scholarly journals Are Branched Narratives and Virtual Patient Models Acceptable Means of Reforming Case-based Learning?

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Alexander Whelan

Case-Based Learning (CBL) has become a major component of medical curricula and is featured prominently at the University of Ottawa. In this article, CBL is defined as a pedagogical method that uses fictional cases to reinforce important clinical skills [1]. Cases are organized into written sections pertaining to the patient’s chief complaint, a history and physical examination, laboratory and diagnostic investigations, as well as management and follow-up plans [1]. These cases are delivered through selfdirected online teaching modules or through group-oriented discussions. With either method, learners are expected to identify salient points from a given section, in order to anticipate the next steps in the management plan [1]. For example, if the history section describes a patient suffering from epigastric pain, students are encouraged to identify potential pain sources and use this knowledge to recognize the components that should be included in their approach to the physical examination. The ability to synthesize information to direct decision-making is a necessary competency of medicine supported by CBL [1-2]...

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Mia Rodziewicz ◽  
Terence O'Neill ◽  
Audrey Low

Abstract Background/Aims  Rheumatology departments were required to switch rapidly from face-to-face (F2F) to remote consultations during the COVID-19 pandemic in the UK. We conducted a patient satisfaction survey on the switch to inform future service development. Methods  All patients [new (NP), follow-up (FU)] were identified between 1st to 5th June 2020. Patients who attended or did not attend (DNA) a pre-booked F2F consultation or cancelled were excluded. Of the remainder, half the patients was surveyed by phone using a standardised questionnaire and the other half was posted the same questionnaire. Both groups were offered the opportunity to complete the survey online. Patients were surveyed on the organisation and content of the consultation, whether they were offered a subsequent F2F appointment and future consultation preference. Results  233 consultations were scheduled during the study period. After 53 exclusions (34 pre-booked F2F, 16 DNA, 3 cancellations), 180 eligible consultations were surveyed (85 via mailshot, 95 by telephone). 75/180 patients (42%) responded within 1 month of the telephone consultation (20 NP, 47 FU, 8 missing). The organisation of the switch was positively perceived (Table). Patients were highly satisfied with 4 of the 5 consultation domains but were undecided whether a physical assessment would have changed the outcome of the consultation (Table). After the initial phone consultation, 7 of 20 NP and 19 of 47 FU were not offered subsequent F2F appointments at the clinicians’ discretion. Of those not offered subsequent F2F appointments, proportionally more NP (3/7, 43%) would have liked one, compared to FU (5/19, 26%). Reasons included communication difficulties and a desire for a definitive diagnosis. 48/75 (64%) would be happy for future routine FU to be conducted by phone “most of the time" or "always”; citing patient convenience and disease stability. Caveats were if physical examination was required or if more serious issues (as perceived by the patient) needed F2F discussion. Conclusion  Patients were generally satisfied with telephone consultations and most were happy to be reviewed again this way. NPs should be offered F2F appointments for first visits to maximise patient satisfaction and time efficiency. P071 Table 1:Median age, yearsFemale; n (%)Follow-up; n (%)All eligible for survey; n = 18056122 (68)133 (74)Sent mailshot; n = 855459 (69)65 (76)Surveyed by phone; n = 955663 (66)68 (72)Responder by mail; n = 166911 (69)13 (82)Responder by phone; n = 525437 (71)34 (65)Responder by e-survey; n = 7495 (71)UnknownOrganisation of the telephone consultation, N = 75Yes, n (%)No, n (%)Missing, n (%)Were you informed beforehand about the phone consultation?63 (84)11 (15)1 (1)Were you called within 1-2 hours of the appointed date and time?66 (88)6 (8)3 (4)Domains of the consultation, N = 75Strongly disagree, n (%)Disagree, n (%)Neutral, n (%)Agree, n (%)Strongly agree, n (%)Missing, n (%)During the call, I felt the clinician understood my problem3 (4)1 (1)1 (1)20 (27)49 (65)1 (1)During the call, I had the opportunity to ask questions regarding my clinical care1 (1)02 (3)16 (21)55 (73)1 (1)A physical examination would have changed the outcome of the consultation16 (21)18 (24)20 (27)11 (15)10 (13)0The clinician answered my questions to my satisfaction2 (3)06 (8)18 (24)49 (65)0At the end of the consultation, the clinician agreed a management plan with me3 (4)2 (3)6 (8)24 (32)39 (52)1 (1)Future consultations, N = 75Never, n (%)Sometimes, n (%)Most of the time, n (%)Always, n (%)Missing, n, (%)In the future, would you be happy for routine FU to be conducted by phone?5 (7)20 (27)16 (21)32 (43)2 (3) Disclosure  M. Rodziewicz: None. T. O'Neill: None. A. Low: None.


