Linköping University One university – two cities

Linköping University One university – two cities
Norrköping Norrköping Between Stockholm and Copenhagen you will find Linköping University – a large university with campus in the two cities within a distance of 30 min. Besides a large technical university we have the Faculty of health sciences, medical school, education of nurses, physiotherapi etc Håkan Hanberger prof, Div Infect Diseases, coordinator clinical stadium medical school Anne-Christine Persson coordinator web scenarios Bjorn Bergdahl prof, Dept Cardiology Faculty of Health Sciences and University Hospital, Linkoping, Sweden

Web scenarios - building on reality and supporting the problem-based learning structure of an undergraduate medical programme The title of my presentation is Håkan Hanberger prof, Div Infect Diseases, coordinator clinical stadium medical school Anne-Christine Persson coordinator web scenarios Bjorn Bergdahl prof, Dept Cardiology Faculty of Health Sciences and University Hospital, Linkoping, Sweden

of an undergraduate medical programme
Web scenarios - building on reality and supporting the problem-based learning structure of an undergraduate medical programme 1986, Faculty of Health Sciences (FHS) at Linköping University, Sweden, introduced problem-based learning (PBL) as the main educational philosophy for all undergraduate study programmes. The medical programme was second in Europe after Maastricht in this process (1). The rationale and positive effects of using the PBL approach has been reviewed in recent years (2-4) and this model is now, in different formats (5), fairly widespread in medical education. Web scenarios -

Web scenarios - building on reality and supporting the problem-based learning structure of an undergraduate medical programme 1986, Faculty of Health Sciences (FHS) at Linköping University, Sweden, introduced problem-based learning (PBL) as the main educational philosophy for all undergraduate study programmes. 2001, web-based PBL scenarios introduced by the EDIT project (Educational Development using Information Technology). 2001, with inspiration from Sydney University (which had started to use web based scenarios for their new medical programme in 1997) web-based PBL scenarios introduced by the EDIT project (Educational Development using Information Technology). Web scenarios -

Web scenarios - building on reality and supporting the problem-based learning structure of an undergraduate medical programme The main aim of our project was to use information and communication technology (IT) and multimedia in scenarios to improve students’ learning. Web scenarios -

Web scenarios - building on reality and supporting the problem-based learning structure of an undergraduate medical programme The main aim of our project was to use information and communication technology (IT) and multimedia in scenarios to improve students’ learning. Another objective was to familiarise students with handling computers and accessing information from the Internet, thereby preparing them for the use of IT in health care. The IT revolution came late to the hospitals but hospitals in Sweden have computerised systems for diagnostics – radiology, ECG etc and patient records are on computers in most hospitals

Web scenarios - building on reality and supporting the problem-based learning structure of an undergraduate medical programme The main aim of our project was to use information and communication technology (IT) and multimedia in scenarios to improve students’ learning. Another objective was to familiarise students with handling computers and accessing information from the Internet, thereby preparing them for the use of IT in health care. Today patient records, lab systems, diagnostics are on intranet in most hospitals The IT revolution came late to the hospitals but hospitals in Sweden have computerised systems for diagnostics – radiology, ECG etc and patient records are on computers in most hospitals

Revised curriculum subjects are integrated into mainly organ-based themes Within such themes, everyday situations or problems are selected as scenarios The theme groups are producing the web scenarios

Immune-dermathology-infection and microbiology
The role of scenarios in clinical semesters is to complement the clerkships and focus on basic science and pathophysiological mechanisms, epidemiology, prevention, and ethics.

