26gma117 10.3205/26gma117 urn:nbn:de:0183-26gma1170 Meeting Abstract Peltzer Peltzer Nina N

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author Öhler Öhler Kim Sarah KS

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author Scherff Scherff Aline D. AD

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author Richters Richters Constanze C

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author Stadler Stadler Matthias M

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author Braun Braun Leah L

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author Weidenbusch Weidenbusch Marc M

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author Zottmann Zottmann Jan M. JM

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author Schmidmaier Schmidmaier Ralf R

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author Fischer Fischer Martin R. MR

Klinikum der Universität München, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Munich, Germany

author German Medical Science GMS Publishing House

Düsseldorf

610 20260904 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0655 117 Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA) P-02 Poster: Innovative Lehrformate in der Medizin I Dresden 20260917 20260919 P-0205 TextBackground: Case-based learning (CBL) is a well-established approach to foster clinical competences . However, it is crucial to understand what exactly makes a case difficult, as learning outcomes depend on case demands such as case-inherent complexity . Accordingly, this study aims to examine how complexity influences case difficulty for learners, assuming that an increase in complexity leads to an increased difficulty. Methods: Utilizing an innovative standardized evaluation system (CASE) , we operationalized medical case complexity as the summed CASE score, quantifying the amount of information provided across predefined categories (e.g., imaging, laboratory). Across three prior studies (N=342; 45 cases), we used an explanatory item response model with random intercepts for cases and participants to link CASE-category information to case difficulty (diagnostic accuracy; one dataset dichotomized at ≥0.5), to estimate how a one-point increase in category-specific complexity changes the odds of a correct diagnosis.Results: Between-case variability exceeded between-person variability (item variance ≈1.57; person variance ≈0.35), indicating substantial differences in case difficulty beyond individual ability. Across datasets, imaging information was consistently associated with lower diagnostic accuracy (β≈-.19, p<.001; OR≈0.82), whereas laboratory (β≈.034, p≈.009; OR≈1.03-1.04) and physical examination information (β≈.043, p≈.031; OR≈1.04) showed small positive associations; medical history showed no robust effect.Discussion: As expected, our findings indicate that case features systematically shape case difficulty as reflected in diagnostic accuracy, which may partly explain why effects of CBL vary across studies. Diagnostic performance appears at least partly case-dependent, highlighting the relevance of case composition when assembling case sets for different learner levels. Moreover, CASE-based complexity was not uniformly difficulty-increasing: imaging may act as a challenge driver, warranting additional instructional support (e.g., interpretation frameworks, prompts, preparatory instruction), whereas laboratory and physical-examination information support correct diagnoses. Overall, difficulty may not be inferred from information quantity alone, supporting a more fine-grained view of case features.Take home messages: More information alone does not make cases harder; difficulty depends on the type of information, as captured by the CASE categories.CASE may enable transparent, comparable descriptions of case materials across studies and teaching settings.CASE-based profiling could help identify cases that may benefit from additional instructional support. This could further enable the construction of cases that are precisely tailored to different skill levels of medical students.Future research could examine how case complexity can be aligned with learners’ prerequisites. Braun LT Lenzer B Fischer MR Schmidmaier R Complexity of clinical cases in simulated learning environments: proposal for a scoring system 2019 GMS J Med Educ Doc80 Braun LT, Lenzer B, Fischer MR, Schmidmaier R. Complexity of clinical cases in simulated learning environments: proposal for a scoring system. GMS J Med Educ. 2019;36(6):Doc80. DOI: 10.3205/zma001288 https://doi.org/10.3205/zma001288 Kassirer JP Teaching clinical reasoning: case-based and coached 2010 Acad Med 1118-1124 Kassirer JP. Teaching clinical reasoning: case-based and coached. Acad Med. 2010;85(7):1118-1124. DOI: 10.1097/ACM.0b013e3181d5dd0d https://doi.org/10.1097/ACM.0b013e3181d5dd0d Öhler KS Hilger E Stadler M Hege I Papa F Schmidmaier R Fischer MR Weidenbusch M Zottmann J Assessing the complexity of clinical cases 2022 Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA) und des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ). Halle (Saale), 15.-17.09.2022 DocV-10-05 Öhler KS, Hilger E, Stadler M, Hege I, Papa F, Schmidmaier R, Fischer MR, Weidenbusch M, Zottmann J. Assessing the complexity of clinical cases. In: Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA) und des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ). Halle (Saale), 15.-17.09.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV-10-05. DOI: 10.3205/22gma063 https://doi.org/10.3205/22gma063 0 0 0 0