Pontificia Universidad Católica de Valparaíso
Facultad de Filosofía y Educación
Instituto de Literatura y Ciencias del Lenguaje
Developing academic writing skills through a genre-based approach in a blended
learning environment: an elective course for medical students.
TRABAJO DE TITULACIÓN
para optar al título de Profesor de Inglés
y al grado de Licenciado en Educación.
Tesis enmarcada en el proyecto FONDECYT 11130469
Alumna: Romina Jara Marambio
Profesor Guía: Mónica S. Cárdenas-Claros
Co-Director: Walter Koza
Segundo Semestre
2015
2
Acknowledgments
To my teacher for his patience and guidance,
and to my family for supporting me in every challenge I have taken.
Despite the role that academic writing plays in learners' fu
in science disciplines, it is a subject poorly addressed in Chilean higher education. Students
in medical school do not receive enough instruction that would allow them to produce
effective text in their fields of study.
students' academic writing skills in producing a medical case report. In order to achieve this
aim, it is proposed an elective course organized under a genre
students will collaboratively write
Key words: academic writing, genre
writing, blended learning.
Abstract
Despite the role that academic writing plays in learners' future professional life, especially
in science disciplines, it is a subject poorly addressed in Chilean higher education. Students
do not receive enough instruction that would allow them to produce
effective text in their fields of study. This graduation project seeks to develop medical
students' academic writing skills in producing a medical case report. In order to achieve this
an elective course organized under a genre-based approach in which
write using a blended learning methodology.
Key words: academic writing, genre-based approach, medical case report, collaborative
3
ture professional life, especially
in science disciplines, it is a subject poorly addressed in Chilean higher education. Students
do not receive enough instruction that would allow them to produce
graduation project seeks to develop medical
students' academic writing skills in producing a medical case report. In order to achieve this
based approach in which
medical case report, collaborative
4
Tabla de contenido
Abstract ................................................................................................................................... 3
Tabla de contenido.................................................................................................................. 4
Introduction ............................................................................................................................ 5
Literature Review ................................................................................................................... 7
1. Writing in a second language .......................................................................................... 7
1.1. Academic writing ..................................................................................................... 7
1. 2. Genre-based approach to writing ........................................................................... 8
1.2.1. Genre-based instruction ....................................................................................9
1.2.1.1. Medical Case Report........................................................................ 10
1.3. Collaborative writing.............................................................................................. 11
2. Blended learning .......................................................................................................... 12
2.1. Tools used in blended learning............................................................................... 13
2.1.1. Moodle.............................................................................................................13
2.1.2. Google Docs....................................................................................................14
3. Task-based language learning ....................................................................................... 14
Pedagogical Proposal ............................................................................................................ 16
Syllabus design ................................................................................................................. 16
Course description ............................................................................................................ 16
Course organization .......................................................................................................... 17
General Objective ............................................................................................................. 19
Course Syllabus ................................................................................................................ 19
Assessment ........................................................................................................................ 19
Sample lessons ...................................................................................................................... 20
References ............................................................................................................................ 35
Appendix A: Survey ............................................................................................................. 39
Appendix B: Needs Analysis ................................................................................................ 42
Appendix C: Rubrics ............................................................................................................ 48
5
Introduction
English is the international language of research and scholarship and the medium to spread
scientific results (Tardy, 2004). Besides, as Ferguson, Perez-Llantada, and Plo (2011)
claim, it seems likely that English will remain as the dominant international language of
science in the future. The major advantage of English as a lingua franca is that it "is seen as
a tool through which communication can occur in a maximally efficient and effective
manner between people who do not share a common first language. Thus, English courses
must include genres that “the learner has to produce and/or understand” (Dudley-Evans,
2001, p.134) to enter his/her academic or professional community and to share field-
specific “cultural assumptions and practices” (Hyland, 2009).
Ferguson, Perez-Llantada, and Plo claim universities can play an important part in
alleviating linguistic disadvantage by offering contextualized academic writing courses.
However, after a thorough and systematic review of the curriculum descriptions of eleven
institutions that offer medicine programs in our country, the results show that Chilean
educational institutions do not seem to prepare their students well enough to write text in
their specific fields. Most Chilean students in medical school are taught two English
courses that are either common to all programs offered by the institution or focus only on
technical vocabulary and/or reading skills. Some institution additionally offer elective
courses of English but none of them focuses on academic writing. Particularly, Universidad
Católica de Chile, apart from English elective courses, offers courses to pass ALTE
(Association of Language Testers in Europe) tests.
Consequently, the courses available do not meet the needs of a modern medical student that
is inserted in a globalized world and that is actively participating in his or her academic
community. In fact, Chilean students in medical school seem to be interested in publishing
in their field of study, but they just do it in their mother tongue which reduce their
possibilities of spreading their work. The Asociación Nacional Científica de Estudiantes de
Medicina de Chile (ANACEM), an organisation that includes mayor academic institutions
offering medicine in Chile, publishes a three-times-a-year indexed journal where students
share original articles and reports on medical topics. Besides, there are four other
independent indexed journals from individual universities.
6
Based on the evidence, an appropriate approach to tackle English as a second language in
this academic context is a genre-based approach because it sees "writing as purposeful,
socially situated responses to particular contexts and communities" (Hyland, 2003b, p.17).
The genre-based approach has been widely implemented and favourable results have been
obtained and, for the same reason, there are a variety of international studies that provide
evidence of its success. For instance, a study based on an English for engineering course
that used a genre-based approached revealed that "the writing ability of students improved
after the experiment. As for student's attitudes, the findings showed that the students were
satisfied with the teaching method, activities, and exercises. More importantly, they felt
more confident in writing" (Piyatida, 2013, p.735). Nonetheless, there is little evidence on
the use of a based-genre approach to teach medical genres such as the Medical Case Report
that is one of the most published texts in scientific journals worldwide.
Consequently, this graduation project aligns with a genre-based approach and seeks to
develop medical students' academic writing skills in producing a medical case report
through an elective course centred on a blended learning methodology and a syllabus
designed based on tasked-based language learning. Blended learning methodologies have
been integrated as a response to time constrains as well as to facilitate different types of
interactions and personalized feedback. It would be observable at the lesson level in
activities that will involve class work and subsequent online work and at the syllabus level
in units that will required different degrees of face-to-face or online interaction depending
on level of independency required. The project is addressed to a group of 20 students with
an intermediate level of English.
The project is organized into two main sections: the theoretical framework and the
pedagogical proposal. The first section reviews the concept of writing in English as a
Second Language as well as Academic Writing. It also introduces the notions of
collaborative writing and the approach in which writing will be taught. In addition, it
briefly describes blended learning and tasked- based language learning. The second section
puts into practice all the theory obtained for the development of the project. The
pedagogical proposal contains the syllabus design and some sample lessons. It also offers
suggestions for evaluating the course.
