Assessment of a case-based training system (d3web.Train) in rheumatology.

To improve the learning experiences for third year medical students, a case-based training program based on real patient records has been introduced as a supplement to lectures. It was built with the novel training environment d3web.Train. Optimization of the learning environment d3web.Train for both teachers and learners has been considered as equally important and offers several trade-offs. The training program has been evaluated during three subsequent rheumatology courses, the first one voluntary and the latter two mandatory. For each course, we tracked how often and intensive each student used the system. In addition, the students answered questionnaires about their expectations and experiences. In the first voluntary course, 39/92 students finished at least one case and solved 187 cases in total (average: 4.8 cases from 12 cases available). In the second and third mandatory courses, all students (60 resp. 56) finished at least the required 20 cases with an average usage of 22.5 resp. 29.3 out of 31 available cases. Most of the cases were processed twice by the students in preparation for the final examinations. A positive correlation between processed cases per student and the exam score could be shown (30, 73 and 95% in the first, second and third courses, respectively). The findings clearly exceeded the expectations of the students concerning its usefulness as a supplement to lectures and as good preparation for their job as physician, as well as the learning period to use the program. For working through one case, students needed about 9 min on average. The case-based training system d3web.Train offers a new tool for medical education in rheumatology. The main advantage of the system is the relatively low effort needed to create a case-based program starting from the available dismissal records.