The Clinical Case Sandwich: An Innovative Lecture Delivery Model to Enhance Student Engagement in Preclinical Pathology

Abstract

OBJECTIVE: To explore students’ perceptions of a modified pathology lecture format in which each session opened with a clinical case and returned to the same case at the end, named as the “Clinical Case Sandwich” technique.

METHODOLOGY: A cross-sectional mixed-methods study was conducted at the College of Medicine, Gulf Medical University, Ajman, UAE, after one academic year of pathology teaching using this format within a system-based modular curriculum. Forty-three Higher Diploma in Preclinical Sciences students completed a validated questionnaire. Thirteen 5-point Likert-scale items assessed engagement, clinical and examination relevance, learning impact, and satisfaction. Two open-ended questions captured students’ comments. Quantitative data were summarised using descriptive statistics and displayed through frequency plots and a heat map. Free-text responses were reviewed to identify recurring ideas, and Word-It-Out word-cloud software was used to visually summarise commonly occurring terms.

RESULTS: Responses were strongly positive. Eighty-two percent agreed that the cases improved engagement, 95% felt the approach would help them in their clinical years, and 86% believed it would support examination performance. Overall, 83% reported satisfaction and 93% recommended adoption by other faculty. Qualitative comments suggested that the format made lectures more interactive, clinically meaningful, and easier to follow, with the opening case creating curiosity and the closing discussion consolidating learning.

CONCLUSION: Opening and closing pathology lectures with a clinical case was well received and was perceived to strengthen student engagement, understanding, and clinical relevance. This simple lecture modification may help preclinical students connect pathology mechanisms with clinical reasoning.