Impact of Adaptive Case-Based Learning on Clinical Reasoning Confidence in Pre-Clinical Veterinary Students.

Abstract

Pre-clinical veterinary students enter training with varying levels of baseline knowledge and clinical reasoning skills, creating challenges for applying concepts in real-world scenarios. Traditional lecture-based instruction may not sufficiently address these disparities or build student confidence in clinical reasoning. To address this problem, this study investigated whether integrating online adaptive case studies into a third-year small animal medicine course could enhance students' learning outcomes and confidence in clinical reasoning. Students were divided into two groups: a control group that received only instructor-led lectures, and a treatment group that received lectures plus adaptive online case studies on chronic kidney disease. The adaptive case studies, delivered via StepStone software, provided individualized learning paths and immediate feedback, allowing students to progress through increasingly complex cases based on performance. Outcomes were measured using exam scores on related multiple-choice questions and a validated pre- and post-intervention survey of students' confidence in clinical reasoning. The results showed no statistically significant difference in exam scores between groups; however, students who completed the adaptive case studies reported a significant increase in confidence. Qualitative feedback from the university-mandated end-of-course survey highlighted the value of immediate feedback and clinically relevant application, although students noted technical and design challenges. These findings suggest that adaptive case studies can address disparities in student preparedness by enhancing engagement and confidence in clinical reasoning, serving as a valuable complement to traditional instruction.