Case-based learning in surgery: lessons learned.

Background: The aim of the study was to obtain a deepened understanding of the implementation process of case-based learning (CBL) during a surgical semester at the Undergraduate Medical Program at Karolinska Institutet. The objectives are to identify the level of success of the implementation and to identify practical and theoretical implications of importance in connection to the process.

Methods: Based on a qualitative study design, the study explores students' and teachers' perceptions of the educational intervention CBL in context. Five faculty members involved in the entire reform and five students from the second cohort were interviewed 1 year into the implementation phase. Narrative data from the semistructured interviews were coded using a blend of an inductive and deductive approach to derive the coding categories.

Results: The results of the study reflect two overarching themes: the importance of a well-functioning implementation process and the misalignment between the student/faculty Teaching Learning Regime and the attributes of CBL. The findings have resulted in a checklist for implementation of CBL in a surgical curriculum.

Conclusions: The implementation of CBL was not satisfactory. Still, exposure of the weaknesses of the implementation process, the misalignment between CBL and the reigning teaching and learning regime, and promotion of the future use of the checklist are key to future successful implementation of CBL in any surgical undergraduate curriculum.