the office of medical education john a. burns school of medicine university of hawaii the office of...

The Office of Medical EducationJohn A. Burns School of Medicine

University of Hawaii

The Office of Medical EducationJohn A. Burns School of Medicine

University of Hawaii

Office of Medical Education

Championing the Educational Mission of JABSOM

• Tell an engaging story• Stir emotions• Realistic to learners• Make us care about the

characters• Raise learning issues

important to the curriculum

An effective case tells the story of a person who encounters a problem, accesses valid information, and uses their new knowledge and interpersonal skills to understand the problem and identify possible solutions.

• Review principles of PBL case-writing

• Practice a method to incorporate Department of Education content standards into cases

• Complete a draft of your first PBL case.

• Review principles of PBL case-writing

• Practice a method to incorporate Department of Education content standards into cases

• Complete a draft of your first PBL case.

Page 1-2: The Problem and the People

Page 3-4: What Happens

Page 5: Closure

• Step 1: Choose the content area and topic of the case

• Step 2: Choose the major themes of the case

• Steps 3-7: Writing Pages 1-5• Break• Step 8: Resource list• Step 9: Teacher notes• Step 10: Student tips page• Other wrinkles• Sharing Cases

• Which content area will I choose and what case topic will I use to illustrate it?

• Examples:– Content Area: Alcohol and Other Drug Use Prevention

– Topic of Case: Randall Nishimoto, a 16 year old male high school student using Ecstasy

Or

– Content Area: Sexual Health

– Topic of Case: Jennifer Tom, a 18 year old female high school senior exposed to HIV infection

• Injury and Violence Prevention

• Tobacco Use

• Alcohol and Other Drug Use

• Sexual Health

• Nutrition

• Physical Activity

• Mental Health

• Personal and Consumer Health

• Community and Environmental

Health

• Injury and Violence Prevention

• Tobacco Use

• Alcohol and Other Drug Use

• Sexual Health

• Nutrition

• Physical Activity

• Mental Health

• Personal and Consumer Health

• Community and Environmental

Health

• Things to check after choosing the case topic:– Is the case topic one of special need or interest at

my high school or community?

– Will my topic be exciting to my students?

– Can I find ways to bring in my students’ environment in this case topic?

• Write the content area of your first case: _____________________________• Write the topic of your first case: ______________________________

• Step 1: Choose the content area and topic of the case

• Step 2: Choose the major themes of the case

• Steps 3-7: Writing Pages 1-5• Break• Step 8: Resource list• Step 9: Teacher notes• Step 10: Student tips page• Other wrinkles• Sharing Cases

• What do you hope students will learn from your case (Objectives)?

• These themes represent the “learning issues” you hope your students will research as a result of going through your case.

• Step 1: Choose the content area and topic of the case

• Step 2: Choose the major themes of the case

• Steps 3-7: Writing Pages 1-5• Break• Step 8: Resource list• Step 9: Teacher notes• Step 10: Student tips page• Other wrinkles• Sharing Cases

An effective case tells the story of a person who encounters a problem, accesses valid information, and uses their new knowledge and interpersonal skills to understand the case and suggest possible solutions.

An effective case tells the story of a person who encounters a problem, accesses valid information, and uses their new knowledge and interpersonal skills to understand the case and suggest possible solutions.

The Problem and the People

What Happens… Closure

• Introduces the problem

• Provides demographic information about the key characters

• Defines the role of your students in the case

• Consider withholding key elements of the story so that students hypothesize “what they think is going on”.

Brandon Char

Brandon Char, an 18 year-old senior is sent to talk with you, the school counselor, because he has seemed more depressed and withdrawn since a fight at school.

Joel DeMello

It’s been a long day of work and you’re glad to finally get home to your family. Things have been going well with the kids lately, but Joel, your 14 year-old son looks a little tired this evening. He eats three servings of dinner in silence.

You empty the hamper to start a load of laundry. You’re shocked to see a plastic bag fall out of one of Joel’s shirt pockets. It’s filled with marijuana.

