Background

Discussion and reflection are important in university education, and in healthcare education patient cases are commonly used for this purpose. Learning in case seminars has recently been the topic of a systematic BEME review, which called for more qualitative research on how students learn and how much structure is required (1).

Summary of work

The number of students in healthcare education is increasing, and case seminars can involve as many as twenty students. How can we increase students’ opportunities for reflection? To address this question, we alternated large group with small group (three students) discussion approximately four times during a case. Large group discussion including white board notes was unaltered. To understand more about how students learn, we asked them to describe their learning in these kinds of seminars. Written data were collected in September 2013 from 68/80 students in a Swedish nursing program with case seminars. The narratives were analyzed using latent qualitative content analysis (2).

Summary of results

Three themes describing how students learn were identified in the analysis: Being active, Being part of a discussion and Seeing new problems and solutions. The analysis with examples of quotations will be presented at the conference.

Conclusions

In the small group, students were able to test ideas and build self-confidence, allowing them to act as problem-solvers in the large group discussion. Alternating large group seminars using the white board with small group discussions helps students be active and reflective and allows larger numbers of students per seminar.