CASED-BASED TEACHING: Models and Methods Judy Garner, Ph.D., Department of Cell and Neurobiology Keck School of Medicine Distinguished Fellow, CET

CASED-BASED TEACHING:Models and Methods

Judy Garner, Ph.D., Department of Cell and Neurobiology

Keck School of Medicine Distinguished Fellow, CET

CASE BASED TEACHING: Teaching by example or stories

An alternative or adjunct to didactic lecturing

Application of concepts to practical experience

Or vice versa

What is a case?What is a case?

““a case is a descriptive document, a case is a descriptive document, often presented in narrative form, often presented in narrative form, that is based on a real-life situation that is based on a real-life situation or event. or event.

““It attempts to convey a balanced It attempts to convey a balanced multidimensional representation of multidimensional representation of the context, participants, and reality the context, participants, and reality of the situation.of the situation.

–Katherine Merseth, ERIC digests, ERIC clearinghouse on Teaching and Katherine Merseth, ERIC digests, ERIC clearinghouse on Teaching and Teacher Education, Washington, D.C.Teacher Education, Washington, D.C.

What is a case?What is a case?

““Cases are created explicitly for Cases are created explicitly for discussion and seek to include discussion and seek to include sufficient detail and information to sufficient detail and information to elicit active analysis and elicit active analysis and interpretation by users with differing interpretation by users with differing perspectives.”perspectives.”

–Katherine Merseth, ERIC digests, ERIC clearinghouse on Teaching and Katherine Merseth, ERIC digests, ERIC clearinghouse on Teaching and Teacher Education, Washington, D.C.Teacher Education, Washington, D.C.

Value of casesValue of cases

Engaging storiesEngaging stories Open-ended and challengingOpen-ended and challenging Engender controversyEngender controversy Complex enough to allow students to Complex enough to allow students to

recognize the benefits of research recognize the benefits of research and collaborative teamwork in and collaborative teamwork in solving a problemsolving a problem

Value of casesValue of cases Help connect concepts and practice Help connect concepts and practice Develop decision-making or problem-solving Develop decision-making or problem-solving

skillsskills Raise the level of critical thinkingRaise the level of critical thinking Enhance listening/cooperative learningEnhance listening/cooperative learning Understand the relevance of contextUnderstand the relevance of context A method of delivering multiple points of A method of delivering multiple points of

viewview As a learning technique:As a learning technique:

– Active not passive!Active not passive!– The student is the teacherThe student is the teacher

BackgroundBackground

Early use of Case-Based learningEarly use of Case-Based learning– Law schools as early as late 1800sLaw schools as early as late 1800s– Business schools since early 1900sBusiness schools since early 1900s– Parables and Fables—Parables and Fables—

””the moral of the story is…’the moral of the story is…’

CurrentlyCurrently– Professional schools: medicine, dentistry, Professional schools: medicine, dentistry,

law, business, teacherslaw, business, teachers– General education, humanitiesGeneral education, humanities– Really confined to higher educationReally confined to higher education

Learning Outcomes: What do Learning Outcomes: What do you expect your students to you expect your students to

achieve?achieve?

In establishing goals, using cases In establishing goals, using cases may require a subtle modification of may require a subtle modification of how learning goals are phrased:how learning goals are phrased:– Example:Example:

From “Know the chemical structure of a From “Know the chemical structure of a benzene ring.”benzene ring.”

To “What is the value of knowing the To “What is the value of knowing the structure of a benzene ring?”structure of a benzene ring?”

Learning Outcomes: What do Learning Outcomes: What do you expect?you expect?

Example:Example: What is the value of knowing the chemical What is the value of knowing the chemical

structure of a benzene ring?structure of a benzene ring?

To get an answer the student must:To get an answer the student must:

1.1. Know the chemical structure of a benzene ringKnow the chemical structure of a benzene ring

2.2. Determine how the benzene ring interacts with other organic chemical Determine how the benzene ring interacts with other organic chemical forms?forms?