7
Literature Review
This literary review presents an overview of the three elements that will be used in the
development of the pedagogical proposal. The first part reviews the concept of writing in
English as a Second Language (ESL) as well as Academic Writing. It also introduces the
notions of collaborative writing and the approach in which writing will be taught. The
second part focuses on blended learning. Finally, the last part describes task-based language
learning.
1. Writing in a second language
According to Hammer to Harmer (2001) writing is a form of communication to deliver
through written form. Writing involves series of activities going on and involve several
phases. Writing is considered a very demanding activity, with many skills and sub-skills
behind it (Mazandarani, 2010). To develop those skills, the learner will need time to think,
reflect, prepare, make mistakes, evaluate and find solutions (Kotlyarova, 2013). Thus, it is
time consuming and it is usually the last skill acquired by the learner because it implies
complex mental processes (Ferguson, 2007).
Moreover, according to Hyland (2003a) writing in a second language goes beyond learning
a set of rules, acquiring some cognitive abilities or having the chance to compose and
revise. It also implies a clear understanding that "every act of writing is in a sense both
personal and individual, it is also interactional and social, expressing a culturally
recognized purpose, reflecting a particular kind of relationship, and acknowledging and
engagement in a given community" (p. 27).
1.1. Academic writing
According to Strongman (2013), while writing is about communicating with words,
academic writing is about choosing words carefully to communicate complex ideas to a
variety of readers and audiences. Academic writing requires learners to develop "the ability
to integrate a wide range of different types of knowledge in order to create extended written
discourse that is both linguistically accurate and socially appropriate" (Bruce, 2008, p.5).
8
Particularly, academic writing is essential for publications worldwide because it focuses on
objective evidence and follows a logical structure, consequently, it is highly valuable in
scientific contexts (Lillis, T., & Curry, M., 2010). Furthermore, along with the great
expansion of the international use of English, there has been an exponential growth in
Academic Writing instruction. Second Language learners from different academic
disciplines are taught to write specific texts with clear purposes and well defined target
audiences (Flowerdew, 2014).
1. 2. Genre-based approach to writing
The Genre-based approach (GBA) starts as a response to a framework that highlights a
process of planning-writing-reviewing. This framework focuses on strategies for writing
rather than on the linguistic resources that learners need to express themselves effectively
in a foreign language (Hyland, 2003b).
According to Hyland (2007), this approach emphasises that:
Genres are specific to particular cultures, reminding us that our students may not
share this knowledge with us and urging us to go beyond syntactic structures,
vocabulary and composing to incorporate into our teaching the ways language is
used in specific contexts. It assists students to exploit the expressive potential of
society's discourse structures instead of merely being manipulated by them. (p.150)
The genre-based approach has been widely implemented and promising results have been
obtained. There are a variety of international studies that provide evidence of its success.
One study involving three writing initiatives carried out at King’s College London UK
showed that a GBA "is the best starting point for teaching and learning of academic
writing, and that students will be more willing to take a critical perspective when they are
able to understand and control disciplinary discourses" (Wingate, 2012, p.26).
A second study, based on a course focused on teaching to write a summary, showed that
the approach "was effective in improving students’ overall summarization performance of a
narrative source text and that the students benefited to a greater extent in content and
organization" (Chen & Su, 2012, p.184).
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Hyland (2007) summarizes the main advantage of GBA as follows:
Explicit - Makes clear what is to be learnt to facilitate the acquisition of writing skills;
Systematic - Provides a coherent framework for focusing on both language and contexts;
Needs-based - Ensures that course objectives and content are derived from students' needs;
Supportive - Gives teachers a central role in scaffolding students' learning and creativity;
Empowering - Provides access to the patterns and possibilities of variation in valued texts;
Critical - Provides the resources for students to understand and challenge valued
discourses;
Consciousness-raising - Increases teachers' awareness of texts to confidently advise
students on writing. (p.150).
1.2.1. Genre-based instruction
Genre-based instruction is based on four key principles that should be reflected in syllabus
goals and teaching methodologies. Those principles are: (i) writing and learning to write is
a social activity, (ii) learning to write is needs-oriented, (iii) learning to write requires
explicit outcomes and expectations, and (iv) learning to write involves learning to use
language (Hyland, 2003b).
According to Hyland (2007), genre-based instruction sequencing does not have a fix
structure to be followed. Many possibilities are proposed and can be adapted according to
the necessities of the learner. Among these possibilities the most important ones are: to
determine the most critical skills or functions relevant to students' immediate needs; to
follow the sequence of a genre set in a real world series of interactions; and to grade genres
by perceiving increasing levels of difficulty.
Furthermore, genre-based instruction gives importance to peer interaction or collaboration
and teacher-supported learning or scaffolding. Scaffolding is supposed to follow a sequence
based on a methodological model represented by the teaching-learning cycle.
The teaching learning cycle consist of five stages: 1. Building the context: study of genre
purpose and the settings where is usually found; 2. Modelling and deconstructing the text:
analysis of representative samples to identify key features and variations; 3. Join
10
construction of the text: guided practice through tasks that focus on particular stages or
functions of the text; 4. Independent construction of the text: autonomous writing
monitored by the teacher; and 5. Linking related texts: connection between what has been
learnt to other genres and contexts to understand how genres are designed to achieve
particular social purposes (Feez as cited in Hyland 2007).
The cycle stages described above will be the basis for the syllabus' organization in the
pedagogical proposal. Units will be structured following a logical sequence that will
emphasis different stages depending on writing progress. However, it is important to
acknowledge that the cycle is intended to be used flexibly in order to allow students to enter
at any stage depending on their existing knowledge of the genre and to enable teachers to
return to earlier stages of the cycle for revision purposes (Hyland, 2007).
1.2.1.1. Medical Case Report
Genres in medicine are extremely important. They allow effective communication among
medical communities. The most important ones are the Research Article and the Clinical
Case Report. Particularly, Medical Case Reports represent a relevant, timely, and important
study design in advancing medical scientific knowledge (Vihla, 1999).
In medicine, the Medical Case Report (MCR) is a scientific genre used by doctors or
medical practitioners to describe unusual cases worth reporting for being atypical. More
specifically, the MCR deals with a clinical condition and its care (Aitken & Marshall,
2007).
The Medical Case Reports are valuable for students and doctors. Mostly, they can serve as
early warning signals of adverse effects in therapies (Kidd & Hubbard, 2007); they can
provide “detailed accounts” of “what can go wrong” (Mason, 2001) in medical practice or
they can offer a description of pioneering experimental techniques.
