1. Selecting & Developing Cases and Clinical Problems
Janet M. Riddle, MD
Director of Faculty Development
Department of Medical Education
DME Collaborative for Active Learning in Medicine

2. DME Collaborative for Active Learning in Medicine
Today’s goals
Select and develop cases and clinical problems that allow students to apply concepts and practice clinical problem solving
Develop approaches for collaborating with clinical colleagues
Explore strategies for using a “library” of cases across courses
DME Collaborative for Active Learning in Medicine

3. DME Collaborative for Active Learning in Medicine
A brief digression
We all find ourselves in a stressful setting of trying to improve our teaching and make the educational experience better for our students.
Assumptions that I’m making in how I’m teaching this session:
You have a lot of experiencing teaching – and I want to build upon that experience in improving your teaching
You have a lot to learn from each other. Together we are smarter than any of one of us.
I “do” faculty development – stated simply, my job is to help improve the quality of teaching and learning in the COM. What I bring to today’s session is a set of concepts and tools related to instruction – that I hope will allow you to become a better teacher. We’ll accomplish that through discussion, a brief presentation, and an opportunity for you to practice developing an independent learning assignment.
DME Collaborative for Active Learning in Medicine

4. What makes a “good” case?
DME Collaborative for Active Learning in Medicine

5. Let’s review the key points from the last session
DME Collaborative for Active Learning in Medicine

6. Cases and Clinical Problems: A Learner-Centered Perspective
DME Collaborative for Active Learning in Medicine

7. What skills do your learners most need in order to master the content that you are teaching?
Content has two purposes in a learner-centered environment:
Establishes the foundation of knowledge on which subsequent learning occurs
Means for acquiring learning skills and self-awareness of learning (meta-cognition)
Weimer, 2002

8. Content allows the development of learning skills
Process of making judgments
Problem analysis
Problem solving
Critical appraisal
Content functions to:
Develop learning skills – Help learners understand the process of making judgments - e.g. problem analysis, problem solving, critical appraisal
Rethink decisions whenever conditions change and new information comes to light
Discuss how to make decisions when information is uncertain
Explain reasoned judgment
Encourage probabilistic statements
Weimer, 2002

9. Content can promote the self-awareness of learning
How learners learn
Their strengths and weaknesses
Meta-cognition
Weimer, 2002

10. Content allows learners to experience the field first hand
Allow students to do the authentic work of the discipline
Weimer, 2002

11. To make instruction effective . . .
Situate learning in real-life problems
Build on previous experience
Demonstrate what is to be learned
Give learners the opportunity to practice problem-solving
Reinforce learning through transfer of learning to new problems
Merrill’s principles of instruction provide a set of tools to think about designing independent learning assignments
Merrill, 2002

12. Situate learning in real-life problems
What kinds of problems will allow your learners to develop the learning skills they need?
What kinds of activities might you use?
Let’s develop an example together – using Merrill’s principles of instruction
Prioritize skills that learners most need to succeed with the content of the course
DME Collaborative for Active Learning in Medicine

13. DME Collaborative for Active Learning in Medicine
Time to work!
DME Collaborative for Active Learning in Medicine

14. Identifying “good” cases and clinical problems
A needs assessment problem
Informal discussions with clinicians
Direct observations of clinical rounds
Journals, e.g. NEJM
Expert recommendations, e.g. clerkship directors’ guides
DME Collaborative for Active Learning in Medicine

15. What did you learn today that you plan to use in your teaching?
DME Collaborative for Active Learning in Medicine

16. Three core learning principles
Learning builds on prior knowledge
Teachers must identify and work with pre-existing knowledge and understanding learners bring with them
Bransford, 2000

17. Three core learning principles
To develop competence, learners must
Have a deep foundation of factual knowledge
Understand facts & ideas in context of conceptual framework
Organize knowledge to facilitate retrieval
Teachers must teach some material in depth; provide conceptual frameworks
Bransford, 2000

18. Three core learning principles
Develop “metacognitive” approach in learners
Metacognition – monitoring what you know & what you don’t know
Teachers should help learners define learning goals & monitor progress in achieving them
Bransford, 2000