RoleRole

Demographic Data

ProblemProblem

• Begin the story (Content Area and Topic)

• Introduce the problem

• Identify the role of the student

• Provide key demographics

• Tell us more about the problem– Answer some of the “What do we need to know”

questions of the group.– Give some key clues to the likely problem.

• Tell us more about the characters– Help students care about them.– Add something about their personal lives.

• Personalize the case to your setting to make it more meaningful to students

When the coaches arrive Ashleigh starts to wake up. The trainer gives her water to drink and her father arrives later to take her to see her doctor.

The next day you see Ashleigh in the cafeteria. “Geez, Ash! Are you OK?”

“I’m fine,” she says.

You notice Ashleigh looks as though she’s lost weight. 

“Have you been eating anything? You are soooo skinny!” you tell her. 

“Thanks.” she proudly replies. “My doctor says I’m too thin. She’s so wrong!”

You and Ashleigh have been friends for years – ever since the fifth grade. She’s a good student and on the cross country and track teams with you. She has always been thin, but lately she appears unhealthy – her legs look like toothpicks! She now weighs 90 pounds.

Ashleigh gobbles down the chili con carne.

“I love this”, she says, “but not as much as the wieners in a roll on Fridays. Are you going to eat yours?”

“You can have it”, you say, sticking a finger in your mouth and pretending to gag. “I’ll just have the fruit, salad, and milk.”

After finishing off your lunch, you notice Ashleigh swallow a pill, then walk to the bathroom. Funny, she always goes to the bathroom after eating. When she doesn’t return, you decide to go in and check on her.

More about the “Problem”

(clues)

More about the “Problem”

(clues)

More about the “Person” (Character

Development)

• Tell us more about the problem

• Tell us more about the characters

• Personalize

• Tell us what happens…• Raise or model the access of valid information

– Finding a web site– Talking to a community organization– Talking to a trusted advisor

• Personalize the case to your setting to make it more meaningful to students

• Consider Learning Cues

In the bathroom you hear Ashleigh vomiting in a stall.

“Ash, are you OK? Are you sick? Want me to get help?”

“NO! DON’T!” she replies. “I’ll be fine.”

After a minute, she exits the stall, washes her face and turns to you. “Promise me you won’t tell anyone about this, pleeeeeeaaaasssee?

Reluctantly, you agree. But as you look at her reflection in the bathroom mirror, you notice how thin her face looks, how discolored her teeth have become recently, and how sickly your once vibrant friend now appears. Inside, you feel like you’re not doing what’s best for your friend…

“You know,” says Ashleigh, “all the really good models in magazines are thin. The camera alone adds ten pounds. If I want to make it big, I’ll have to be thin, too. It’s not like I’m just acting crazy or something…”

Looking at Ashleigh again in the mirror, you remember hearing about something called bulimia and wonder if Ashleigh has it. You decide to find out more about bulimia.

Access Valid Information

2

Analyze Influences of Media and

Culture

3

• “You wonder if...”

• “You try to recall the reason for...”

• “Your friend asks you...”

• “You make a mental note to review...”

• “You decide to look up the web site for…

• Tell us what happens…• Raise or model the access of valid information • Personalize the case to your setting to make it

more meaningful to students• Consider Learning Cues

• Tell us what happens…• Interpersonal Communication Skills

– Model talking to friends or family– Use “quotations”– Model body language and tone

• Goal Setting and Decision-Making– Raise the setting of goals for health

• Personalize • Consider Learning Cues

After talking to the school counselor about “a friend” and checking out some resources on the web, including “On the Teen Scene”, a site hosted by the US Food and Drug Administration (FDA), you make some decisions about your own health and go to talk with Ashleigh. 

“Ashleigh, I’m kinda worried about you.” 

“Why? I’m fine,” she says. 

“Well, all I know is I’ve seen you eat a lot of food and go barf it up later. I know you’re getting really thin.” 

“I’m not thin.” 

“Ashleigh, I read that Jane Fonda had bulimia since she was 12. She would eat then vomit up to twenty times a day. I know it can kill you. You gotta go talk to the school counselor!” 

“There’s nothing wrong with me!” Ashleigh’s eyes begin to tear. 

“Ash I…” The two of you sit silently together for a long time.

