Many medical schools, including Oklahoma State University – Center for Health Sciences (OSU-CHS), have discontinued the Microbiology wet laboratory in light of cost, space issues, and curricular changes [1
]. Initially, to circumvent potential deficiencies in student learning as a result of wet lab removal, faculty retained the lab's time block and instead presented material typically conveyed in the laboratory session through a variety of mixed media presentations, lectures and physician-led case discussions. Student feedback was overwhelmingly negative in response to the lectures, mostly negative for the mixed media presentations and somewhat positive for the physician-led case discussions. Thus, to make more effective use of this time block, the course instructors introduced an interactive case-based tutorial in the Medical Virology module. Case-based learning has been shown to be effective for dental and allopathic medical programs in the U.S., Europe, and South America [2
]. Problem-based learning was also considered but discarded because its use would require significantly greater faculty manpower. The interactive case-based session was designed to show students the value of basic science information in clinical applications, to provide a review of course material and to familiarize the students with differential diagnosis. Given that the majority of questions on board exams are case-based, faculty believed that such a session would also better prepare students to answer the types of questions they would encounter on board exams. The interactive case based tutorials have been used at OSU-CHS since 2006.
In 2008, OSU-CHS began a major curriculum review of its Osteopathic Physician Program. The review is on-going and includes consideration of questions such as, "How do didactic teaching, problem-based learning, case-based learning, systems approaches and other educational methods fit into the new model of health education?" OSU-CHS students already do very well on the first level Comprehensive Osteopathic Medical Licensing Examination (COMLEX) exam, which tests biomedical science knowledge. Because students typically achieve the top or near top pass rate and class average nationally, there is resistance to "fixing" how OSU-CHS faculty teach students, but there are continued calls in the medical education literature to update the curriculum [6
]. These calls for changes correspond to upcoming changes in the certifications exams for physicians, including the United States Medical Licensing Examination™ (USMLE) and COMLEX, which will involve a reduction of biomedical science content and an increase in physical exams and clinical problems. Thus, curricular changes are necessary, but specifically how the Microbiology curriculum should be changed remains unanswered.
The current study addresses a small part of this issue. Removal of the wet laboratories from the OSU-CHS Medical Microbiology course and subsequent replacement with a mixture of lecture and tutorial periods resulted in a clear, negative response by students. Following the change, a group of students met with the faculty requesting more hands-on experience and greater student – teacher interaction. In response to this request, the course coordinator (the senior author) for the Medical Microbiology course developed an interactive, case-based session built upon a Microbial Jeopardy!™ idea from MicrobeLibrary.org [8
] and a Jeopardy! PowerPoint template obtained at http://teach.fcps.net/trt10/PowerPoint.htm
. Student worked in teams to demonstrate their knowledge of microbiological concepts. The session encouraged students to review and integrate basic science material in a more clinical approach. While feedback from students has generally been favourable about this component of their microbial education, the question remained "Does it do any good?" The Microbial Jeopardy!™ session is time-consuming for faculty to develop and administer and occupies a two-hour lecture block. This study was conducted to test the efficacy of the interactive session.
Students exposed to an interactive, case-based review session would perform significantly better on case-based exam questions than students who were not exposed to the interactive, case-based session.
Students would respond favourably to the interactive, case-based session including indicating that the session was (a) enjoyable, (b) useful for preparing to answer case-based exam questions in the current and other classes, and (c) facilitated transfer of knowledge to realistic situations.
A two-part study was used to test these hypotheses and evaluate outcomes of this interactive, case-based review session. Part One assessed student performance; it was conducted to determine whether the interactive, case-based review session increased student performance on case-based exam questions. Part Two was conducted to examine students' perceptions of the Microbial Jeopardy! session using both a retrospective survey and course evaluations. The OSU-CHS Institutional Review Board reviewed and approved this research protocol (#2007037).