And may, through the use of a case (pharmaceutical case) take it further.And may, through the use of a case (pharmaceutical case) take it further.

1.1. How do you chemically alter a benzene ring?How do you chemically alter a benzene ring?

2.2. Would that be useful in attempting to alter the efficacy of a particular Would that be useful in attempting to alter the efficacy of a particular pharmaceutical compound?pharmaceutical compound?

Learning Outcomes: What do Learning Outcomes: What do you expect from students in you expect from students in

your field?your field? Collaborative learning and working in Collaborative learning and working in

groups:groups:– Is this of value in your field?Is this of value in your field?

Cases can be used with variable Cases can be used with variable degrees of student-student interactiondegrees of student-student interaction– Individual creativity vs group processIndividual creativity vs group process– Assessment of individual student’s abilityAssessment of individual student’s ability

Learning Outcomes: What do Learning Outcomes: What do you expect through use of you expect through use of

cases?cases? Increased student engagementIncreased student engagement

Retention time of facts vs skills and Retention time of facts vs skills and conceptsconcepts– Use it or lose it!Use it or lose it!

Elements of Case DesignElements of Case Design

Selection of appropriate casesSelection of appropriate cases– Mirroring professional experience/real Mirroring professional experience/real

world contextworld context– How complex or how simple?How complex or how simple?

SIMPLE CASE: Calculus 101SIMPLE CASE: Calculus 101

Chalk toss. Chalk toss. Draw a graph of the height of the Draw a graph of the height of the

chalk relative to the floor over time, chalk relative to the floor over time, with the height being the vertical with the height being the vertical axis of the graph, and the time being axis of the graph, and the time being the horizontal axis of the graph.the horizontal axis of the graph.

IN FEET

10

4

2 sec

SIMPLE CASE: Calculus 101SIMPLE CASE: Calculus 101

After finishing, students exchange After finishing, students exchange their graphs. They are asked to write their graphs. They are asked to write a brief paragraph describing the a brief paragraph describing the position of the chalk based on the position of the chalk based on the graph they are looking at. Each graph they are looking at. Each paragraph should include:paragraph should include:– Maximum height of the chalkMaximum height of the chalk– Length of time the chalk was in the air.Length of time the chalk was in the air.

SIMPLE CASE: Calculus 101SIMPLE CASE: Calculus 101 After the exercise there is a discussion about After the exercise there is a discussion about

– the importance of scales and units in graphs. the importance of scales and units in graphs. – do they get a sense of change in velocity of the do they get a sense of change in velocity of the

chalk through this exercise even though not chalk through this exercise even though not explicitly requested?explicitly requested?

– communicating information in generalcommunicating information in general

This exercise then can be expanded by variations This exercise then can be expanded by variations (dropping the chalk, bouncing the chalk off of the (dropping the chalk, bouncing the chalk off of the wall, velocity of the chalk over time, etc.)wall, velocity of the chalk over time, etc.)

COMPLEX CASESCOMPLEX CASES

CASES IN AN INTEGRATED MEDICAL CASES IN AN INTEGRATED MEDICAL CURRICULUMCURRICULUM

Neurosciences in Medicine

Neuroanatomy Neurophysiology Neurochemistry Gross anatomy of the Head and Neck Neuropathology Neurology Ophthalmology Neuroradiology Neurosurgery Psychiatry CNS and Autonomic Pharmacology

Choice of casesChoice of cases

Case selection must take into accountCase selection must take into account– How common is the case in real lifeHow common is the case in real life– Ability of the case to integrate multiple Ability of the case to integrate multiple

subdisciplinessubdisciplines– Ability of the case to effectively teach Ability of the case to effectively teach

important learning objectives in the important learning objectives in the coursecourse

– The case must not be too burdensome in The case must not be too burdensome in the acquisition of data for the answers the acquisition of data for the answers

