCL classroom, small groups of four are maintained through the entirety of the semester. The close relationships that students build with each other are sustained through norms that groups set for themselves. Cockrill reflects that this collaborative...

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    Circulating the room during small group case discussions

    Though small group time is student time, instructors can glean important information about student learning by strategically eavesdropping. In this video, Barbara Cockrill reflects on her rationales for continually circulating during small group case discussions. Among those discussed are listening for and addressing misconceptions, priming particular groups to share out during subsequent whole group dialogues, and finding an opportunity to spotlight quiet students.

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    Sharing relevant experiences from the field

    While too much storytelling from an instructor can pull a lesson off-track, a strategically placed anecdote from the field can substantially enliven a case. In Barbara Cockrill’s Homeostasis I course, instructors are practicing physicians themselves, and they find ways to purposefully share prior field experiences with students to illuminate otherwise abstract concepts. What one student calls “pearls of wisdom” also spur impromptu but vital conversations about the many ethical dilemmas practitioners face.

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    Moving class forward while honoring curiosity spurred by the case

    A central tension many instructors face is how to keep a lesson moving forward while also encouraging students’ inquisitiveness and answering their questions. As Barbara Cockrill describes in this video, curiosity is something teachers should be careful not to “thwart.” However, some insights or questions raised by students can quickly pull a carefully timed class off-track. In this video, Cockrill describes how she honors students’ curiosity while also managing potential tangents that students raise. In particular, she discusses how to manage the especially inquisitive student and...

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    Channeling expertise in the room to enhance the case

    Classrooms, especially those at the graduate level, are mosaics of students with wide-ranging backgrounds and areas of expertise. In case-based classes where disciplinary knowledge is situated in context, drawing on this reservoir of expertise can help incorporate more voices into the classroom and enhance case discussions. In this video, Barbara Cockrill’s students discuss the value of working with peers from different disciplinary backgrounds, and Cockrill solicits input from one particular student to make a high-stakes case even more relevant.

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    Using Simulations in the Case-Based Collaborative Learning Classroom

    In contrast to paper cases, simulations in the classroom push students to enact what they have learned. In Homeostasis I, instructors immerse groups of students in high-stress, realistic hospital scenarios. The exercise forces student groups to collectively come to a consensus about treatment and quickly, all the while navigating the stress that accompanies taking care of patients. From the instructors’ end, engineering such a learning space requires hitting what Richard Schwartzstein calls the “sweet spot,” in which students are agitated enough to make...

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    Designing a Simulation Session

    Simulation scenarios are carefully chosen in order to build on and complicate textbook concepts in realistic settings. In this way, Homeostasis I is a “flipped classroom”: students prepare and learn concepts independently while time in class presents opportunities to put those concepts into practice and synthesize them during simulation-inspired discussions. Richard Schwartzstein underscores this element of transfer as critical to simulation design. Accordingly, the concepts students confront in the learning exercise might be “foundationally the same” but presented...

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    Planning for Unpredictability in Simulations

    Teacher-driven lessons afford instructors the luxury (and limitations) of a predictable plan. By contrast, the learning that emerges out of simulations is evolving, spontaneous, and contingent on the specific set of individuals participating. For facilitators, these circumstances require being open to students’ thinking and flexible with lesson plans, without letting efficiency or structure go by the wayside. Richard Schwartzstein calls the “unscripted” nature of simulations the challenge and fun in their facilitation. Noting that “no two sessions are exactly the...

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    Normalizing Uncertainty Through Simulations

    Most fields, especially those that involve working with people, are not nearly as straightforward as textbooks might have students believe. However, many students find confronting uncertainty and not getting the “right answer” to be a discomforting experience. In Homeostasis I, Richard Schwartzstein and Jeffrey William see simulations as powerful exercises to get students used to navigating uncertainty. Through modeling, questioning, and devising scenarios without clear-cut answers, Schwartzstein and William emphasize to students the importance of “being okay with...

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    Engaging the Whole Class Through Strategic Role Assignment

    When a simulation or role play requires the direct involvement of only a small subset of students, the rest of the class may find themselves disconnected from the action. Even students within the subset of chief participants can become disengaged if their individual role is ill-defined. In this video, Richard Schwartzstein and Jeffrey William discuss how strategic role assignments can maintain engagement and “involve the crowd.” In this simulation specifically, the main actors in the simulation fulfill roles that mirror those on a hospital floor, while other...

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    Defining Strategic Roles for Simulation Facilitators

    As an expert in one’s field, it can be challenging for instructors to move to the periphery of the classroom and let students take the lead. Not doing so, however, can impede students’ problem-solving and critical thinking skills. Fortunately, acting as a facilitator in simulations does not necessarily mean instructors stand idly by. In this video, Jeffrey William discusses how instructors in Homeostasis I find ways to guide students’ thinking without overpowering them by posing questions, issuing subtle hints, and purposefully walking away. Considering the role of...

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    Debriefing the Emotional Experience of the Simulation

    When the simulation has formally ended, this does not mean the learning is over. Debriefing the simulation experience with students is a critical component of achieving instructors’ learning objectives. More intense than a paper case, role plays and simulations also stir emotions and raise stress levels among participants. Given this, taking time to debrief the anxieties and emotions simulations raise is imperative. In this video, Richard Schwartzstein, Jeffrey William, and Homeostasis I students discuss the importance of acknowledging the emotional component of the...

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    Asking and Answering Questions to Deepen Student Understanding

    Simply because one student has offered a correct answer does not mean other students are on the same page. In this video, Richard Schwartzstein discusses how he responds to student questions and responses in a way that invites the whole class into the conversation. “Tell me more about that,” is one of his go-to responses to gently probe students’ understanding and demystify their thought process for other learners in the room. “If they tell me the right answer, I don’t always validate it,” Schwartzstein explains, “because I’ll still turn to someone else and say...

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