Medical Case Reports have an educational and communicative purpose. Generally, they do
not exceed 1500 to 2000 words. They can contain a few figures, including; radiographs,
ultrasound scans or photographs; and some charts. Besides, they are usually written by four
o more authors (Aitken & Marshall, 2007).
11
The Medical Case Report format resembles the research article (see Swales 2004) as it
consists of the following sections: abstract, introduction, case description, discussion and
conclusion. According to Aitken and Marshall (2007) the main characteristics of a Medical
Case Report can be summarize as it is shown in the following chart:
There are a few research articles on linguistics that analyzed the genre but there is not much
evidence of studies that show the use of a based-genre approach to teach Medical Case
Report in academic writing.
1.3. Collaborative writing
Collaborative writing could be considered a text written by more than one individual, but
collaboration implies more; frequently, the writer builds his work in response to feedback
that can come from peers or from the teacher in a school setting. They can learn from each
other through the editing process until they get the final product. Thus, collaborative
writing is about communal work and shared responsibilities (Speck, 1999).
According to Smith and MacGregor (2009) learning is shifting from "passive reception" to
"active creation". Students tend to be more responsible of their contributions and to think
ABSTRACT Brief overview: why the case is important, case details, clinical
impact on literature. It should stand alone and attract perspective
readers’ attention.
INTRODUCTION Setting the scene: general overview of the condition (disorders,
relevant clinical signs to introduce the case), brief review of
literature to contextualize the case.
CASE
PRESENTATION
Description: relevant background info (health history, family
history, current problems, disorders, clinical signs relevant to
contextualize the case, care details: tests, drugs).
DISCUSSION &
CONCLUSION
Commentary: put the case in context to explain results and medical
decisions, recommend future care based on present results, state the
educational message.
12
critically about related issues when they work as a team. The collaboration process
enhances students’ learning and develops their social skills like decision-making, conflict
management, and communication.
Collaborative writing brings in a new dimension of social interaction. "Not only do
collaborating writers have differing strategies for writing that need to be reconciled, but
they also form a social group, with its own personality and dynamic" (Sharples, 2012,
p.28). In addition, the outcome of a collective writing activity is not only "the jointly
produced text, it is also collective cognition, emerging when two or more people reach
insights that neither could have reached alone" (Stahl as cited in Storch, 2013, p.2).
Pruitt (2012) suggest six steps to success in collaborative writing: (i) identify the unique
pieces of the project, (ii) Identify everyone’s strengths and specialties and take advantage of
them, (iii) agree on a project schedule and benchmarks for completion along the way, (iv)
assign a project coordinator, (v) assign a final editor, and (vi) disseminate the final draft to
all involved for review and feedback.
2. Blended learning
"Blended learning (BL) is the thoughtful integration of classroom face-to-face learning
experiences with online learning experiences" (Garrison & Kanuka, 2004, p.96). BL
implies blended courses and programs in which online and face-to-face modalities are not
easily distinguishable (Picciano, Dziuban, & Conclusion is not present, 2014).
It is claimed by Bonk and Graham (2012) that BL promotes "improvements in the rate of
learning, as well as the efficiency of training, maximizing corporate investments in reusable
training materials, and, of course attempts to save on training time" (p.16). Furthermore, it
facilitates different types of interaction; learner-instructor, learner-content, learner-learner,
where the student can be independent of space and time but still connected with class
members and where the teacher can provide personalized and extended feedback (Garrison
& Kanuka, 2004).
Based on Garrison and Vaughan (2008) a key element for Blended Learning to work
successfully is group cohesion. Sustained discourse and collaborative activities are
13
excellent tools to build it and maintain it. Moreover, distribution of tasks and activities is
particularly important. For instance, "Face-to-face classroom environment may be good
context to introduce a topic and focus interest. However, students must have extended
opportunities to construct meaning and confirm understanding; this is often best done
online" (Garrison and Vaughan, 2008, p.93).
2.1. Tools used in blended learning
Nowadays, there are many online tools that can be used with pedagogical purposes.
"Online programs offer flexibility to students and to professors, increasing opportunities for
learners to experience classroom observations and practice teaching" (Williamson, Mears,
& Bustos, 2015, p.138). Furthermore, "when tasks are asked for interaction with partners,
language production is increased in asynchronous environments" (Thomas, 2010, p.31)
2.1.1 Moodle
Cole (2005) defines Moodle as an open source course system that universities, community
colleges, businesses, and even individual instructors use to add web technology to their
courses. More than 30,000 educational organizations around the world currently use
Moodle to deliver online courses and to support traditional face-to-face courses. Moodle is
available for free on the Web so anyone can download and install it. At the most basic it
give educators tools to create a course web site and provide access control so only enrolled
student can view it. Also, Cole (2005) states that Moodle provides different academic tools,
such as: "an easy way to upload material and share material, hold online discussions and
chats, give quizzes and surveys, gather and review assignments, and record grades" (p.1).
A study based on an online academic writing course showed that Moodle encourages
teamwork and helps developing the skills to write scientific articles (Sánchez et al, 2012).
Another study revealed that "by implementing Moodle’s technologies into an L2
composition course, participants benefit in the areas of organization, implementation,
distribution, communication and assessment" (Robertson, 2008 p.58).
2.1.2 Google Docs
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Google Docs is an application that allows access from any computer and eases the ability to
collaborate by sharing a document with others as viewers or collaborators, or by publishing
it on the web (Conner, 2008). Google Docs supports synchronous editing and comment
writing, and saves versions of the document, options that afford real-time collaborative
learning. "Similar to Wikis, Google Docs enables collaboration by editing a document
written by other students, and by suggesting modifications through comment writing,
without editing the document itself " (Blau & Caspi, 2009, p. 49).
A study based on collaborative writing, suggests that Google Docs is an excellent platform
for collaboration on document creation. "The interface is usable, effective, and efficient. In
addition, setting up collaboration with colleagues proved to be exceedingly simple"
(Dekeyser & Watson (2006). Another study on collaborative writing suggests Google Docs
is "well-suited as a tool for out-of-class collaborative assignments" (Zhou, Simpson, &
Domizi, 2012, p.366). The same study showed enriched learning experiences compared to
the assignment without Google Docs. Also, students reported to be interested in using
Google Docs for future assignments (Zhou, Simpson, & Domizi, 2012).
3. Task-based language learning
Task-based language learning centers around task completion. A task is a plan for learner
activity. The plan takes form of teaching materials or activities and has a clearly define
communicative outcome. It focuses on meaning and engages cognitive processes (Ellis,
2003). "The aim of the task is to create a real purpose for language use and provide a
natural context for language study" (Willis, 1996, p. 10)
In a TBLL context, target language exposure should be presented in a naturally occurring
context. Material are selected and adapted from authentic sources, they are not prepared
especially for the lesson. Therefore, task-based learning requires that learners
independently interpret and analyse language, and that they experiment with their prior
knowledge in order to fully exploit the different activities they face (Willis and Willis,
2009).
