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 important discoveries but not so agitated that they shut down.


Richard Schwartzstein, Ellen and Melvin Gordon Professor of Medicine and Medical Education

Student Group



Harvard Medical School


Homeostasis I

  • Design simulations and other active learning exercises that “agitate” students. While you should be careful not to design activities that are so intense that participants shut down, immersing students in simulations that push them to apply their learning realistically can be far more valuable than sitting back and taking in a lecture.
  • To make simulations realistic and better reflect real-world practice, you might consider adding time constraints or having students collaborate in uncertain conditions and with incomplete information.
  • Simulations have been linked to improved knowledge retention and improvement in performance in medical training, in addition to helping students develop collaborative teamwork skills (Okuda et al., 2009). 
  • According to the expectancy-value theory of achievement motivation, student expectations for success in a task can influence achievement-related student choices (Wigfield & Eccles, 2000). This theory suggests that finding the right degree of difficulty is important when considering student motivation.