Purpose: Educators are increasingly seeking ways to integrate basic and clinical sciences throughout undergraduate medical education, as medical education is moving away from the traditional two years of preclinical education followed by two years of clinical clerkships. One way of doing this is to use clinical cases that integrate basic and clinical sciences in several curricular formats that use team-based learning (TBL), case-based learning (CBL) or problem-based learning (PBL) with or without lectures. The outcomes of these curricular modalities will depend on how actively students engage and learn using clinical cases. Therefore, the quality of the clinical cases, clarity of learning objectives, and the learning environment created by the cases are important components in all of the modalities mentioned above. The purpose of our workshop is to provide educators and administrators with the foundations to incorporate these modalities into their curriculum.
Goals: The objectives of our workshop are:
- To deliver key concepts that authors have to consider when developing cases,
- Work in small groups to develop learning objectives and start writing a case based on the chief complaint and template provided,
- Discuss various components of the case amongst the groups so that participants can learn how cases can be created to fit different modalities such as CBL, TBL, PBL or lecture-based formats.
Our goals are to provide participants with methods to develop active learning cases that will encourage student discussion and collaboration.
Timeliness and Significance to the Field: As medical educators, we strive to instill curiosity and foster the development of life-long learning skills in our students throughout their medical school journey. In this day of digital fluency where Millennials and Generation Z students are adept at instant messaging and social networking, how do we motivate our students to be curious, actively seek out information, and learn? Through the course of the workshop, participants will work in groups to identify learning objectives, and starting with a case outline, create a case that matches the learning objectives defined by them. An important component of this process is having basic science and clinical faculty work together to write/create clinical cases that can be used alone or as a supplement to lectures. Knowing how to write a case that engages both the students and faculty will be essential to everyone's career, as medical schools move away from traditional lectures and towards interactive learning approaches. Case creation is greatly enhanced when authors work in a team, just as students' learning is enhanced when they work in teams rather than as individuals. We will form groups for attendees to work in, based on the needs of their program/curriculum. We will use principles of case construction that are in use in four different medical schools in the US. Using these principles and our experiences, we will guide groups through the process of case writing, providing techniques and tools, which we find to be very effective. We will provide a format for participants to actively create and discuss cases so that by the end of the workshop, they will have a fairly well written scenario that is realistic and challenging. Participants will provide the educational and subject matter expertise. We will provide guidance in case writing so that elements of critical thinking, and principles and skills necessary for solving problems in heath and disease which are important for medical students' education, are included in each case. We will wrap-up our session with an open forum discussion to address issues identified during the workshop.
Workshop Description including teaching methods and timeline for educational activities: The workshop will be divided into the following three components:
- Case Development (100 min):
- Didactic session (15 min): Introduction to Case Writing. This session will highlight methods to create learning objectives and begin case development. We will introduce the key elements of creating engaging cases from both a student and faculty perspective.
- Large Group Discussion (10 min): All groups will share learning objectives based on the chief complaint.
- Small Group Case Writing (55 min): Participants will work together in small groups to refine the Chief Complaint, and develop a Patient History and Physical Exam.
- Gallery Walk (20 min): Groups will post their Chief Complaint, History, and Physical Exam. The groups will then view and critique each other.
- Case Refinement (70 min):
- Small Group Case Writing (50 min): Participants will continue with case construction in their small groups, beginning with a discussion of the critiques provided by the other groups. Following this discussion, groups will begin selecting appropriate laboratory data, clinical images, treatment strategies, and an outcome for their case.
- Large Group Discussion (20 min): Groups will present their written cases. During this discussion, groups will share which components of clinical data, treatment strategies and management plans were included in their cases and how these components aligned with their learning objectives and teaching modalities.
- Wrap-Up (10 min): We will close with an overview of the workshop and use an open forum discussion to address issues identified during the workshop.
Presenter's qualifications/expertise in area: Together, the presenters have over 50 years of experience working with CBL, TBL, and PBL in the medical and dental fields. They have developed numerous cases both at their institutions and as members of multi-institutional teams. Additionally, they served as consultants to a new medical school during its pre-accreditation phase where they discussed the merits of CBL, TBL, and PBL and the planning required for the implementation of each. Finally, the presenters also serve as Directors/Assistant Directors/Academic Coordinators with the PBL programs of their home institutions.
Outcomes - What skills will attendees acquire?
- Participants will be introduced to techniques, which are currently being used in our curricula, to develop a clinical case in an active learning-based format.
- Participants will recognize the importance of faculty collaboration in creating clinical cases and assessing the basic sciences learned in the case.
- Participants will gain a better understanding of how creating a clinical case can supplement lectures, thereby allowing the process of active learning to be implemented in their curricula.
- Our goal is to show that the process can be generalized and is transferable to other schools and learning formats, since we represent four different curricula, which use the same process.
- The group activity will encourage participation amongst attendees, and our direction will allow them to create a case that they can take with them after the workshop.
Donna MCMAHON - NYIT College of Osteopathic Medicine
Swapan Nath - Professor of Medical Education
Todd Nolan - Lake Erie College of Osteopathic Medicine
Naunihal Zaveri - Arkansas College of Osteopathic Medicine