According to Robinson (2011), tasks provide opportunities for obtaining feedback by a
partner or a teacher, and for noticing the gap between a participant’s production and input
15
provided, as well as, for metalinguistic reflection on the form of output. Also, Robinson
(2011) states that "task demands can focus attention on specific concepts required for
expression in the second language (L2) and prompt effort to grammaticize them in ways
that the L2 formally encodes them, with consequences for improvements in accuracy of
production" (p.2).
16
Pedagogical Proposal
Name of the course: Writing to be read worldwide
Type: Elective course
Target: Medical students (20 participants)
English Level: Intermediate
Duration: 40 hours (45') [Online time required: 20 hours (45')]
Teacher: Romina Jara Marambio
Email address: [email protected]
Syllabus design
This elective course follows a genre-based approach since it is expected that the students
write specific texts needed in their target contexts outside the ESL classroom. The course is
centred in a blended learning methodology that is implemented through a task-based
language learning syllabus design.
The syllabus of the course is based on the results of the needs analysis (appendix A)
conducted to senior students in medical school at Universidad Católica de Chile. The
results of the analysis (appendix B) showed three main aspects to be considered in the
syllabus:
1. Time constrains.
2. Recognition of the structure and conventions of specific texts.
3. Collaborative work and feedback.
Course description
This is an elective workshop designed for senior students in medical school with an
intermediate level of English. This workshop exposes students to authentic material
regarding medical report cases and includes topics that are relevant for participants.
17
The students are required to work collaboratively in the process of writing, mimicking real
life interactions inside the classroom and through two online platforms: Moodle and
Google Docs. Students will have to virtual interact in the process of writing itself by
editing, commenting and composing. Also, they will have to virtually interact through
forums, by building common glossaries, by sharing material and experiences and by giving
feedback.
Course organization
The course is structured in 5 units following the stages proposed by the genre-based
approach (building the context; modelling and deconstructing the text: join construction of
the text; independent construction of the text and linking related texts).
Unit 1 works as an introduction, presenting different medical texts and describing
specifically a medical case report. Students get familiar with the structure and
characteristics of the genre covered during the course. [It implies building the context and
deconstructing the text.].
Unit 2 tackles each section of the medical case report more specifically. Students are
divided into groups and assigned a case to work with. They start to write some paragraphs
and to plan their texts together based on the examples given. [It implies deconstructing the
text and join construction of the text.]
Unit 3 promotes collaborative work. Students work hand-in-hand sketching and writing two
different sections of the medical case report. [It implies join construction of the text.]
Unit 4 gives the students the chance to check their progress. Students work applying
knowledge acquired during previous units in the construction of the text. Individual and
group work is required. Most part of the unit will be covered online. [It implies join
construction of the text and independent construction of the text.]
Unit 5 provides the chance to evaluate and assemble the final product as well as to assess
appropriateness according to a given context. Student reflect on their learning process. [It
implies linking related texts.]
18
During Unit 1 and Unit 2, online interaction would be mostly reduced to simple follow-up
tasks based on in-class activities as a way to get familiar with the platforms and the
different tools available. More demanding tasks and activities will be increasingly added.
Virtual participation will be strongly guided. Face-to-face meetings will be scheduled twice
a week.
During Unit 3 and Unit 5, online and face-to-face interaction would be evenly distributed.
There will be simple and complex tasks to be completed online. Participation will be both
guided and free. Face-to-face sessions will be scheduled once a week.
Most of Unit 4 will be held online. Interaction in the platforms will be free. However,
active participation is expected (and will be formally assessed). Teacher will constantly
provide personalized and extended feedback through the platforms. Only two face-to-face
lessons will be schedule, one at the beginning and another at the end of the Unit.
19
General Objective
By the end of this course students will be able to collaboratively write a medical case report
through face-to-face and online interaction.
Course Syllabus
Assessment
Final grades will be based on the following percentages:
Self assessment (10%) Each student will assess his/her performance during the course.
Peer assessment (10%) Each student will assess the performance of the members of his/her group during the course.
Group interaction (20%) Online interaction will be weekly supervised (5%). Work Distribution and participation will be assessed in Unit 4 (15%).
Progress reports (20%) Students will have to present two progress reports. The first one at the end of unit 3 and the second one at the end of unit 4.
Final report (40%) Each group will hand over their final work (appendix C).
UNITS OBJECTIVES Unit 1: Exploring a Medical Case Report
• Define main medical academic genres. • Describe the medical case report. • Identify the structure of a medical case report and its general
characteristics. Unit 2: Getting to know an unusual occurrence
• Recognize the specific purpose, structure, grammar and vocabulary of each section involved in a medical case report.
• Write short paragraphs describing signs and symptoms and other medical aspects.
• Relate the case facts assigned with the medical case report sections analyzed
Unit 3: Taking Shape
• Plan the different sections of a medical case report. • Assign roles and independent work among the group. • Compose some sections of a medical case report: case
presentation, discussion and conclusions. Unit 4: Becoming a professional writer
• Revise the progress. • Apply skills used to write previous sections to work on the
introduction, and abstract. Unit 5: Checked and done
• Assemble the medical case report. • Asses audience adaptation. • Compare and evaluate classmates' work.
SYMBOLS
Pl_n[ry
In^ivi^u[l Work P[ir Work
Stu^y /R_m_m\_r
The following sample lessons belong to either the first or the second lesson of the units (Lesson 2 ohttps://demo.moodle.net/user/profile.php?id=3d=23§ion=1)The ideal classroom consists of 20 students with an intermediate
level of English.
Group Work P[ir Work
Stu^y /R_m_m\_r
Onlin_ Work
[@t Hom_]
R_fl_]tion
Sample lessons
The following sample lessons belong to either the first or the nd lesson of the units 1, 2, 3 and 5 from the students' book.
of Unit 4 is available online ahttps://demo.moodle.net/user/profile.php?id=3/course/view.php?i
) The ideal classroom consists of 20 students with an intermediate
Onlin_ Work
[In Cl[ ss]
20
Onlin_ Work
[@t Hom_]
The following sample lessons belong to either the first or the book.
at course/view.php?i
The ideal classroom consists of 20 students with an intermediate
Onlin_ Work
[In Cl[ ss]
II. Compare your though
classmate and write the things you
have in common.
