Objective: To determine the effects of a case-based, core content-orie
nted emergency medicine (EM) curriculum on the basic EM knowledge of s
enior medical students. Methods: All senior medical students rotating
through the Milwaukee County EM elective during the 1992-1993 academic
year were assigned specific chapter readings from a case-oriented EM
textbook. A course curriculum consisting of goals and objectives for e
ach chapter and two to three representative cases for the discussion t
opic also was distributed to each student. Interspersed with the cases
was a series of questions directed at pathophysiology, diagnosis, man
agement, and disposition. The EM faculty and residents conducted case
discussions three times per week. All students completing the rotation
were given a pretest at the beginning and a final examination at the
end of the rotation. In addition, the students rated the textbook,. co
ursebook, and lecture series at the end of the rotation using a five-p
oint Likert scale. Results: Seventy-five students rotated through the
elective. The students showed a significant improvement in their EM kn
owledge base as judged by improvement in final examination scores comp
ared with pretest scores (pretest score 62.2 +/- 7.1%; final examinati
on score 76.2 +/- 6.3%; p < 0.0001). The mean change in scores was 14.
8%, with a range of -1.6% to 34%. The students also rated the textbook
, coursebook, and lecture series as effective, as shown by high median
scores on a Likert scale. Conclusions: A case-based EM curriculum cou
pled with ED clinical experience improves basic EM diagnostic and mana
gement knowledge of senior medical students.