30 EDIT scenarios per semester.

Role of scenarios in clinical semesters is
to complement the clerkships and to focus on Basic science Pathophysiological mechanisms Epidemiology Prevention Ethics 30 EDIT scenarios per semester. 9 EDIT-scenarios per semester

The EDIT group room computer (cordless mouse and keyboard) with internetaccess projector, screen, whiteboard. More than 600 medical students now use the EDIT system every semester and we have plenty of edit group room. Web scenarios -

Web scenarios - http://www.hu.liu.se/lakarprogr/om_lakarprogrammet
Guided Tour EDIT-scenario Guided Tour through a EDIT-scenario Web scenarios -

semester 8 (medicine & surgery integrated)
Maj-Britt 80 years EDIT scenario, semester 8 (medicine & surgery integrated) Web scenarios -

A scenario starts with a short and open review of a patient’s complaints and background to encourage a broad discussion Maj-Britt Liljegren, 80 years old, arrives at the Emergency department because of severe abdominal pain for the last three hours. During the last six months she has experienced intermittent discomfort in the upper part of the abdomen particularly in relation to meals. However, this time the abdominal pain, which radiates to her back, is much more severe.

Maj-Britt sees her GP once a year because of hypertension
Maj-Britt sees her GP once a year because of hypertension. Last year she had a TIA, with temporary weakness in her right arm. Maj-Britt´s husband died three years ago. She lives alone and has no children. She is a former office clerk and has never smoked. She consumes one or two glasses of wine at weekends.

Medication: Trombyl® (acetyl salicylic acid) 75 mg once daily, Atenolol 50 mg once daily, Simvastatin 20 mg once daily. Web scenarios -

Scenarios develop gradually without exposing all the information at once Web scenarios -

The EDIT base-group 1st meeting
Reading and understanding the vinjetto Brain-storming on the principles hidden in the theme Severe pain.. may be pancreatitis or intraabdominal infection?

Reading and understanding the vinjetto Brain-storming on the principles hidden in the theme We should brainstorm on different cause of pain in upper part of abdomen Severe pain.. may be pancreatitis or intraabdominal infection?

Reading and understanding the vinjetto Brain-storming on the principles hidden in the theme We should brainstorm on different cause of pain in upper part of abdomen Severe pain.. may be pancreatitis or intraabdominal infection? I heard that acute pancreatitis is the worst case

Reading and understanding the vinjetto Brain-storming on the principles hidden in the theme We should brainstorm on different cause of pain in upper part of abdomen Severe pain.. may be pancreatitis or intraabdominal infection? Which are the mechanisms behind pancreatitis? I heard that acute pancreatitis is the worst case

Reading and understanding the vinjetto Brain-storming on the principles hidden in the theme We should brainstorm on different cause of pain in upper part of abdomen Severe pain.. may be pancreatitis or intraabdominal infection? Which are the mechanisms behind pancreatitis? Obstruction of pancreatic outflow may be due to alcohol or gallstone I heard that acute pancreatitis is the worst case

Reading and understanding the vinjetto Brain-storming on the principles hidden in the theme I know Leakage of enzymes into the pancreatic tissue causes release of pro-inflammatory mediators from pancreatic macrophages release of pro-inflammatory mediators from pancreatic macrophages is the mechanism We should brainstorm on different cause of pain in upper part of abdomen Which are the mechanisms behind pancreatitis? Obstruction of pancreatic outflow may be due to alcohol or gallstone Back to practice! What about radiology – which methods do you suggest CT, Ultrasonography? I heard that acute pancreatitis is the worst case to encounter

Reading and understanding the vinjetto Brain-storming on the principles hidden in the theme Grouping suggested ideas into categories

3. Grouping suggested ideas into categories Different cause of pain in upper part of abdomen Acute pancreatitis Acute cholecystitis - gallstones Mechanisms behind pancreatitis? Obstruction of pancreatic outflow may be due to alcohol or gallstone Leakage of enzymes into the pancreatic tissue causes release of pro-inflammatory mediators from pancreatic macrophages Diagnosis Radiology – which methods do you suggest CT, Ultrasonography? Laboratory tests I know Leakage of enzymes into the pancreatic tissue causes release of pro-inflammatory mediators from pancreatic macrophages release of pro-inflammatory mediators from pancreatic macrophages is the mechanism We should brainstorm on different cause of pain in upper part of abdomen Which are the mechanisms behind pancreatitis? Obstruction of pancreatic outflow may be due to alcohol or gallstone Back to practice! What about radiology – which methods do you suggest CT, Ultrasonography? I heard that acute pancreatitis is the worst case to encounter

To stimulate discussions on a general and detailed level more information is added in a stepwise fashion about: diagnostics treatments, mechanisms Web scenarios -

Suspected pancreatitis
Elevated P-amylase Suspected pancreatitis !Confirmed!