_________________________________________
_________________________________________
_________________________________________
_________________________________________
GET READY
I. Answer the following questions:
1. Have you ever written a medical case report? What about a scientific research article?
___________________________________________________________________________
______________________________________________
2. Have you ever had problems distinguishing both of them?
___________________________________________________________________________
___________________________________________
H@NDS ON
IV. Read the text assigned online (Figure 1) and complete the following chart.
Similarities Medical Case Report
Scientific research article
UNIT 1: Exploring [ M_^i][ l C[ s_ R_port
Lesson 2
II. Compare your thoughts with a
classmate and write the things you
have in common.
_________________________________________
_________________________________________
_________________________________________
_________________________________________
I. Answer the following questions:
1. Have you ever written a medical case report? What about a scientific research article?
___________________________________________________________________________
___________________________________________________________________________
2. Have you ever had problems distinguishing both of them?
___________________________________________________________________________
__________________________________________________________________________
IV. Read the text assigned online (Figure 1) and complete the following chart.
Differences
Exploring [ M_^i][ l C[ s_ R_port
III. Share with the
rest of the class
Figure 1
Objectives:
-Describe the
-Identify the structure of a Medical
Case Report
21
1. Have you ever written a medical case report? What about a scientific research article?
___________________________________________________________________________
_____________________________
___________________________________________________________________________
_______________________________
III. Share with the
rest of the class
Figure 1
Describe the Medical Case Report.
Identify the structure of a Medical
V. Come up with a definition of a Medical Case Report
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
_______________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
____ ABSTRACT ____ INTRODUCTION
____ CASE PRESENTATION ____ DISCUSSION AND CONCLUSIONS
TASK 1: a. Choose one mem
[Medical Case Report definition
b. Individually, vote for the best definition. Explain why. (Figure 2)
a.
recomm
educational message.
b.
It should stand alone and attract perspective readers’ attention.
c.
to introduce the case), brief review of literature to contextualize the
case.
d.
problems, disorders, clinical signs relevant to contextualize the case,
ca
Figure 2
V. Come up with a definition of a Medical Case Report
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
VI. Guess and match each section with its most important
components and/ or characteristics.
____ ABSTRACT ____ INTRODUCTION
____ CASE PRESENTATION ____ DISCUSSION AND CONCLUSIONS
Remember!
A definexplanation of the meaning of a
Three Steps to an effective
definition:
1. Tell readers what concept is being defined.
2. Present clear and basic information.
3. Use facts or examples that readers will understand.
TASK 1: a. Choose one member of the group to upload your definition to the corresponding forum
Medical Case Report definition].
b. Individually, vote for the best definition. Explain why. (Figure 2)
a. put the case in context to explain results and medical decisions,
recommend future care based on present results, state the
educational message.
b. why the case is important, case details, clinical impact on literature.
It should stand alone and attract perspective readers’ attention.
c. general overview of the condition (disorders, relevant clinical signs
to introduce the case), brief review of literature to contextualize the
case.
d. relevant background info (health history, family history, current
problems, disorders, clinical signs relevant to contextualize the case,
care details: tests, drugs).
22
atch each section with its most important
____ CASE PRESENTATION ____ DISCUSSION AND CONCLUSIONS
Remember!
A definition is an explanation of the meaning of a concept.
Three Steps to an effective
Tell readers what concept is being defined.
Present clear and basic information.
Use facts or examples that readers will understand.
ber of the group to upload your definition to the corresponding forum
put the case in context to explain results and medical decisions,
end future care based on present results, state the
why the case is important, case details, clinical impact on literature.
It should stand alone and attract perspective readers’ attention.
isorders, relevant clinical signs
to introduce the case), brief review of literature to contextualize the
relevant background info (health history, family history, current
problems, disorders, clinical signs relevant to contextualize the case,
VII. Identify the components and characteristics des
given. Assign a different colour or symbol to each one. Then highlight or marked your text
accordingly.
Example Context
Explanation of results and medical decisions
Recommendations on future care
Educational message
THINK ABOUT IT
• Tick the box if you...
thoroughly read and compare different medical genres
wrote a definition trying to include as much as y
actively participated in class discussion
• What would I do different
_________________________________________________________________________
TASK 2: Do your own research. Go to Journal of Medical Case Reports
(http://www.jmedicalcasereports.com/). Then, find a Medical Case Report that clearly portraits all
the components and characteristics covered durin
Activity VII and upload the file (Figure 3).
VII. Identify the components and characteristics described above in the Medical Case Report
given. Assign a different colour or symbol to each one. Then highlight or marked your text
blue
Explanation of results and medical decisions green
Recommendations on future care purple
Educational message orange
thoroughly read and compare different medical genres
wrote a definition trying to include as much as you have learned so far
actively participated in class discussion
What would I do differently next time?
_________________________________________________________________
TASK 2: Do your own research. Go to Journal of Medical Case Reports
(http://www.jmedicalcasereports.com/). Then, find a Medical Case Report that clearly portraits all
the components and characteristics covered during the lesson. Highlight the text, as you did in
Activity VII and upload the file (Figure 3).
23
cribed above in the Medical Case Report
given. Assign a different colour or symbol to each one. Then highlight or marked your text
@
#
<<
*
ou have learned so far
_________________________________________________________________
TASK 2: Do your own research. Go to Journal of Medical Case Reports
(http://www.jmedicalcasereports.com/). Then, find a Medical Case Report that clearly portraits all
g the lesson. Highlight the text, as you did in
Figure 3
GET RE@DY
I. 1. Read the following ext
rivaroxaban in an elderly patient with intermediate
pulmonary embolism: a case report
- INTRODUCTION -
a._____________ In summary, this is the first case report showing that initial intensive
treatment with rivaroxaban in an elderly patient resulted in a rapid clinical
improvement and normalization of PE
b. _____________ An 80
department (DEA) presenting with dyspnea; this symptom appeared 2 weeks before
and worsened a few days prior to hospital admission.
c. _____________ Anticoagulant; C
embolism; Rivaroxaban
d. _____________ The main clinical characteristics of patients with suspected PE are
dyspnea, chest pain, fever, hemoptysis, syncope and signs of DVT.
2. Think of your answers. Was there any clue that helped you? Why did you take those decisions?
(Give 2 reasons).
________________________________________________________________________________
________________________________________________________________________________
H@NDS ON
II . Read the following paragraph and highlight the formulaic expressions.
UNIT 2: G_tting to know [ n unusu[ l
o]]urr_n]_
Lesson 1
Formulaic expressions may consist of a single word or of
several words acting as a meaningful or understandable unit.