Goal Setting and

Decision Making

5

Interpersonal Communication

Skills

4

• Tell us what happens…• Interpersonal Communication Skills

– Model talking to friends or family– Use “quotations”– Model body language and tone

• Goal Setting and Decision-Making– Raise the setting of goals for health

• Personalize • Consider Learning Cues

• Closure• Personalize

• Closure• Personalize

An effective case tells the story of a person who encounters a problem, accesses valid information, and uses their new knowledge and interpersonal skills to set understand the problem and identify possible solutions.

An effective case tells the story of a person who encounters a problem, accesses valid information, and uses their new knowledge and interpersonal skills to set understand the problem and identify possible solutions.

The Problem and the People

What Happens… Closure

• Step 1: Choose the content area and topic of the case

• Step 2: Choose the major themes of the case

• Steps 3-7: Writing Pages 1-5• Break• Step 8: Resource list• Step 9: Teacher notes• Step 10: Student tips page• Other wrinkles• Sharing Cases

• Step 1: Choose the content area and topic of the case

• Step 2: Choose the major themes of the case

• Steps 3-7: Writing Pages 1-5• Break• Step 8: Resource list• Step 9: Teacher notes• Step 10: Student tips page• Other wrinkles• Sharing Cases

• Be selective• Get permission, then contact

information for resource people

• Consider web-sites, computer-aided instruction

• Teacher Notes– Gives some content or

processing background

• Possible Teacher Prompts– Questions the tutor may ask

his students

• Possible Learning Issues- Select to fulfill objectives

Information about the content area or suggestions for facilitation.

Information about the content area or suggestions for facilitation.

Questions teachers can ask the students during processing.

Questions teachers can ask the students during processing.

Possible learning issues (themes) relevant to the page that students may wish to choose as learning issues.

Possible learning issues (themes) relevant to the page that students may wish to choose as learning issues.

• Precedes the first page of the case

• Reminds students of certain learning skills

• Focuses attention• Sets the tone

• Step 1: Choose the content area and topic of the case

• Step 2: Choose the major themes of the case

• Steps 3-7: Writing Pages 1-5• Break• Step 8: Resource list• Step 9: Teacher notes• Step 10: Student tips page• Other wrinkles• Sharing Cases

• Consider videotaped segments for some cases

• Consider longitudinal threads, recurring characters to increase meaningfulness

• Experiment with time course– Consider cases that take place over 5 minutes

and some that take place over 50 years

• Case Nodes

• A dilemma is presented to the case reader at the end of a page.

• Students must choose a course of action.

• Their choice determines which page they will receive next.

...On this home visit she looks particularly bad. She reaches for your hand and holds it tightly. “Doctor”, she said, “I can’t take the pain anymore. Will you help me end it all?”

Student Note: This page represents a node in the case. There are two versions of the next page. The page you receive will be determined by your group’s answer to Mrs. Stillner’s question. After discussion, please inform your tutor whether or not you will or will not provide physician-assisted suicide and you will receive the appropriate page. After completing the next page, which is the last page of the case, you will receive both versions to review. (Edna Stillner HCP Unit 2)

...On this home visit she looks particularly bad. She reaches for your hand and holds it tightly. “Doctor”, she said, “I can’t take the pain anymore. Will you help me end it all?”

Student Note: This page represents a node in the case. There are two versions of the next page. The page you receive will be determined by your group’s answer to Mrs. Stillner’s question. After discussion, please inform your tutor whether or not you will or will not provide physician-assisted suicide and you will receive the appropriate page. After completing the next page, which is the last page of the case, you will receive both versions to review. (Edna Stillner HCP Unit 2)

• We must make choices.

• Our choices have consequences.

• Students can see the consequences of our actions.

• The node is a powerful cue

• The node generates discussion

• Use nodes strategically

• Step 1: Choose the content area and topic of the case

• Step 2: Choose the major themes of the case

• Steps 3-7: Writing Pages 1-5• Break• Step 8: Resource list• Step 9: Teacher notes• Step 10: Student tips page• Other wrinkles• Sharing Cases

Office of Medical Education

Championing the Educational Mission of JABSOM