OBJECTIVE: To describe an innovative teaching/learning option that engages the student as an active learner without compromising the financial advantages of large group/classroom teaching.

METHOD: A case study is used to demonstrate an innovative teaching/learning format. The content of the case study is based upon the identification of referral criteria at the patient-health care system interface. The learning experience consists of a quiz followed by class discussion.

SAMPLE: A convenience sample of final-year chiropractic and osteopathy students at RMIT.

DISCUSSION: The case study demonstrates how this format may be used to create an environment in which each student is personally confronted by the necessity to reach a decision about referring a patient on the basis of the information provided. Having engaged each student in the decision-making process, this format then provides an opportunity for self-assessment and the enunciation of general guidelines during class discussion. An additional demonstrable benefit of this teaching/learning strategy is the lecturer's enhanced awareness of the learning needs of the student group.

CONCLUSION: The format proposed provides an additional option for teaching/learning that is acceptable to students and is consistent with the need to contain costs, maintain standards and conform to the requirements of a competency-based curriculum.

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