2021 ◽  
Author(s):  
Marija Raković ◽  

The paper deals with the observation of the specifics of online teaching of lexicology and syntax of the Serbian language at the Faculty of Philology of students studying a foreign language. The aim is to notice possibilities of realization of online teaching. The research was conducted on the basis of the implementation of the teaching process in the subject Serbian language 2 (lexicology and syntax) and a survey of students on the advantages and disadvantages of online teaching. The analysis showed that online teaching provides shortcomings in the form of insufficient time for the teacher to deal in more detail with student ambiguities, but also provides numerous opportunities for progress in education – mostly in terms of student time organization and uninterrupted questioning, which is not always the case. Based on the obtained results, we will try to give methodological implications for teaching practice, which concern the possibility of improving online teaching of the Serbian language at the university level.


Author(s):  
Despo Ktoridou ◽  
Epaminondas Epaminonda ◽  
Achilleas Karayiannis

Technological, economic, and social developments represent dynamic changes for businesses across industries, creating opportunities for young entrepreneurs to build profitable companies. A key consideration relates to the need to recognize market opportunities and understand when and how to capitalize on them, whether starting a new type of business or growing on existing ideas; entrepreneurial thinking is a central attribute in cultivating an answer to this consideration. This chapter examines the impact of case-based learning introduced in a multidisciplinary undergraduate course, “Management of Innovation and Technology,” at the University of Nicosia. A core element in this process are the students' and lecturers' experiences, benefits, and challenges of cultivating entrepreneurial thinking. The findings can be useful for academics teaching entrepreneurship-related topics and seeking ways to incorporate innovative approaches in their teaching and learning processes in order to motivate students towards the development of entrepreneurial thinking in their professional engagements.


2020 ◽  
Vol 13 (2) ◽  
pp. e233567 ◽  
Author(s):  
Stephanie Vella ◽  
Kelvin Cortis ◽  
David Pisani ◽  
James Pocock ◽  
Luca Aldrighetti

We describe the case of a 77-year-old woman, presenting with non-specific epigastric pain. Physical examination and subsequent imaging revealed the presence of a large mass in the right liver lobe. This was shown to be a leiomyosarcoma on biopsy histology. Further investigation confirmed this to be a primary hepatic leiomyosarcoma with no evidence of metastases. The patient underwent successful surgical resection. She is currently under imaging follow-up, with no evidence of disease recurrence.


2020 ◽  
Author(s):  
Yuan Pan ◽  
Xiuqi Chen ◽  
Qiuwen Wei ◽  
Jinmin Zhao ◽  
Xun Chen

Abstract Background: In view of the harsh reality Chinese paediatricians face, the challenge of paediatric education is about instilling not only knowledge and clinical skills but also resilience and beliefs. The aim of the study is to explore a more effective method than the traditional lecture-based learning (LBL) model for optimizing educational outcomes by establishing an innovative, comprehensive, case-based learning (CBL) model combined with the micro-film technique (MF+CBL). This approach has four important components: interests (attraction), knowledge application, competency, and scenario coping skills.Methods: Experimental research was conducted via a controlled parallel group study. The total sample of 104 senior-year students (Chinese) majoring in clinical medicine was randomly divided into two groups. The experimental group was exposed to the MF+CBL model and the control group to the LBL model. Overall, the results were assessed after an 8-week course via a student self-assessment questionnaire, a satisfaction survey and the final examination.Results: The experimental group generally performed better than the control group on the student self-assessment (P<0.05), satisfaction survey (P<0.05), and final examination (80.02±3.77 vs 73.65±3.69, P = 0.000). The open question at the end of the questionnaire revealed that a small number of students did not favour the MF+CBL model due to its time- and energy-consuming features.Conclusions: Compared with LBL, the MF+CBL model was an innovative teaching method that promoted more comprehensive quality development. It represents an alternative model for optimizing the capacity of future paediatric doctors.


