Protocol for a realist review of case-based learning in undergraduate medical education

Case-based learning has become increasingly adopted as a pedagogical approach in health professions education. The successful implementation of case-based learning programmes can be impacted by factors including resources, organisational attitudes and cultural dynamics. This protocol outlines a methodology for a realist review which aims to elucidate the mechanisms and contexts that influence the implementation of a case-based learning programme in health professions education. This study aims to understand the underlying causal mechanisms and contextual factors which can lead to the success or failure of case-based learning programmes. This review will involve a systematic literature review on case-based learning in health professions education, under a realist synthesis framework. A realist synthesis was chosen as the approach as it is suited to the review of such complex interventions, such as the implementation and delivery of a case-based learning programme. Through an iterative literature search and analysis, relevant literature will be explored in order to develop an understanding of the contextual elements and mechanisms which may affect the success of a case-based learning programme. This review will employ thematic analysis to synthesize findings across studies, iteratively refining a programme theory explaining how case-based learning programmes work, for whom, and in what contexts. This realist review protocol provides a systematic and rigorous approach to examining the complexities of case-based learning and the outcomes produced by its underlying mechanisms and contexts. This review aims to offer valuable insights for educators, curriculum developers, and policymakers to optimize the implementation of case-based learning interventions in medical education.