CHOICE OF CASESCHOICE OF CASES

SEQUENCE OF CASES:SEQUENCE OF CASES:– PRIOR KNOWLEDGEPRIOR KNOWLEDGE– LOGICAL ORDERLOGICAL ORDER– EARLY CASES REVISITED AS SYSTEM EARLY CASES REVISITED AS SYSTEM

PROGRESSES AND KNOWLEDGE PROGRESSES AND KNOWLEDGE INCREASESINCREASES

CASE THEMES OF THE CASE THEMES OF THE WEEKWEEK

Cases:Cases:

Week 2: Trauma, Substance abuse, Acute Stress DisorderWeek 2: Trauma, Substance abuse, Acute Stress DisorderWeek 3: Parkinson’s Disease with DepressionWeek 3: Parkinson’s Disease with DepressionWeek 4: Stroke with Adjustment DisorderWeek 4: Stroke with Adjustment DisorderWeek 5: Panic Disorder (Brain tumor)Week 5: Panic Disorder (Brain tumor)Week 6: Herpes Encephalitis, Status Epilepticus, DeliriumWeek 6: Herpes Encephalitis, Status Epilepticus, DeliriumWeek 7: Evidence based medicine (Stroke studies)Week 7: Evidence based medicine (Stroke studies)Week 8: Alzheimer’s Disease with Psychosis.Week 8: Alzheimer’s Disease with Psychosis.

Week 1Week 1INTRO to NS IINTRO to NS I ICMICM Resting Resting

Membrane Membrane potential and potential and Action potentialAction potential

Cranial Cavity Cranial Cavity and Brainand Brain

Reticular Reticular formation EEG formation EEG and Sleepand Sleep

Neural Cell Neural Cell BiologyBiology

CNS CNS DevelopmentDevelopment

Tissue response Tissue response to injuryto injury

Gross Anatomy Gross Anatomy LabLab

Sensory Sensory Physiology and Physiology and receptorsreceptors

NeuroanatomyNeuroanatomy

LabLabPathology LabPathology Lab Vascular Vascular

OverviewOverview

Mental Status Mental Status ExamExam

Congenital Congenital defects of the defects of the CNSCNS

Mentor GroupMentor Group INTRO to NS IIINTRO to NS II ICM WORKSHOP:ICM WORKSHOP: Students Students receive case receive case plus reading plus reading

Neuroanatomy Neuroanatomy LabLab

MENTAL STATUS MENTAL STATUS EXAMEXAM

assignments assignments in case bookin case book

Microanatomy of Microanatomy of the CNSthe CNS

PPP Case 1: Trauma, substance abuse, Acute Stress Disorder

PPP Case 2: Parkinson’s Disease with Depression Disorder

PPP Case 3: Stroke with Adjustment Disorder

PPP Case 4: Generalized Anxiety Disorder (Brain Tumor)

PPP Case 5: Herpes Encephalitis, Epileptic seizures, Delirium

PPP Case 6: Alzheimers Disease with Psychosis

Development Series

Autonomic Nervous System Series

Neuromuscular series

Special Senses Series

KEY: Each Lecture/Laboratory that corresponds to:

Week 1Week 1INTRO to NS IINTRO to NS I ICMICM Resting Resting

Membrane Membrane potential and potential and Action Action potentialpotential

Cranial Cavity Cranial Cavity and Brainand Brain

Reticular Reticular formation EEG formation EEG and Sleepand Sleep

Neural Cell Neural Cell BiologyBiology

CNS CNS DevelopmentDevelopment

Tissue Tissue response to response to injuryinjury

Gross Gross Anatomy LabAnatomy Lab

Sensory Sensory Physiology Physiology and receptorsand receptors

NeuroanatomyNeuroanatomy

LabLabPathology LabPathology Lab Vascular Vascular

OverviewOverview

Mental Status Mental Status ExamExam

Congenital Congenital defects of the defects of the CNSCNS

Mentor GroupMentor Group INTRO to NS IIINTRO to NS II ICM ICM WORKSHOP:WORKSHOP:

