How the story unfolds: exploring ways faculty develop open-ended and closed-ended case designs.

Open-ended or closed-ended case study design schemes offer different educational advantages. Anatomy and physiology faculty members who participated in a conference workshop were given an identical case about blood doping and asked to build either an open-ended study or a closed-ended study. The workshop participants created a rich array of case questions. Participant-written learning objectives and case questions were compared, and the questions were examined to determine whether they satisfied criteria for open or closed endedness. Many of the participant-written learning objectives were not well matched with the case questions, and participants had differing success writing suitable case questions. Workshop participants were more successful in creating closed-ended questions than open-ended ones. Eighty-eight percent of the questions produced by participants assigned to write closed-ended questions were considered closed ended, whereas only 43% of the questions produced by participants assigned to write open-ended questions were deemed open ended. Our findings indicate that, despite the fact that instructors of anatomy and physiology recognize the value of open-ended questions, they have greater difficulty in creating them. We conclude that faculty should pay careful attention to learning outcomes as they craft open-ended case questions if they wish to ensure that students are prompted to use and improve their higher-order thinking skills.