For example:
I. 1. Read the following extracts from a Medical Case Report called "
rivaroxaban in an elderly patient with intermediate-low early mortality risk due to
pulmonary embolism: a case report" and guess to which section it belongs to. [ABSTRACT
CASE PRESENTATION - DISCUSSION AND CONCLUSION]
a._____________ In summary, this is the first case report showing that initial intensive
treatment with rivaroxaban in an elderly patient resulted in a rapid clinical
improvement and normalization of PE-related early mortality risk parameters.
b. _____________ An 80-year-old white man was admitted to our emergency
department (DEA) presenting with dyspnea; this symptom appeared 2 weeks before
and worsened a few days prior to hospital admission.
c. _____________ Anticoagulant; Case report; Elderly; Mortality risk; Pulmonary
embolism; Rivaroxaban
_____________ The main clinical characteristics of patients with suspected PE are
dyspnea, chest pain, fever, hemoptysis, syncope and signs of DVT.
ere any clue that helped you? Why did you take those decisions?
________________________________________________________________________________
________________________________________________________________________________
II . Read the following paragraph and highlight the formulaic expressions.
G_tting to know [ n unusu[ l
Formulaic expressions may consist of a single word or of
several words acting as a meaningful or understandable unit.
For example: By focusing on... / The writer points out that
Objectives:
-Recognize the specific purpose, structure, grammar
and vocabulary of each section involved in a
medical case report.
-Write short paragraphs describing signs and
symptoms and other medical aspects
24
racts from a Medical Case Report called "Use of
low early mortality risk due to
" and guess to which section it belongs to. [ABSTRACT
DISCUSSION AND CONCLUSION]
a._____________ In summary, this is the first case report showing that initial intensive
treatment with rivaroxaban in an elderly patient resulted in a rapid clinical
risk parameters.
old white man was admitted to our emergency
department (DEA) presenting with dyspnea; this symptom appeared 2 weeks before
ase report; Elderly; Mortality risk; Pulmonary
_____________ The main clinical characteristics of patients with suspected PE are
ere any clue that helped you? Why did you take those decisions?
________________________________________________________________________________
________________________________________________________________________________
Formulaic expressions may consist of a single word or of
several words acting as a meaningful or understandable unit.
By focusing on... / The writer points out that...
Recognize the specific purpose, structure, grammar
and vocabulary of each section involved in a
hs describing signs and
symptoms and other medical aspects.
In our data, the TFEB driver mutation favored enhanced osteoclast activity, and upregulated
cathepsin K was confirmed in several biopsies, and promoting a gene signature c
MAPK and c-MET signal pathways. It is known that TFEB, the master regulator of lysosome
biogenesis, controls transcription of target genes closely related to lysosomal structure and
function, including hydrolases. Our findings in the DNA motif
genes previously reported to be induced in cells where TFEB was overexpressed. The same
signature overlapped with the CLEAR motif in RNA samples. Tsuda
mTORC1 is a key upstream kinase that directly p
In addition, nuclear TFEB translocation may re
activity in cancer cells normally seen in periods of starvation conducted by the autophagy
program. Again, the gene signature showed increased expression of autophagy
supporting our assumption.
III. Now, go back to activity I and highlight all formulaic expressions you find.
Formulaic expressions list
IV. Read the Medical Case Report assigned online an
(Figure 1)
Figure 1
In our data, the TFEB driver mutation favored enhanced osteoclast activity, and upregulated
cathepsin K was confirmed in several biopsies, and promoting a gene signature connected to
MAPK and c-MET signal pathways. It is known that TFEB, the master regulator of lysosome
biogenesis, controls transcription of target genes closely related to lysosomal structure and
function, including hydrolases. Our findings in the DNA motif demonstrated upregulation of gene
previously reported to be induced in cells where TFEB was overexpressed. The same signature
overlapped with the CLEAR motif in RNA samples. Tsuda et al. showed recently that mTORC1 is
a key upstream kinase that directly phosphorylates TFEB and inhibits i
nuclear TFEB translocation may re
cells normally seen in periods of starvation conducted by the autophagy program. Again, the
gene signature showed increased expression o
assumption.
In our data, the TFEB driver mutation favored enhanced osteoclast activity, and upregulated
cathepsin K was confirmed in several biopsies, and promoting a gene signature c
MET signal pathways. It is known that TFEB, the master regulator of lysosome
biogenesis, controls transcription of target genes closely related to lysosomal structure and
function, including hydrolases. Our findings in the DNA motif demonstrated upregulation of
genes previously reported to be induced in cells where TFEB was overexpressed. The same
signature overlapped with the CLEAR motif in RNA samples. Tsuda et al. showed recently that
mTORC1 is a key upstream kinase that directly phosphorylates TFEB and inhibits its activity.
In addition, nuclear TFEB translocation may re-establish autophagy, enforcing metabolic
activity in cancer cells normally seen in periods of starvation conducted by the autophagy
ure showed increased expression of autophagy-related genes,
III. Now, go back to activity I and highlight all formulaic expressions you find.
IV. Read the Medical Case Report assigned online and complete the following chart.
Read the MCR and take notes on the main formulaic expressions you can find in the different sections [examples are given]: ABSTRACT The aim... is...
INTRODUCTION This condition is...
DISCUSSION AND CONCLUSION
Results show...
In our data, the TFEB driver mutation favored enhanced osteoclast activity, and upregulated
cathepsin K was confirmed in several biopsies, and promoting a gene signature connected to
pathways. It is known that TFEB, the master regulator of lysosome
biogenesis, controls transcription of target genes closely related to lysosomal structure and
function, including hydrolases. Our findings in the DNA motif demonstrated upregulation of gene
previously reported to be induced in cells where TFEB was overexpressed. The same signature
overlapped with the CLEAR motif in RNA samples. Tsuda et al. showed recently that mTORC1 is
a key upstream kinase that directly phosphorylates TFEB and inhibits its activity. In addition,
nuclear TFEB translocation may re-establish autophagy, enforcing metabolic activity in cancer
cells normally seen in periods of starvation conducted by the autophagy program. Again, the
gene signature showed increased expression of autophagy-related genes, supporting our
25
In our data, the TFEB driver mutation favored enhanced osteoclast activity, and upregulated
cathepsin K was confirmed in several biopsies, and promoting a gene signature connected to
MET signal pathways. It is known that TFEB, the master regulator of lysosome
biogenesis, controls transcription of target genes closely related to lysosomal structure and
demonstrated upregulation of
genes previously reported to be induced in cells where TFEB was overexpressed. The same
. showed recently that
hosphorylates TFEB and inhibits its activity.
establish autophagy, enforcing metabolic
activity in cancer cells normally seen in periods of starvation conducted by the autophagy
related genes,
III. Now, go back to activity I and highlight all formulaic expressions you find.
d complete the following chart.