Students Students receive case receive case plus reading plus reading

NeuroanatomNeuroanatomy Laby Lab

MENTAL MENTAL STATUS EXAMSTATUS EXAM

assignments assignments in case bookin case book

Microanatomy Microanatomy of the CNSof the CNS

Week 2Week 2Chemical Chemical Neurotrans-Neurotrans-missionmission

ICMICM Motor Neurons Motor Neurons and Spinal and Spinal ReflexesReflexes

The OrbitThe Orbit Psychological Psychological TraumaTrauma

Limb-Axial Limb-Axial SomatosensorSomatosensory Pathsy Paths

Upper Motor Upper Motor Neurons/LoweNeurons/Lower Motor r Motor NeuronsNeurons


Endogenous Endogenous Pain PathwaysPain Pathways

NA LabNA Lab NA LabNA Lab NeuroradiologNeuroradiologyy

PPP CASE 1 PPP CASE 1 DISCUSSIONDISCUSSION

Mentor GroupMentor Group HeadacheHeadache ICM ICM WorkshopsWorkshops

Neurological Neurological ExamExam

Sensory Sensory Cranial Nerves Cranial Nerves and Pathsand Paths

OtolaryngologOtolaryngology Examy Exam

WORK ON PPP WORK ON PPP CASE #1CASE #1

NA LabNA Lab OphthalmologOphthalmology Examy Exam

Week 3Week 3Motor Cranial Motor Cranial NervesNerves

ICMICM AcetylcholineAcetylcholine Innervation Innervation patterns to patterns to the head and the head and neckneck

Direct acting Direct acting ParasympathoParasympatho-mimetics-mimetics

Motor Cranial Motor Cranial Nerve LabNerve Lab

Autonomic Autonomic Nervous Nervous SystemSystem


Brain TumorsBrain Tumors

Movement Movement DisordersDisorders

Path LabPath Lab

Corticobulbar Corticobulbar pathspaths

Movement Movement disorders disorders CasesCases

PPP CASE 2 PPP CASE 2 DISCUSSIONDISCUSSION

Mentor GroupMentor Group Mood Mood DisordersDisorders

ICM ICM WorkshopsWorkshops


Basal GangliaBasal Ganglia OtolaryngologOtolaryngology Examy Exam

WORK ON PPP WORK ON PPP Case 2Case 2

NA LabNA Lab OphthalmologOphthalmology Examy Exam

Week 4Week 4

CerebellumCerebellum ICMICM Muscarinic Muscarinic BlockersBlockers

Fascia and Fascia and Lymphatics of Lymphatics of the Head and the Head and NeckNeck

Ganglionic Ganglionic Blockers and Blockers and StimulantsStimulants

Cerebellar Cerebellar Pathways and Pathways and DisordersDisorders

CerebrovasculCerebrovascular Diseasear Disease


DeliriumDelirium

NA LabNA Lab Pathology Pathology LaboratoryLaboratory

Development Development of the Head of the Head and Neckand Neck

CASE 3 CASE 3 DISCUSSIONDISCUSSION

Mentor GroupMentor Group CholinesteraCholinesterase Inhibitorsse Inhibitors

CatecholamineCatecholaminess

NeuromusculaNeuromuscular Blockersr Blockers

CNS CNS VasculatureVasculature

WORK ON PPP WORK ON PPP CASE #3CASE #3

NA LabNA Lab

Week 5Week 5

NEUROSCIENCENEUROSCIENCESWRITTEN SWRITTEN MIDTERM MIDTERM EXAMEXAM

Infratemporal Infratemporal Fossa and TMJFossa and TMJ

Pathology of Pathology of CNS InfectionsCNS Infections

STUDY TIMESTUDY TIME Gross Gross Anatomy LabAnatomy Lab

Pathology of Pathology of CNS Infections CNS Infections LabLab

Sympatho-Sympatho-mimeticsmimetics

CASE 4 CASE 4 DISCUSSIONDISCUSSION

Microbiology Microbiology of CNS of CNS Infections Infections

NEUROSCIENCENEUROSCIENCES PRACTICAL S PRACTICAL MIDTERM MIDTERM EXAMEXAM

Microbiology Microbiology LaboratoryLaboratory

Week 6Week 6Sympatho-Sympatho-mimeticsmimetics

ICMICM Adrenergic Adrenergic BlockersBlockers

Middle EarMiddle Ear Indirect acting Indirect acting Sympatho-Sympatho-mimeticsmimetics

