Department of Community Medicine, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India


BACKGROUND: Modern competency‑based medical education emphasizes student‑centered
teaching‑learning strategies where students take responsibility of their own learning. Student‑centered
approaches facilitate multifaceted learning such as observation, critical evaluation, analysis, deeper
understanding, and application of knowledge. The current study aims at assessing the students’
perception on utilization of clinical case problem‑solving approach (CCPS) to promote their lifelong
MATERIALS AND METHODS: The present cross‑sectional study was conducted at College of
Medicine and Health Sciences (CoMHS) during the year 2021‑2022. MD3 students of the academic
year 2021‑2022 were the study participants. The study was approved by institutional Ethic and Review
Committee. Students’ performances were assessed through pre‑test and post‑test performances.
Students’ feedback was collected through a predesigned questionnaire on a 3‑point Likert scale.
Cronbach’s alpha coefficient test was used to assess the reliability of the questionnaire. The data was
entered to Microsoft Excel and analyzed using SPSS software version 22. Paired t‑test was used to
compare pre‑test and post‑test scores and the data was expressed as numbers and percentages.
RESULTS: In total, 103 participants were included in the study. Post‑test scores were significantly
higher compared to pre‑test scores (p < 0.05). Questionnaire results showed that CCPS approach
was accepted as an effective learning strategy. Majority (>90%) of the students expressed CCPS
approach was interesting, motivated to learn, encouraged peer discussion, enhanced knowledge,
and clarified their topic‑related doubts. More than 80% students opined that CCPS enhanced their
critical thinking, problem‑solving ability, deep learning, and lifelong learning skills. Nearly 90% of
the students suggested for including such sessions for more topics in immunology course in future.
CONCLUSION: From our study results, it can be concluded that CCPS is an effective learning
strategy to encourage students’ engagement and promote their deep learning skills.


1. Dankner R, Gabbay U, Leibovici L, Sadeh M, Sadetzki S.
Implementation of a competency‑based medical education
approach in public health and epidemiology training of medical
students. Isr J Health Policy Res 2018;7:13.
2. Hopper MK, Brake DA. Student engagement and higher order
skill proficiency: A comparison of traditional didactic and
renewed integrated active learning curricula. Adv Physiol Educ
3. Sakai DH, Fong SF, Shimamoto RT, Omori JS, Tam LM. Medical
school hotline: Transition to clerkship week at the John A. Burns
School of Medicine. Hawaii J Med Public Health 2012;71:81‑3.
4. Altalhia F, Altalhia A, Magliaha Z, Abushala Z, Althaqafia A,
FalembanA, et al. Development and evaluation of clinical reasoning
using ‘think aloud’ approach in pharmacy undergraduates – A
mixed‑methods study. Saudi Pharm J 2021;29:1250‑7.
5. Sannathimmappa MB, Nambiar V, Aravindakshan R. Learning
out of the box: Fostering intellectual curiosity and learning skills
among the medical students through gamification. J Edu Health
Promot 2022;11:79.
6. Mahajan R, Badyal DK, Gupta P, Singh T. Cultivating lifelong
learning skills during graduate medical training. Indian Pediatr
7. Banerjee Y, Tuffnell C, Alkhadragy R. Mento’s change model in
teaching competency‑based medical education. BMC Med Educ
8. Gul A, KhanRA, YasmeenR, Ahsan NU. How case based learning
promotes deep learning in preclinical years of medical students?
J Ayub Med Coll Abbottabad 2020;32:228‑33.
9. Das S, Das A, Rai P, Kumar N. Case‑based learning: Modern
teaching tool meant for present curriculum: A behavioral analysis
from faculties’ perspective. J Edu Health Promot 2021;10:372.
10. Ali M, Han SC, Bilal HSM, Lee S, Kang MJY, Kang BH, et al. iCBLS:
An interactive case‑based learning system for medical education.
Int J Med Inform 2018;109:55‑69.
11. Ibrahim ME, Al‑Shahrani AM, Abdalla ME, Abubaker IM,
Mohamed ME. The effectiveness of problem‑based learning in
acquisition of knowledge, soft skills during basic and preclinical
sciences: Medical students’ points of view. Acta Inform Med
12. Burgess A, Haq I, Bleasel J, Roberts C, Garsia R, Randalet N, et al.
Team‑based learning (TBL): A community of practice. BMC Med
Educ 2019;19:369.
13. Sannathimmappa MB, Nambiar V, Aravindakshan R, Kumar A.
Are online synchronous team‑based‑learning (TBL) pedagogy
effective?: Perspectives from a study on medical students in
Oman. J Adv Med Educ Prof 2022;10:12‑21.
14. Sannathimmappa MB, Nambiar V, Aravindakshan R. Concept
maps in immunology: A metacognitive tool to promote
collaborative and meaningful learning among undergraduate
medical students. J Adv Med Educ Prof. 2022; 10 (3):172‑178. doi:
10.30476/JAMP. 2022.94275.1576.
15. Haidaris CG, Frelinger JG. Inoculating a new generation:
Immunology in medical education. Front Immunol 2019;10:2548.
16. Novack JP. Designing cases for case‑based immunology teaching
in large medical school classes. Front Immunol 2020;11:995.
17. Sannathimmappa MB, Nambiar V, Gowda S, Aravindakshan S.
Crossword puzzle: A tool for enhancing medical students’
learning in microbiology and immunology. Int J Res Med Sci
18. McLean SF. Case‑based learning and its application in medical
and health‑care fields: A review of worldwide literature. J Med
Educ Curric Dev 2016;3:JMECD.S20377. doi: 10.4137/JMECD.
19. Sangam M, Praveen K, Vinay G, Bokan RR, Deka R, Kauret A.
Efficacy of case‑based learning in anatomy. Cureus 2021;13:e20472.20. Nair SK, Rai N. Comparing the effectiveness of case based learning
with conventional teaching in anatomy. Acad Anat Int 2019;2:34‑6.
21. Al‑Drees AA, Khalil MS, Irshad M, Abdulghani HM. Students’
perception towards the problem based learning tutorial
session in a system‑based hybrid curriculum. Saudi Med J
22. Hanse K. Basic Medical Education, WFME Global Standards for
Quality Improvement. University of Copenhagen (Denmark):
WFME office; 2012. THE WFME GLOBAL STANDARDS. p. 1–46.
Available from:
23. Ghazivakili Z, Norouzi Nia R, Panahi F, Karimi M, Gholsorkhi H,
Ahmadi Z. The role of critical thinking skills and learning styles
of university students in their academic performance. J Adv Med
Educ Prof 2014;2:95‑102.
24. Jhala M, Mathur J. The association between deep learning
approach and case based learning. BMC Med Educ 2019;19:106