The Effect of Instruction on Learning- Case Based Versus Lecture Based
Published Nov 11, 2022 · Updated Mar 05, 2026
How much of a lecture do students remember months later, and can they apply it when it matters? A study at the American University of Beirut compared traditional Lecture-Based Learning (LBL) with Case-Based Learning (CBL) to explore how teaching methods affect long-term learning and clinical judgement (Kantar & Sailian, 2018), a question that also comes up when comparing lectures with non-traditional immersive seminars.
Nursing, as one of the foundations of healthcare systems worldwide, depends on individuals with strong knowledge and judgement skills. The actions and decisions of nurses can have serious and immediate consequences for those in their care, which is why nursing education is under constant scrutiny.
The researchers compared the long-term efficacy of two distinct teaching models. In LBL, lectures form the core of students’ instruction. Within nursing programmes, this model has received criticism, with some research suggesting that it can leave students with disjointed concepts that are difficult to apply in practice.
In CBL, real-world scenarios provide a basis for discussion within the lecture theatre. Students identify relevant facts, draw conclusions, and present them to their peers (Nilson, 2010).
The researchers chose to carry out this study with their university’s Nursing Care of Adults course within their three-year nursing programme. This course aims to provide students with the relevant knowledge and application skills to care for patients experiencing, or at risk of developing, acute or chronic surgical or medical issues.
A single cohort of 47 nursing students was divided into two groups, with the first receiving instruction through the LBL model and the second through the CBL model.
Eight months after the course, these students were asked to complete a 65-question multiple-choice questionnaire, with a single best answer for each question. The questions were divided into categories based on the four recognised clinical judgement dimensions: Noticing, Interpreting, Responding, and Reflecting. Each represents a phase in the nurse’s thinking practice during care provision (Tanner, 2006).
- Noticing: Knowledge and skills involved in patient and situation assessment.
- Interpreting: Reasoning skills, including analysis, intuition, and situation narration.
- Responding: The action taken by the nurse in a given situation.
- Reflecting: Considering the appropriateness of an action after the fact.
Overall, the LBL and CBL groups showed no significant difference in knowledge gained and retained. However, the CBL group scored significantly higher on questions in the Reflecting dimension. Tanner (2006) suggests that reflective practice supports further clinical maturity and learning in healthcare professionals.
CBL prompts students to consider their own experiences, reflect on those of their peers, and reach a conclusion. Kantar (2016) argues that this process can help students become emotionally and intellectually invested in the material, which in turn aids retention.
Takeaway: if you want students to build reflective judgement, case-based activities may offer an advantage, even when overall knowledge scores are similar.
The number of participants used in this study was modest, leading the authors to conclude that it should be replicated with a larger sample size in the future. However, this work builds on others (Nilson, 2010; Kantar, 2016) to suggest that immersive, case-based teaching can be an effective alternative to the traditional lecture model.
Case-based learning could find application across a broad range of subjects, from mathematics and engineering problem solving to business and resource management. For educators, the practical implication is straightforward: where reflection and judgement matter, building structured case discussion into teaching may help students engage more deeply with the material.
FAQ
The questions below expand on how student voice and feedback can fit into case-based teaching, and how you might measure what students are learning beyond multiple-choice tests.
Q: How does student voice play a role in the effectiveness of Case-Based Learning (CBL) compared to Lecture-Based Learning (LBL)?
A: Student voice refers to how students share input on what they learn and how they learn, see what student voice means in higher education. In Case-Based Learning (CBL), student voice is typically more prominent than in Lecture-Based Learning (LBL) because students are encouraged to discuss cases, share perspectives, and reflect on their experiences. This participation can deepen investment in the learning material, which may support knowledge retention and clinical maturity. While the original article does not explicitly address the role of student voice, it is reasonable to infer that CBL’s effectiveness may be partly driven by giving students more opportunities to contribute, reflect, and learn from peers.
Q: Are there any text analysis tools or methods used to evaluate the students' responses in the study, and how could they enhance understanding of student learning outcomes?
A: The study assessed learning using a multiple-choice questionnaire, rather than analysing students’ written responses. However, text analysis tools and methods for student feedback could enhance understanding of learning outcomes by providing insights into the complexity, depth, and nuance of students’ reasoning and reflection. For instance, it could be used to assess the quality of written reflections in the CBL group and compare them with those in the LBL group. By analysing language, themes, and sentiment in student responses, educators could build a clearer picture of how effectively each teaching method fosters critical thinking, problem-solving, and reflective skills.
Q: How might the incorporation of student voice through feedback mechanisms impact the future design of both Lecture-Based Learning and Case-Based Learning models?
A: Incorporating student voice through feedback mechanisms can shape the future design of both Lecture-Based Learning (LBL) and Case-Based Learning (CBL) models by making them more responsive to students’ learning needs and preferences, including how student voice informs curriculum design. Feedback can reveal which teaching methods feel most effective, which materials feel most relevant, and where engagement drops. For LBL, this might prompt the integration of more interactive elements, such as discussion prompts or practical examples, to complement lectures. For CBL, feedback can help refine the cases used, ensuring they are diverse, relevant, and challenging enough to stimulate deeper learning. By actively listening to student voice, educators can continuously improve their teaching strategies and foster a more engaging, effective, student-centred learning environment.
References:
Nilson, L. B. (2010). Teaching at its best: A research-based resource for college instructors (3rd ed.). Jossey-Bass: A Wiley Imprint.
ISBN: 978-1-119-09632-0
Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204–211.
DOI: 10.3928/01484834-20060601-04
Kantar, L. (2016). Context-based pedagogy: A framework from experience. Journal of Nursing Education, 55(7), 391–395.
DOI: 10.3928/01484834-20160615-06
Kantar, L. & Sailian, S. (2018). The effect of instruction on learning: Case based versus lecture based. Teaching and Learning in Nursing, 13 (2018), 207-211
DOI: 10.1016/j.teln.2018.05.002
Request a walkthrough
Book a free Student Voice Analytics demo
See all-comment coverage, sector benchmarks, and reporting designed for OfS quality and NSS requirements.
- All-comment coverage with HE-tuned taxonomy and sentiment.
- Versioned outputs with TEF-ready reporting.
- Benchmarks and BI-ready exports for boards and Senate.
UK-hosted · No public LLM APIs · Same-day turnaround
Related Entries
- Feeding-Forward
- Simulation-Based Learning in Higher Education
- Non-Traditional Immersive Seminars
- Can a ‘flipped classroom’ approach help students succeed?