Adrenergic Adrenergic BlockersBlockers

NeuromusculaNeuromuscular Disordersr Disorders


SympatholyticSympatholyticss

Seizures and Seizures and Seizure Seizure DisordersDisorders

Visual Visual PhysiologyPhysiology

Microanatomy Microanatomy of the Eyeof the Eye

NeuromusculaNeuromuscular Casesr Cases

EBM Case EBM Case DiscussionDiscussion

Mentor GroupMentor Group Vestibular Vestibular and Auditory and Auditory SystemsSystems

ICM ICM WorkshopsWorkshops


OtolaryngologOtolaryngology Examy Exam

Work on EBM Work on EBM CaseCase

Vestibular Vestibular and Auditory and Auditory LabLab

OphthalmologOphthalmology Examy Exam

Week 7Week 7Pharmacology Pharmacology of the Eyeof the Eye

ICMICM Opiates and Opiates and NeuropeptidesNeuropeptides

Cranial Nerves Cranial Nerves IX and XIX and X

Opioid Opioid analgesics and analgesics and antagonistsantagonists

Central Visual Central Visual PathwaysPathways

HypothalamusHypothalamus Gross Gross Anatomy LabAnatomy Lab

NA LabNA Lab Hypothalamus Hypothalamus LabLab

AntidepressanAntidepressants, Mood ts, Mood StabilizersStabilizers

Case Case WorkshopWorkshop

PPP Case #5 PPP Case #5 DiscussionDiscussion

Mentor GroupMentor Group DemyelinatinDemyelinating Diseasesg Diseases

Serotonin, Serotonin, histamine histamine and GABAand GABA

Work on PPP Work on PPP Case #5Case #5

Anxiety Anxiety DisordersDisorders

ThalamusThalamus

Week 8Week 8StimulantsStimulants ICMICM Stupor and Stupor and

ComaComaSleep DisordersSleep Disorders Schizophrenia Schizophrenia

CasesCases

Sedative-Sedative-hypnoticshypnotics

Cerebral Cerebral Cortex and Cortex and Higher Higher Cerebral Cerebral FunctionFunction

Dementia Dementia DisordersDisorders

Antipsychotic Antipsychotic drugsdrugs

Limbic SystemLimbic System Cortex Cortex laboratorylaboratory

Pathology of Pathology of Dementia Dementia DisordersDisorders

Higher Higher Cortical Cortical FunctionFunction

Limbic System Limbic System LaboratoryLaboratory

Seizure Cases Seizure Cases and and Antiepileptic Antiepileptic DrugsDrugs

PPP Case #6 PPP Case #6 DiscussionDiscussion

Mentor GroupMentor Group Drugs of Drugs of abuse, abuse, dependence,dependence,

and addictionand addiction

Work on PPP Work on PPP Case #6Case #6

Substance Substance AbuseAbuse

Anxiolytic Anxiolytic DrugsDrugs

1) Patient History and Symptoms:1) Patient History and Symptoms: Fred Hoskins, a 17-year-old boy, was admitted to the Fred Hoskins, a 17-year-old boy, was admitted to the

emergency room at 1:30 (AM) after a car accident. emergency room at 1:30 (AM) after a car accident. Fred’s friends, who had also been involved in the car accident, Fred’s friends, who had also been involved in the car accident,

had told EMT personnel that Fred had been trapped in the car had told EMT personnel that Fred had been trapped in the car upside down, suspended from his seatbelt, and it took the upside down, suspended from his seatbelt, and it took the firemen over an hour to release him from the wreckage. firemen over an hour to release him from the wreckage.