Read the MCR and take notes on the main formulaic expressions you can find in the different sections [some
In our data, the TFEB driver mutation favored enhanced osteoclast activity, and upregulated
cathepsin K was confirmed in several biopsies, and promoting a gene signature connected to
pathways. It is known that TFEB, the master regulator of lysosome
biogenesis, controls transcription of target genes closely related to lysosomal structure and
function, including hydrolases. Our findings in the DNA motif demonstrated upregulation of genes
previously reported to be induced in cells where TFEB was overexpressed. The same signature
overlapped with the CLEAR motif in RNA samples. Tsuda et al. showed recently that mTORC1 is
ts activity. In addition,
establish autophagy, enforcing metabolic activity in cancer
cells normally seen in periods of starvation conducted by the autophagy program. Again, the
related genes, supporting our
V. Choose one of the MCR assigned among your group members and complete the
following chart.
VI. 1. In no more than 100
chosen including the information in the chart. Remember to incorporate new formulaic
expressions recently learned.
r
Read the MCR and take notes on:Number of subjects involved Medical signs Familiarity / Medical history Routine tests Treatment Drugs Positive Results Negative
TASK 1: Upload your formulaic expressions to the corresponding glossary [
ABTRACT, Formulaic expressions INTRODUCTION, Formulaic expressions CASE PRESENTATION,
Formulaic expressions DISCUSSION AND CONCLUSION
*Remember to check the glossary before typing in your entry in order to avoid repetition (Figure 2)
Remember A summary is a shortened version of aprimary purpose of a summary is to "give an accurate, objective representation of what the work says." As a general rule, "you should not include your own ideas or interpretations"
Check list
___The main idea is clearly identify.
___ All important ideas are present.
___ All unnecessary details were left aside .
___ Author meaning is kept the same.
V. Choose one of the MCR assigned among your group members and complete the
VI. 1. In no more than 100-110 words write a summary of the Medical Case Report
information in the chart. Remember to incorporate new formulaic
expressions recently learned.
Read the MCR and take notes on:
TASK 1: Upload your formulaic expressions to the corresponding glossary [Formulaic expressions
ABTRACT, Formulaic expressions INTRODUCTION, Formulaic expressions CASE PRESENTATION,
expressions DISCUSSION AND CONCLUSION]
*Remember to check the glossary before typing in your entry in order to avoid repetition (Figure 2)
A summary is a shortened version of a text that highlights its key points. The primary purpose of a summary is to "give an accurate, objective representation of what the work says." As a general rule, "you should not include your own ideas or
Figure
s clearly identify. ___I used my own words.
___ I used citations to refer author's ideas.
___ All unnecessary details were left aside . ___ Sentences are built upon the ones before.
___ Author meaning is kept the same.
26
V. Choose one of the MCR assigned among your group members and complete the
110 words write a summary of the Medical Case Report
information in the chart. Remember to incorporate new formulaic
Formulaic expressions
ABTRACT, Formulaic expressions INTRODUCTION, Formulaic expressions CASE PRESENTATION,
*Remember to check the glossary before typing in your entry in order to avoid repetition (Figure 2)
that highlights its key points. The primary purpose of a summary is to "give an accurate, objective representation of what the work says." As a general rule, "you should not include your own ideas or
Figure 2
___ I used citations to refer author's ideas.
lt upon the ones before.
Be prepared to:
• Project and read your summary in front of the class.
• Take notes and give feedback on the check list.
2. Make corrections based on yo
THINK ABOUT IT
• Tick the box if you...
paid attention to expressions and vocabulary used while reading each section of
the Medical Case Report.
wrote a summary trying
actively participated in group discussions.
gave feedback when needed.
• What would I do different next time?
_________________________________________________
TASK 2: a. Choose one member of the group to upload your summary to the corresponding
forum [Medical Case Report Summary
b. Individually, make at least one comment about other group's
Project and read your summary in front of the class.
Take notes and give feedback on the check list.
2. Make corrections based on your classmates advice.
paid attention to expressions and vocabulary used while reading each section of
the Medical Case Report.
wrote a summary trying to include as much as you have learned so far.
actively participated in group discussions.
gave feedback when needed.
What would I do different next time?
__________________________________________________________________
TASK 2: a. Choose one member of the group to upload your summary to the corresponding
Medical Case Report Summary].
b. Individually, make at least one comment about other group's work. (figure 3)
Figure
27
paid attention to expressions and vocabulary used while reading each section of
to include as much as you have learned so far.
_________________________
TASK 2: a. Choose one member of the group to upload your summary to the corresponding
work. (figure 3)
Figure 2
GET RE@DY
I. 1. Look at the following images, What section do they belong to?
___________________________________________________
2. Describe what you remember about this section
____________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
3. Share with a classmate. Wha
_____________________________________________________________
____________________________________________________________
UNIT 3: T[ king Sh[ p_
Lesson 1
I. 1. Look at the following images, What section do they belong to?
___________________________________________________
2. Describe what you remember about this section
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
3. Share with a classmate. What can you add?
_____________________________________________________________
____________________________________________________________
Objective:
-Assign roles among the group
-Compose a section of a Medical Case
Report
28
_________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
____________________________________________________________
ection of a Medical Case
H@NDS ON
II. Match the following pictures with the corresponding description
III. 1. Read the following information, go to Google Drive and start writing the first paragraph of a case presentation. Use the figures above to complement your writing.
a
b
c
e
Sex: Male Age: 48 years Body temperature: 37 °C. Heart rate: 70 beats per minute. Respiration Rate: 19 breaths per minute. Blood Pressure: 100/70 mmHg.Smoking: one pack of cigarettes daily aAlcohol: occasionally consumed alcohol. Weight: it had decreased by 10 kg during the last 6 weeks before his admission.Reason for admission:More info: self-limited diarrhea, and the stools did not contain mucus or blood. Evolution: diarrhea became persistent accompanied by black, tarry, malodorous feces.Other symptoms: dull abdominal pain, predradiated to the lumbar region. History: no family history of colon cancer, history of peptic ulcer disease, inflammatory bowel disease, trauma or abdominal surgery
II. Match the following pictures with the corresponding description
III. 1. Read the following information, go to Google Drive and start writing the first paragraph of a case presentation. Use the figures above to complement your writing.
_____ Fig. 1. a Coronal compimage showing a gastrocolic fistula secondary to a tumor of the splenic flexure of the colon infiltrating the greater curvature of the stomach and diaphragm. b Computed tomography image of the abdomen showing passage of contrast material through a fistulous connection between the stomach and the splenic flexure of the colon _____ Fig. 2. a Gastroscopy image showing an ulcerated mass at the body of the stomach and theopening of a fistula above the mass.splenic flexure of the colon _____ Fig. 3. Thoracoabdominal positron emission tomography image showing a splenic flexure tumorwith enhancement of the greater curvature of the stomach and diaphragm _____ Fig. 4. Surgical specimen showing the fistula between the stomach and the transverse colon _____ Fig. 5. A colon adenocarcinoma infiltrating the gastric wall
d
Patient's fact sheet
37 °C. 70 beats per minute.
