Do case studies mislead about the nature of reality?
This paper attempts a partial, critical look at the construction and use of case studies in ethics education. It argues that the authors and users of case studies are often insufficiently aware of the literary nature of these artefacts: this may lead to some confusion between fiction and reality. Issues of the nature of the genre, the fictional, story-constructing aspect of case studies, the nature of authorship, and the purposes and uses of case studies as "texts" are outlined and discussed. The paper concludes with some critical questions that can be applied to the construction and use of case studies in the light of the foregoing analysis. (+info)
Application of the problem-based learning model for continuing professional education: a continuing medical education program on managed care issues--Part II.
Physicians must incorporate concepts of practice management and knowledge of managed care into their practices. Managed care presents an immediate and challenging opportunity to providers of continuing medical education to offer effective educational programs for physicians on managed care issues. In this exploratory research, the problem-based learning model was used to develop a continuing medical education program that would offer an interactive and effective method for teaching physicians about managed care. Problem-based learning is a departure from the traditional lecture format of continuing medical education programs because it is designed for small groups of self-directed learners who are guided by a faculty facilitator. Although only a small number of participants participated in this program, the findings offer important considerations for providers of continuing medical education. For example, participants reported increased confidence in their knowledge about managed care issues. Participants also clearly indicated a preference for the small group, interactive format of the problem-based learning model. (+info)
An interdisciplinary approach to a day-long palliative care course for undergraduate students.
Although it is desirable that students in the health sciences be educated together to prepare them for interdisciplinary practice, many educational programs remain discipline specific. An undergraduate course in palliative care, originally designed for medical students at McMaster University, Hamilton, Ont., was expanded in 1993 to include students from various health sciences programs in the region. The course introduces students to the components of palliative care and its interdisciplinary nature in a problem-based way and directs students to additional educational resources. The authors describe the planning, content and evaluation of the course material. The observed decline in attendance by medical students, which coincided with the introduction of the interdisciplinary format, warrants further investigation. Future directions of the course are discussed. (+info)
Implementing practice guidelines for diabetes care using problem-based learning. A prospective controlled trial using firm systems.
OBJECTIVE: A controlled trial with 15-month follow-up was conducted in two outpatient clinics to study the effects of using the problem-based learning technique to implement a diabetes clinical practice guideline. RESEARCH DESIGN AND METHODS: A total of 144 patients with type 2 diabetes aged 25-65 years in two internal medicine outpatient clinics were enrolled in the study. African-Americans and Hispanics made up > 75% of the patients. Doctors and staff in one of the clinics were trained in the use of a clinical practice guideline based on Staged Diabetes Management. A problem-based learning educational program was instituted to reach consensus on a stepped intensification scheme for glycemic control and to determine the standards of care used in the clinic. HbA1c was obtained at baseline and at 9 and 15 months after enrollment. RESULTS: At 9 months, there was a mean -0.90% within-subject change in HbA1c in the intervention group, with no significant changes in the control group. The 15-month mean within-subject change in HbA1c of -0.62% in the intervention group was also significant. Among intervention patients, those with the poorest glycemic control at baseline realized the greatest benefit in improvement of HbA1c. The intervention group also exhibited significant changes in physician adherence with American Diabetes Association standards of care. CONCLUSIONS: Clinical practice guidelines are an effective way of improving the processes and outcomes of care for patients with diabetes. Problem-based learning is a useful strategy to gain physician support for clinical practice guidelines. More intensive interventions are needed to maintain treatment gains. (+info)
Teaching experimental design to biologists.
The teaching of research design and data analysis to our graduate students has been a persistent problem. A course is described in which students, early in their graduate training, obtain extensive practice in designing experiments and interpreting data. Lecture-discussions on the essentials of biostatistics are given, and then these essentials are repeatedly reviewed by illustrating their applications and misapplications in numerous research design problems. Students critique these designs and prepare similar problems for peer evaluation. In most problems the treatments are confounded by extraneous variables, proper controls may be absent, or data analysis may be incorrect. For each problem, students must decide whether the researchers' conclusions are valid and, if not, must identify a fatal experimental flaw. Students learn that an experiment is a well-conceived plan for data collection, analysis, and interpretation. They enjoy the interactive evaluations of research designs and appreciate the repetitive review of common flaws in different experiments. They also benefit from their practice in scientific writing and in critically evaluating their peers' designs. (+info)
Challenges of teaching physiology in a PBL school.
A problem-based learning (PBL) curriculum was introduced at McMaster University more than three decades ago. Not many schools have adopted the system despite its distinct advantages. The present paper examines the challenges of teaching physiology in a PBL curriculum and gleans through the literature supporting PBL. It appears that one of the reasons why PBL is not becoming readily acceptable is the lack of concrete reports evaluating the curricular outcomes. The suggestion (R.E. Thomas. Med Educ. 31:320-329, 1997) to standardize and internationalize all components of validated PBL curricula is quite valid. A database needs to be generated that can be easily accessed by traditional institutions to see the rationality and easy implementation of the PBL curriculum. (+info)
An inquiry-based teaching tool for understanding arterial blood pressure regulation and cardiovascular function.
Educators are placing a greater emphasis on the development of cooperative laboratory experiences that supplement the traditional lecture format. The new laboratory materials should encourage active learning, problem-solving, and inquiry-based approaches. To address these goals, we developed a laboratory exercise designed to introduce students to the hemodynamic variables (heart rate, stroke volume, total peripheral resistance, and compliance) that alter arterial pressure. For this experience, students are presented with "unknown" chart recordings illustrating pulsatile arterial pressure before and in response to several interventions. Students must analyze and interpret these unknown recordings and match each recording with the appropriate intervention. These active learning procedures help students understand and apply basic science concepts in a challenging and interactive format. Furthermore, laboratory experiences may enhance the students' level of understanding and ability to synthesize and apply information. In conducting this exercise, students are introduced to the joys and excitement of inquiry-based learning through experimentation. (+info)
Learning the regulation of peripheral blood flow.
Students can learn a great deal about the peripheral circulation when teaching is based on five building blocks: hemodynamic principles, neurohumoral control, and three elements of local control of blood flow (metabolic, myogenic, and paracrine). Study of a particular special circulation starts with the application of these building blocks in the context of the function of that tissue. For example, control of skin blood flow is largely concerned with regulation of body temperature (neurohumoral control) and the response to injury (paracrine control). Regulation of coronary blood flow is almost entirely a matter of meeting the metabolic needs of the myocardium (metabolic control). By mixing and matching the five building blocks and keeping in mind the special functions of a particular tissue, students can master the peripheral circulation efficiently. (+info)