2014 ◽  
Vol 2 (1) ◽  
pp. 22
Author(s):  
Marcelo Tomas de Oliveira ◽  
Talita Bressan ◽  
Saulo Pamato ◽  
Ana Carolina Niehues ◽  
Nara Farias Niehues ◽  
...  

Purpose: The aim of this study was to evaluate the effectiveness of bite splints in the treatment of children with bruxism, reduction or elimination of symptoms and effective use of the dental appliance by patients. Methods: The sample consisted of 30 children with bruxism, aged 7 to 10 years, attending the Pediatric Dentistry Clinic of the University of Southern Santa Catarina. After approval by the ethics committee and parental informed consent agreement, children underwent anamnesis, physical examination, and alginate molding for fabrication of acrylic bite splints. The children were reassessed after 15 days and after 4, 8 and 12 months of splinting use through new clinical examination and questionnaires. Results: The use rate of bite splints shows that there was a positive correlation (rP=0.9961) between the decrease in use and time elapsed. The parafunctional habit of bruxism was no longer observed in 76.7% of the sample. It was observed that both symptoms evaluated, headache and muscular discomfort, showed a behavior that, if present at the beginning of treatment, declined during follow-up. No splint wear and tear was observed. Conclusion: There was a significant reduction in parafunctional activity, headache and muscular discomfort with the use of bite splints. The higher the persistence of patients, the higher the use rate of bite splints.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jasmin Nessler ◽  
Elisabeth Schaper ◽  
Andrea Tipold

Case-based learning is a valuable tool to impart various problem-solving skills in veterinary education and stimulate active learning. Students can solve imaginary cases without the need for contact with real patients. Case-based teaching can be well performed as asynchronous remote-online class. In time of the COVID-19-pandemic, many courses in veterinary education are provided online. Therefore, students report certain fatigue when it comes to desk-based online learning. The app “Actionbound” provides a platform to design digitally interactive scavenger hunts based on global positioning system (GPS)—called “bounds” —in which the teacher can create a case study with an authentic patient via narrative elements. This app was designed for multimedia-guided museum or city tours initially. The app offers the opportunity to send the students to different geographic localizations for example in a park or locations on the University campus, like geocaching. In this way, students can walk outdoors while solving the case study. The present article describes the first experience with Actionbound as a tool for mobile game-based and case-orientated learning in veterinary education. Three veterinary neurology cases were designed as bounds for undergraduate students. In the summer term 2020, 42 students from the second to the fourth year of the University of Veterinary Medicine Hannover worked on these three cases, which were solved 88 times in total: Cases 1 and 2 were each played 30 times, and case 3 was played 28 times. Forty-seven bounds were solved from students walking through the forest with GPS, and 41 were managed indoors. After each bound, students evaluated the app and the course via a 6-point numerical Likert rating scale (1 = excellent to 6 = unsatisfactory). Students playing the bounds outdoors performed significantly better than students solving the corresponding bound at home in two of the three cases (p = 0.01). The large majority of the students rated the course as excellent to good (median 1.35, range 1–4) and would recommend the course to friends (median 1.26, range 1–3). Summarizing, in teaching veterinary neurology Actionbound's game-based character in the context of outdoor activity motivates students, might improve learning, and is highly suitable for case-based learning.


The medical training comprises not only cognitive element but most important component is psychomotor skills. Although cognitive element is covered by the online lectures, tutorials and small group sessions like problem-based learning (PBL), case-based learning (CBL) but competencies like attitudes and clinical skills are the areas of concern. Although few medical colleges switched to online teaching within a week (who had already management systems in place and strong information technology (IT) departments) and tried to show live demonstrations of patient interaction like history taking and examinations through zoom links and video recordings but it may not be sufficient to certify the students as doctors. Moreover, it is not practiced in every medical college especially those who lacks the facilities. The particular concern is for fourth and final year students passing in COVID-19 era.