During the accident, Fred had received a blow to the head During the accident, Fred had received a blow to the head and had been rendered briefly unconscious after the accident and had been rendered briefly unconscious after the accident but had regained consciousness within a few minutes. but had regained consciousness within a few minutes.

He had been terrified throughout the entire ordeal that the He had been terrified throughout the entire ordeal that the car would explode. His friends had also told EMT personnel car would explode. His friends had also told EMT personnel that Fred had been at a “rave” prior to driving home. that Fred had been at a “rave” prior to driving home.

In the emergency room, his examination was normal but he In the emergency room, his examination was normal but he was sleepy, and he was held for observation. was sleepy, and he was held for observation.

EXAMPLE OF A CASE:

2) RELEVANT DATA2) RELEVANT DATA

Vital Signs on admissionVital Signs on admission TTest Results: Drug screen, Blood Alcohol, est Results: Drug screen, Blood Alcohol,

CTCT Further sequelae: time courseFurther sequelae: time course SurgerySurgery Post surgical interview after hospital Post surgical interview after hospital

admissionadmission Detailed post-release interviewDetailed post-release interview


Fridays:Fridays: Written case with ~6 general discussion questions Written case with ~6 general discussion questions

receivedreceived

Examples:Examples:

What is your differential diagnosis? Include in What is your differential diagnosis? Include in your answer a discussion of how you would your answer a discussion of how you would differentiate among the different types of differentiate among the different types of intracranial hemorrhages.intracranial hemorrhages.

What psychiatric disorder does this patient What psychiatric disorder does this patient manifest after the accident that wasn’t manifest after the accident that wasn’t present before it? How is it diagnosed? It present before it? How is it diagnosed? It appears to be a good predictor of what other appears to be a good predictor of what other major psychiatric disorder?major psychiatric disorder?


Monday afternoon:Monday afternoon:

Small groups meet after doing reading. Small groups meet after doing reading. Discussion of general diagnosis, and Discussion of general diagnosis, and negotiation for answer “responsibility” negotiation for answer “responsibility” of individual students. Later in the of individual students. Later in the week the students share answers so week the students share answers so each has a complete set.each has a complete set.


Monday through Thursday:Monday through Thursday:

Students share answers so each has a complete Students share answers so each has a complete set.set.

Friday morning:Friday morning:

Students present answers to the questions to Students present answers to the questions to their peers and instructor (experts) with their peers and instructor (experts) with discussion as different answers are discovered.discussion as different answers are discovered.

Web posting: Detailed answers to Web posting: Detailed answers to questions.questions.

How can one distinguish among subdural, How can one distinguish among subdural, epidural, subarachnoid, or intraparenchymal epidural, subarachnoid, or intraparenchymal hemorrhage? Which of these types of hemorrhage? Which of these types of hemorrhage is evident in the CT scan?hemorrhage is evident in the CT scan?

1) Epidural bleeds1) Epidural bleeds (between the dura and the cranium) (between the dura and the cranium) are usually confined to the limits of the overlying are usually confined to the limits of the overlying cranial bone cranial bone (the dura adheres to the suture points)(the dura adheres to the suture points). . The smooth contour of the hematoma in the CT The smooth contour of the hematoma in the CT suggests the blood is confined in the space between suggests the blood is confined in the space between the bone and dura. Patients with epidural bleeds are the bone and dura. Patients with epidural bleeds are often characterized as experiencing a brief period of often characterized as experiencing a brief period of unconsciousness, followed by a conscious lucid period, unconsciousness, followed by a conscious lucid period, then later lapsing back into unconsciousness.then later lapsing back into unconsciousness.

