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

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Title: Impact of Adaptive Case-Based Learning on Clinical Reasoning Confidence in Pre-Clinical Veterinary Students.
Authors: Ritter NL; College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4458 TAMU, College Station, TX 77843-4458 USA., Heseltine JC; Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474 USA.
Source: Journal of veterinary medical education [J Vet Med Educ] 2026 Aug; Vol. 53 (4), pp. 472-477. Date of Electronic Publication: 2026 May 15.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: University of Toronto Press Country of Publication: Canada NLM ID: 7610519 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0748-321X (Print) Linking ISSN: 0748321X NLM ISO Abbreviation: J Vet Med Educ Subsets: MEDLINE
Imprint Name(s): Publication: Toronto : University of Toronto Press
Original Publication: Knoxville, Institute of Agriculture, University of Tennessee
MeSH Terms: Education, Veterinary*/methods , Problem-Based Learning*/methods , Clinical Reasoning* , Clinical Competence*, Humans ; Educational Measurement ; Animals
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.
Contributed Indexing: Keywords: PBL (problem-based learning); clinical reasoning; competency/competencies; curriculum; e-learning; educational methods
Entry Date(s): Date Created: 20260519 Date Completed: 20260814 Latest Revision: 20260814
Update Code: 20260814
DOI: 10.3138/jvme-2025-0052
PMID: 42154569
Database: MEDLINE
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  Data: Impact of Adaptive Case-Based Learning on Clinical Reasoning Confidence in Pre-Clinical Veterinary Students.
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  Data: <searchLink fieldCode="AU" term="%22Ritter+NL%22">Ritter NL</searchLink>; College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4458 TAMU, College Station, TX 77843-4458 USA.<br /><searchLink fieldCode="AU" term="%22Heseltine+JC%22">Heseltine JC</searchLink>; Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474 USA.
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  Data: <searchLink fieldCode="JN" term="%227610519%22">Journal of veterinary medical education</searchLink> [J Vet Med Educ] 2026 Aug; Vol. 53 (4), pp. 472-477. <i>Date of Electronic Publication: </i>2026 May 15.
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22University+of+Toronto+Press%22">University of Toronto Press </searchLink><i>Country of Publication: </i>Canada <i>NLM ID: </i>7610519 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Print <i>ISSN: </i>0748-321X (Print) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%220748321X%22">0748321X </searchLink><i>NLM ISO Abbreviation: </i>J Vet Med Educ <i>Subsets: </i>MEDLINE
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  Data: <i>Publication</i>: Toronto : University of Toronto Press<br /><i>Original Publication</i>: Knoxville, Institute of Agriculture, University of Tennessee
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  Data: <searchLink fieldCode="MM" term="%22Education%2C+Veterinary%22">Education, Veterinary*</searchLink>/<searchLink fieldCode="MM" term="%22Education%2C+Veterinary+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Problem-Based+Learning%22">Problem-Based Learning*</searchLink>/<searchLink fieldCode="MM" term="%22Problem-Based+Learning+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Clinical+Reasoning%22">Clinical Reasoning*</searchLink> <br /><searchLink fieldCode="MM" term="%22Clinical+Competence%22">Clinical Competence*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Educational+Measurement%22">Educational Measurement</searchLink> ; <searchLink fieldCode="MH" term="%22Animals%22">Animals</searchLink>
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  Label: Abstract
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  Data: 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.
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  Data: <i>Keywords: </i>PBL (problem-based learning); clinical reasoning; competency/competencies; curriculum; e-learning; educational methods
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  Data: 10.3138/jvme-2025-0052
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        Value: 10.3138/jvme-2025-0052
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      – Code: eng
        Text: English
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      Pagination:
        StartPage: 472
    Subjects:
      – SubjectFull: Humans
        Type: general
      – SubjectFull: Educational Measurement
        Type: general
      – SubjectFull: Animals
        Type: general
      – SubjectFull: Education, Veterinary methods
        Type: general
      – SubjectFull: Problem-Based Learning methods
        Type: general
      – SubjectFull: Clinical Reasoning
        Type: general
      – SubjectFull: Clinical Competence
        Type: general
    Titles:
      – TitleFull: Impact of Adaptive Case-Based Learning on Clinical Reasoning Confidence in Pre-Clinical Veterinary Students.
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          Name:
            NameFull: Ritter NL
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            NameFull: Heseltine JC
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            – D: 01
              M: 08
              Text: 2026 Aug
              Type: published
              Y: 2026
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              Value: 53
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              Value: 4
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            – TitleFull: Journal of veterinary medical education
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