2020 ◽  
Author(s):  
Yuan Pan ◽  
Xiuqi Chen ◽  
Qiuwen Wei ◽  
Jinmin Zhao ◽  
Xun Chen

Abstract Background: In view of the harsh reality Chinese paediatricians face, the challenge of paediatric education is about instilling not only knowledge and clinical skills but also resilience and beliefs. The aim of the study is to explore a more effective method than the traditional lecture-based learning (LBL) model for optimizing educational outcomes by establishing an innovative, comprehensive, case-based learning (CBL) model combined with the micro-film technique (MF+CBL). This approach has four important components: interests (attraction), knowledge application, competency, and scenario coping skills. Methods: Experimental research was conducted via a controlled parallel group study. The total sample of 104 senior-year students (Chinese) majoring in clinical medicine was randomly divided into two groups. The experimental group was exposed to the MF+CBL model and the control group to the LBL model. Overall, the results were assessed after an 8-week course via a student self-assessment questionnaire, a satisfaction survey and the final examination.Results: The experimental group generally performed better than the control group on the student self-assessment (P<0.05), satisfaction survey (P<0.05), and final examination (80.02±3.77 vs 73.65±3.69, P = 0.000). The open question at the end of the questionnaire revealed that a small number of students did not favour the MF+CBL model due to its time- and energy-consuming features.Conclusions: Compared with LBL, the MF+CBL model was an innovative teaching method that promoted more comprehensive quality development. It represents an alternative model for optimizing the capacity of future paediatric doctors.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Alan Hakim ◽  
Jane Schubart ◽  
Clair Francomano ◽  
Rebecca Bascom ◽  
Lara Bloom

Abstract Background/Aims  The Ehlers-Danlos Society is an affiliate of Project ECHO, a non-profit organisation supporting health professionals manage their patients through telehealth case-based learning. To increase access to expert advice and learning, in 2019 the Ehlers-Danlos Society introduced EDS ECHO, a series of programmes for health professionals supporting them in learning and sharing knowledge in the management of Ehlers-Danlos syndromes (EDS) and hypermobility spectrum disorders (HSD). Programmes run from the UK, USA, and Australia; participants and experts joining from all over the world, and, from multiple specialties. This study explores participant perceptions of a 9-session programme covering all aspects of diagnosis and management in EDS and HSD, and, their co-morbidities. Each session is 90 minutes long, providing a total of 13.5 hours of learning. All materials are made available for review. The programme is repeated throughout the year. Methods  The study had IRB approval from Penn State, USA. At the beginning of each 9-session programme, participants were invited to join the study. Using REDCap, a series of questions surveyed the participants confidence in managing patients with EDS or HSD; and, re-explored this at 6 months following completion of the programme. In addition, participants were surveyed for their perceptions of the value of the programme. Results  185 of 237 eligible participants completed the baseline and 6-month follow-up survey. At baseline 17%, 47%, and 36% reported their levels of confidence in diagnosing EDS or HSD as either low, moderate, or high respectively. The most reported motivations for joining the programme were: to increase knowledge (90% of responders), access experts (71%), and, increase confidence in managing EDS and HSD (68%). At 6-month follow-up 80-95% of participants reported positive experiences across the various fields of enquiry. With regard to increasing level of knowledge 46% reported a 'slight' increase and 46% a 'great' increase. Levels of confidence in diagnosis and management had risen 'slightly' in 54% and 'greatly' in 40% of participants. 78% of participants reported an overall increase in their interest in EDS and HSD. Conclusion  The Project ECHO model of 'all teach all learn', case-based learning, and use of telehealth technology is well-established in supporting healthcare professionals managing patients across the breadth of Medicine. EDS ECHO follows these principles and practices, providing a series of programmes aligned to the multiple disciplines that manage people with EDS and HSD. For the majority of participants their perception was that the EDS ECHO 9-week program increased their knowledge and confidence in assessing and managing EDS and HSD. Further analysis will explore themes for developing the program, and how changes in confidence are influenced by baseline perceptions. In addition, a study is underway to explore perceptions of care among patients of participants in the EDS ECHO programme. Disclosure  A. Hakim: Consultancies; The Ehlers-Danlos Society. J. Schubart: Grants/research support; The Ehlers-Danlos Society. C. Francomano: Grants/research support; The Ehlers-Danlos Society. R. Bascom: None. L. Bloom: Corporate appointments; The Ehlers-Danlos Society.


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