Case 2: DataCase 2: Data

Case 2: Trauma with Acute Stress Case 2: Trauma with Acute Stress Syndrome: Learning ObjectivesSyndrome: Learning Objectives

After examination of this case, each student should After examination of this case, each student should be able to: be able to: – Distinguish among subdural, epidural, subarachnoid, Distinguish among subdural, epidural, subarachnoid,

and intraparenchymal hemorrhage. and intraparenchymal hemorrhage. (N, Npath, GA, NA, (N, Npath, GA, NA, NRad)NRad)

– Discuss the pupillary light reflex and oculomotor signs Discuss the pupillary light reflex and oculomotor signs in terms of CNS herniation. (in terms of CNS herniation. (NA, GA, NNA, GA, N ) )

– Describe the progression of herniation. Describe the progression of herniation. (GA, NA, N)(GA, NA, N)

– Explain the significance of papilledema. Explain the significance of papilledema. (N, GA, Npath, (N, GA, Npath, Ophthal)Ophthal)

– Define the difference between substance abuse and Define the difference between substance abuse and substance dependence substance dependence (Pharm, Psych, NC)(Pharm, Psych, NC)

– Define the criteria for Acute Stress Disorder Define the criteria for Acute Stress Disorder (Psych)(Psych)

– Describe, in general, the treatment plan for epidural Describe, in general, the treatment plan for epidural hematoma hematoma (N, Nsurg, GA)(N, Nsurg, GA)

– Describe, in general, the treatment plan for Acute Describe, in general, the treatment plan for Acute Stress disorder Stress disorder (Psych, GA, Pharm)(Psych, GA, Pharm)

SUMMARY: SUMMARY: The use of complex cases:The use of complex cases:

– Facilitates understanding of the complexity of real Facilitates understanding of the complexity of real life situations to be faced by medical studentslife situations to be faced by medical students

– Allows abstract conceptual information to be Allows abstract conceptual information to be applied to situations likely to be experienced by applied to situations likely to be experienced by the studentsthe students

– Integrates information from multiple subdisciplines Integrates information from multiple subdisciplines and multiple points of view as it is focused upon a and multiple points of view as it is focused upon a single problemsingle problem

– Helps the students recognize that even in sciences Helps the students recognize that even in sciences there is not always a “right” and a “wrong” answerthere is not always a “right” and a “wrong” answer

– Underscores the professional value of cooperative Underscores the professional value of cooperative learning and workinglearning and working

No coursesNo courses Series of Series of problems orproblems or cases cases solved by solved by

student small groups student small groups Facilitators/ TutorsFacilitators/ Tutors Small group (6-10)Small group (6-10) Self-directed studySelf-directed study

PROBLEM-BASED LEARNING (PBL)

Problem based learning Problem based learning (PBL)(PBL)

Identification of learning issuesIdentification of learning issues

Data acquisitionData acquisition

Case solution or development of a Case solution or development of a plan of action in solving the caseplan of action in solving the case

““PERFORMANCE” IN THE PERFORMANCE” IN THE CLASSROOMCLASSROOM

Cases don’t necessarily have to Cases don’t necessarily have to be narrative or didacticbe narrative or didactic– Use of AV aidsUse of AV aids– Use of performance (skits) Use of performance (skits) – Use of unexpected changes in a Use of unexpected changes in a

situation.situation.

Case Exercise:Case Exercise:

Form small groupsForm small groups Generate learning issuesGenerate learning issues Data acquisition (if possible)Data acquisition (if possible) Presentation of casePresentation of case

Case writing exercise:Case writing exercise:

Think about a learning goal you wish Think about a learning goal you wish your students to achieveyour students to achieve

Identify a “real-life” situation in which Identify a “real-life” situation in which one would use that learning goalone would use that learning goal

Write a short vignetteWrite a short vignette Design a ‘stem’ that will direct the Design a ‘stem’ that will direct the

students towards achieving the goal students towards achieving the goal through examination of the casethrough examination of the case

Documents

CASED-BASED TEACHING: Models and Methods Judy Garner, Ph.D., Department of Cell and Neurobiology Keck School of Medicine Distinguished Fellow, CET