Though those trained in business, law, and medicine are no strangers to active learning techniques in the classroom, scholars in graduate biomedical research programs are still frequently taught using passive lecture-based techniques. This is challenging for many pre-doctoral and master’s level students, who will spend the bulk of their training years conducting inquiry-based research. They are inherently curious and learn best through hands-on techniques. I say this as an individual for whom a single case-based course during my graduate biomedical research training not only vastly improved my educational experience as a student, but also dramatically changed my views on what biomedical research education was and could be.

Why use case- and problem-based learning in graduate biomedical research training?

The broad field of biomedical research is increasingly becoming more focused on clinical translation; that is, how best to conduct research with a plan as to how to quickly and safely bring effective discoveries to patient care (and following through on those plans!). This demands that investigators be lifelong learners, continuously gaining new knowledge and immediately bringing it to bear on the work at hand. As this means of operation is heralded as the “future of biomedical research,” it follows that we, as graduate biomedical research educators, should be working to shift the paradigm of how didactic training is delivered to ensure we are preparing our scholars for such a future.

This shift in thinking is supported by several different adult learning theories, and underscored by the use of constructivist and situated learning techniques in fields like business, law, policy, and medicine. These techniques include case- and problem-based learning (CBL and PBL, respectively). While definitions may vary with regard to what exactly these terms mean, our team has taken to thinking of it as “a case study allows trainees to critically analyze an event, topic, or issue through a multi- or transdisciplinary lens.”

How can these methods be applied in these settings?

Our faculty have used variations of CBL and PBL in several different ways throughout our curriculum, primarily in more advanced and elective courses for which scholars have prerequisite knowledge that they can apply to the problems presented to them. These have included a scholar-driven approach to cases in one course (“Case Studies in Translation”), in which each scholar is assigned a landmark biomedical treatment or innovation that is utilized in clinical care, and asked to trace it from its initial discovery through to widespread implementation. We purposefully assign scholars cases outside of their field of training (i.e., as an epidemiologically-focused cancer researcher, I was assigned the more basic science-focused gene therapy as a case).

Scholars are encouraged to take a multidisciplinary approach, and examine facilitators and barriers to translation through scientific, political, economic, and social lenses. In short, scholars are presented with a problem (the case topic) and work through researching it and developing it as a case; this portion of the course relies more on PBL. The scholar then presents the case to their peers and leads related discussion. This thrusts the presenting scholar into the role of educator as they lead their case-based exercise. Students who wish to publish their cases as a means of disseminating them for widespread use at other institutions are provided support and mentorship; examples of published cases include Zika Diagnostics, CAR T-cell therapy, and Magnetic Resonance Elastography.

While this is only one of many means of implementing these techniques into graduate biomedical curriculum, my team and I believe that this is a strong example of what can be done to innovate in this space. I say this from the perspective of a former student in this class who now has the distinct privilege of co-directing the course, and has experienced the fun and impactful nature of incorporating such techniques into graduate research curricula.

What barriers and challenges might faculty face in implementing CBL and PBL methods? What are next steps in bringing CBL and PBL to graduate biomedical research?

One broad challenge we face is encouraging faculty to learn about these situated and constructivist learning techniques and providing guidance as to which courses these teaching methodologies would lend themselves well. While it requires relatively little faculty development time to learn about CBL and PBL, finding protected time to actually invest in course iteration can be difficult. The courses which are currently offered using CBL and PBL were designed to utilize these learning techniques initially; they were not existing courses which were reorganized to use these methods. As we work to innovate in this space with existing courses, we may find that revamping a course takes less time than creating a new one using these methods.

Another challenge is that there is often a need for a basic level of knowledge a student must have in biomedical research before CBL- and PBL-type methods can be implemented as an effective educational tool. Therefore, it is necessary to evaluate whether these methods are appropriate for the content being delivered, and whether they will provide a learning advantage (both short- and long-term) for scholars.

Finally, we need to encourage faculty across the clinical translational spectrum to explore using CBL- and PBL-type activities in the classroom. Clinical training programs excel at using these pedagogies; advanced basic science courses might benefit from exploring these methods, particularly those taught in small group seminars or tutorials.



Did you know that the Harvard Macy Institute Community Blog has had more than 185 posts? Previous blog posts have explored topics including creating case-based e-learning modules, aligning learning theory with technology, and health systems science.

Alexandra J Greenberg-Worisek, PhD, MPH

Alexandra J. Greenberg-Worisek, PhD, MPH  (Leaders ’19) is a biomedical research educator, Assistant Professor of Epidemiology at Mayo Clinic College of Medicine and Science, and Associate Director for Graduate Curriculum in the Center for Clinical and Translational Science at Mayo Clinic. Alexandra’s areas of professional interest include experiential learning in research education, diversity and inclusion in biomedical research, and the digital divide in health information technology. Alexandra can be followed on Twitter and LinkedIn, or contacted via email.