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This study examined differences between student interactions, levels of cognitive and perceived online presence in case-based discussions. Data were collected from two online case-based discussions and an online survey. Degree centrality was used to divide students by high and low levels of interaction. Findings revealed that students at high level of interaction expressed higher levels of cognitive presence and participated more frequently in both discussions. Students at low level of interaction rated application of knowledge to real life and combining new information as the lowest one. All students rated teaching presence higher than cognitive presence and social presence. Social presence was the lowest perceived presence to compare with teaching presence and cognitive presence in case-based discussions.