# Impact of Studying Clinical Case Notes on the Learning of Medical Students: A Comparative Study

## TL;DR

Medical students who studied real patient case notes improved more in knowledge than those who didn't, suggesting case notes are useful for learning.

## Contribution

This study shows that using real clinical case notes enhances medical students' learning outcomes compared to standard teaching.

## Key findings

- Students who studied case notes scored significantly higher after training (19.6 vs. 17.1).
- Pre-placement scores were similar between groups, but post-placement scores showed significant improvement in the case note group.
- Case note review is a practical and effective addition to traditional medical education.

## Abstract

Objectives

The purpose of this study was to evaluate the impact of case notes on the learning of medical students. Patients’ case notes reflect real-life events and may be used as valuable learning resources for medical students. This study aims to investigate whether learning is improved when students study real case notes compared to students who do not.

Design

We allocated 14 third-year medical students into two groups during their six weeks of surgical clinical placement. Both groups received teaching on five common surgical conditions from the same clinical teaching fellow. Group 1 received standard teaching, while Group 2 received standard teaching and were also given the task of summarising clinical case notes featuring the same five conditions. Students’ knowledge was assessed at the beginning and end of their placement by a multiple-choice written paper using 25 standardised questions pertaining to the five surgical cases. The scores obtained were then analysed to establish any significant difference in the knowledge of the two groups.

Setting

The study was performed in the Epsom and St Helier University Hospitals NHS Trust. This is a tertiary care centre, affiliated with St George's, University of London.

Participants

Medical students from St George's Medical School participated in this study.

Results

There were seven students in each group. The average pre-placement score for Group 1 was 14.2, and for Group 2 it was 14. The difference between the pre-placement scores was not significant (p = 0.633). Both groups showed improvement in their scores after their placements. The average post-placement score for Group 1 was 17.1, and for Group 2 it was 19.6. We compared the assessment scores of the two groups as a measure of their improvement. The difference in their post-placement scores was significant (p =0.044).

Conclusion

The results of this study indicate that incorporating real clinical case notes into undergraduate teaching can significantly enhance students’ learning outcomes. Students who engaged with authentic patient documentation demonstrated greater improvement in knowledge compared to those who received standard teaching alone. These findings suggest that structured case note review is a valuable, practical, and easily implementable adjunct to traditional medical education, offering a bridge between theoretical learning and clinical practice.