(PO-008) Case-based Assessment in Postgraduate Education: A Critical Literature Review

Author: Klara Deskovic, D.M.D.
Author: Samar Shaikh, BDS, MS – Assistant Clinical Professor, Tufts University School of Dental Medicine
Author: Irina F. Dragan, D.D.S., D.M.D, M.S – Associate Professor, Department of Periodontology, Tufts University School of Dental Medicine
Submitter: Klara Deskovic, D.M.D.

Objective: Stand-alone multiple-choice questions (MCQs) examinations are used for national summative assessments in healthcare education. Integrated National Board Dental Examination uses a case-based format that allows for contextual application and deeper understanding of the foundational knowledge for the predoctoral dental students. The aim of this critical review was to identify the best andragogical practices to integrate a national case-based assessment format with MCQs in postgraduate healthcare education.

Methods: A thorough search of the literature from 1997-2021 was performed. The search engines queried were PubMed, ERIC and MedEd. The search string included various MeSH terms (“case-based", “assessment“, “examination”, “healthcare”, “dental”, “medical”, “value”) and Boolean operators (“AND”, “OR”). The references identified were reviewed by title, abstract and full-text review, and only articles relevant to the topic were included in the final analysis. Excel was used for data tabulation and a circular literature review map was compiled with the main domains identified.

Results: This search yielded 1836 articles in total (892 through PubMed, 219 through ERIC and 725 through MedEd), with both qualitative and quantitative data. After the inclusion and exclusion criteria were applied a total of 20 articles were selected with various levels of evidence (1 systematic review, 6 case-control studies, 6 case series and 7 case reports). The main domains integrated into the circular map were case-based learning and national assessments that integrate case-based MCQs. The specialty programs that use integrated case-based MCQs for the summative assessments included nuclear medicine, internal medicine, pediatrics, and pharmacology. Limited evidence is available regarding the dental specialty programs that integrate a national case-based assessment format with MCQs for summative exams.

Conclusion: There is significant evidence in healthcare education professions regarding the value of national case-based assessment format with MCQs in the educational framework of residency programs, with limited data for the field of dentistry.