what's in your case? optimizing content for clinical learning
TRANSCRIPT
What’s in Your Case?OPTIMIZING CONTENT FOR CLINICAL EDUCATION
Alexandra Howson MA CHCP PhD
a wee introductionTO THE CONTEXT OF CLINICAL EDUCATION
Lucey CR. JAMA 2013;173(17):1639-1643
IOM Framework
Foundational education
Graduate educationContinuing education
Clinical Learning Across a Continuum
Learning Paradigms Have Changed Too
Why Case-Based Learning?
Adult Learning
Andragogy
Cognitive Theory
Situated LearningCritical theory
Social Learning
Principles of Adult LearningSelf-directed
RelevantProblem-orientedEngaging
Feedback
The Anatomy of Cases
The advantages of the case-based method are the promotion of self-
directed learning, clinical reasoning, clinical problem-solving,
and decision-making by providing repeated experiences in class with a
collegial infrastructure and by focusing the student on the complexity of clinical care.
Richards PS, Inglehart MR. J Dent Educ . 2006 70(3):284–291
“”
Set well-defined learning objectives + outcomes measures
Establish a knowledge/competence baseline
Sequence tasks + decisions across ↑ levels of difficulty
Provide feedback
Principles of Case-Based Learning
Levels of Outcome
Participation
1 2Satisfactio
n
3Knowledge
4 5Performan
ce
6Patient Health
7Community Health
5Performan
ce
6Patient Health
Moore DE, et al. JCEHP. 2009;29(1):1-15
Competence
Knowledge
Competence
e.g. HCV treatment
On-site + tele-ECHO case-based clinics
Over 18 months, 280 enrolled in program + 46% started treatment
MEASURABLE OUTCOMESAligned with learning objectives
AUTHENTICComplex problems
CREDIBLEActivities aligned with real-world challenges
ACTIVE DISCOVERYMirrors clinical reasoning + allows safe failures
FEEDBACKCorrection + reinforcement
Components of Effective Cases
Compelling story
Supporting information
Unfolds over time
Relevant prompts
Case Characteristics
Case Examples
Live Program Case Sequence
Case introduction
Clinical informati
onARS
questionCorrect
answer + rationale
Case Introduction + Clinical Information
ARS Question
Correct answer + rationale
Online Case-Based Sequence
Case introduction Clinical information
Knowledge or
procedural question
FeedbackCorrect
answer + rationale
Expert commentaryVirtual patient commentaryCountersClinical outcome
Case Introduction
Knowledge-based question
Feedback
Rationale and reinforcement
Multiple choice questions
Active Discovery
Expert commentary
Feedback
Correct response
Correct response
Feedback
Open-ended question
Active Discovery
A More Complex CaseONLINE INTERACTIVE
MEASURABLE OUTCOMESAligned with learning objectives
CREDIBLEComplex problems
AUTHENTICActivities aligned with real-world challenges
ACTIVE DISCOVERYMirrors clinical reasoning + allows safe failures
FEEDBACKCorrection + reinforcement
Compelling story
Supporting information
Unfolds over time
Relevant prompts
Case introduction Clinical information
Knowledge or
procedural question
FeedbackCorrect
answer + rationale
Summary
The Benefits of CasesBuild competencies
Foster deep learning
Integrate different kinds of knowledge
Enhance motivation to learn
Model real-world applications