Suspected pancreatitis
Yes! We should go a little deeper into radiology – and check the links CT, Ultrasonography! Elevated P-amylase Suspected pancreatitis !Confirmed!

Time for new brainstorming!!

Reading and understanding the vinjetto Brain-storming on the principles hidden in the theme Grouping suggested ideas into categories Producing questions based on each category Specifying study goals Individual studies Presenting acquired knowledge – testing general level Applying revised knowledge on the specific case The 1st meeting is coming to an end and after several brainstorming should the group produce questions based on each category etc…

The EDIT base-group 2nd meeting
Reading and understanding the vinjetto Brain-storming on the principles hidden in the theme Grouping suggested ideas into categories Producing questions based on each category Specifying study goals Individual studies Presenting acquired knowledge Applying revised knowledge on the specific case A few days later will the group present acquired knowledge…

7. Presenting acquired knowledge release of pro-inflammatory mediators from pancreatic macrophages is the mechanism What did you learn about the mechanisms of pancreatitis and how to prevent development of pancreatic necrosis ?

7. Presenting acquired knowledge – testing general level release of pro-inflammatory mediators from pancreatic macrophages is the mechanism What did you learn about the mechanisms of pancreatitis and how to prevent development of pancreatic necrosis ? I did a Medline search and I will summarise the main message in 5 minutes based on a recent review

7. Presenting acquired knowledge – testing general level OK, I found an algoritm for treatment of pancreatitis with different severities scores on the hospital intranet it is on your ….. release of pro-inflammatory mediators from pancreatic macrophages is the mechanism What did you learn about the mechanisms of pancreatitis and how to prevent development of pancreatic necrosis ? I did a Medline search and I will summarise the main message in 5 minutes based on a recent review

8. Applying revised knowledge on the specific case I have checked why this patient was not accepted for surgery,

8. Applying revised knowledge on the specific case Fine, and I can summarise the conservative treatment she successfully responded to I have checked why this patient was not accepted for surgery,

Each step & meeting should be evaluated!

EDIT- web scenarios Simple, robust technical solutions
Integrated part of undergraduate education programmes Scenarios are easy to revise and reuse Well received by students and teachers About 600 regular users in medical school More than 150 teachers involved in scenario construction

EDIT- web scenarios Powerful tool for change Review scenarios
Review semesters Review programmes Use in other contexts Open source?

”Base Group” applied in Clinical clerkships
Students are trained to be responsible for their own learning also in the clinical training

Student education ward - first in the world

Student education wards
In 1996, the first student training-ward in Sweden started in Linköping. Several clinical education wards have later started both in Sweden and abroad. In Linköping, and later in Norrköping, students at the end of their education in the nursing, occupational therapy, medicine and physiotherapy programmes form inter-professional teams with 5-8 members at orthopaedic wards and recently also at a geriatric ward.

Two or three teams are in charge of a ward, in alternating turns, and supported by clinical tutors. The teams organise and carry through care, rehabilitation and treatment within the expected level of competence. The majority of the patients are elderly having complicated medical records apart from their orthopaedic-surgical problems.

The two-week placement ends with a seminar. Reflecting on actual experiences, each team selects a problem, makes a presentation and leads a discussion for minutes. Finally, they summarise the issue with special attention to differences and similarities between professions, and make conclusions relevant for their professional practice to come

EDIT - finalist in the European Academic Software Award (EASA) competition in Switzerland 2004.
The medical program in Linköping has a top position in the national evaluation and was awarded for excellence in higher education in 2007 Håkan Hanberger, coordinator clinical education

Linköping University One university – two cities

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