19 breaths per minute. 100/70 mmHg.
one pack of cigarettes daily a occasionally consumed alcohol.
it had decreased by 10 kg during the last 6 weeks before his admission.Reason for admission: 3-month history of intermittent watery diarrhea.
limited diarrhea, and the stools did not contain mucus or blood. diarrhea became persistent accompanied by black, tarry, malodorous feces.
dull abdominal pain, predominantly in the left upper quadrant, which radiated to the lumbar region.
no family history of colon cancer, history of peptic ulcer disease, inflammatory bowel disease, trauma or abdominal surgery
29
III. 1. Read the following information, go to Google Drive and start writing the first paragraph of a case presentation. Use the figures above to complement your writing.
Coronal computed tomography image showing a gastrocolic fistula secondary to a tumor of the splenic flexure of the colon infiltrating the greater curvature of the stomach and
Computed tomography image of the abdomen showing passage of contrast material
rough a fistulous connection between the stomach and the splenic flexure of the colon
Gastroscopy image showing an ulcerated mass at the body of the stomach and the opening of a fistula above the mass. b A mass at the
Thoracoabdominal positron emission tomography image showing a splenic flexure tumor with enhancement of the greater curvature of the
Surgical specimen showing the fistula between the stomach and the transverse colon
A colon adenocarcinoma infiltrating
it had decreased by 10 kg during the last 6 weeks before his admission. month history of intermittent watery diarrhea.
limited diarrhea, and the stools did not contain mucus or blood. diarrhea became persistent accompanied by black, tarry, malodorous feces.
ominantly in the left upper quadrant, which
no family history of colon cancer, history of peptic ulcer disease, inflammatory
2. Upload your case presentation paragraph to
Moodle. (Figure 1)
3. In group, decide which one of the case
presentations uploaded (do not consider yours) is
the best. Copy and paste it on Google Docs. Then,
make all the editing you consider necessary.
4. Upload it again to receive feedback.
IV. 1. Fill in the following patient's fact sheet with imaginary information. Be creative!
2. Exchange your patient's fact sheet with other group.3. Now is time to assign roles. Choose one role randomly.
Sex: Age: Body temperature: Heart rate: Respiration Rate: Blood Pressure: Smoking:
Alcohol:
Weight:
Reason for admission: More info: Evolution: Other symptoms: History:
Drafter 1 – This person does the primary writing.
Drafter 2person does the primary writing
2. Upload your case presentation paragraph to
3. In group, decide which one of the case
presentations uploaded (do not consider yours) is
the best. Copy and paste it on Google Docs. Then,
make all the editing you consider necessary.
4. Upload it again to receive feedback.
. 1. Fill in the following patient's fact sheet with imaginary information. Be creative!
2. Exchange your patient's fact sheet with other group. 3. Now is time to assign roles. Choose one role randomly.
Patient's fact sheet
Drafter 2 – This does the
primary writing.
Reviewer – This person will read what the others have written to identify and examine paragraph focus, idea arrangement, and development. He/she will choose the one to work with.
30
. 1. Fill in the following patient's fact sheet with imaginary information. Be creative!
Editor – This person will do grammar check, formatting, and review source integration.
Figure 1
THINK ABOUT IT
• Tick the box if you...
wrote a case presentation trying to include as much as you have learned so far
actively participated in group work assignments
• What would I do differently next time?
_________________________________________________________________________
TASK 1: a. Drafters: go to Google drive and start writing. intervene when is your turn. b. You have got 3 days to complete your task. When you are ready upload your paragraMoodle to receive feedback. (Figure 2)
TASK 2: a. Once you received feedback, go and checked the information assigned to start writing your medical case report (Case presentation only). b. Start organizing the information c. Assign roles, this time think on each group member skills.
wrote a case presentation trying to include as much as you have learned so far
actively participated in group work assignments
do differently next time?
_________________________________________________________________
go to Google drive and start writing. Reviewer and Editor:intervene when is your turn. b. You have got 3 days to complete your task. When you are ready upload your paragraMoodle to receive feedback. (Figure 2)
TASK 2: a. Once you received feedback, go and checked the information assigned to start writing your medical case report (Case presentation only). (Figure 2) b. Start organizing the information
s, this time think on each group member skills.
Figure 2
31
wrote a case presentation trying to include as much as you have learned so far
_________________________________________________________________
Reviewer and Editor: be prepare and
b. You have got 3 days to complete your task. When you are ready upload your paragraph on
TASK 2: a. Once you received feedback, go and checked the information assigned to start writing
G_t R_[ ^yG_t R_[ ^yG_t R_[ ^yG_t R_[ ^y
I. 1. Read the following Introduction.
2. What is wrong with it? Take notes on everything
that need to be changed.
______________________________________________
______________________________________________
UNIT 5: Ch_]k_^ [ n^ Don_
Lesson 1
Introduction
Schistocyte rate was 6%. Coombs test was negative. A
Plasmapheresis with fresh frozen plasma was initiated immediately after this test. Bone
marrow examination was performed as he was unresponsive to 5 courses of plasmapheresis
with 1:1 volume. Bone marrow aspiration revealed signs
nonhematopoetic cell infiltration. Pathologic evaluation of trephine biopsy revealed
myelonecrosis and carcinoma metastasis (
was seen on computerized tomography of the abdomen. The patient was referred to the
medical oncology department.
A 67-year old man living in a nursing hom
complaints of fatigue, severe back pain and extensive bruises at his left hip and thigh. At
physical examination, he was pale, he had difficulty in breathing and there were ecchymoses
around his left hip and thigh. At laboratory examination, he was anemic (7.5 gr/dl) and
platelet count was 13.000/µl. Creatinine level was normal but lactate dehidrogenase level
was high (1827 U/l). Schistocytes, polichromasia, fragmantated and nucleated red blood
cells and severe thrombocytopenia were observed on the blood film and he was hospitalized
with a provisional diagnosis of TTP. TTP has a well
diagnosis: thrombocytopenia, microangiopathic hemolytic anemia, neurologic and renal
abnormalities, and fever [5]. In rece
for diagnosis of TTP. Combination of some clinical symptoms and laboratory findings leads to
diagnosis as there are no specific biological markers or symptoms. Our patient had
thrombocytopenia, signs of microangiopathic hemolytic anemia on blood film, he had severe
back pain but he had no signs of renal failure.
I. 1. Read the following Introduction.
2. What is wrong with it? Take notes on everything
______________________________________________
______________________________________________
Ch_]k_^ [ n^ Don_
Schistocyte rate was 6%. Coombs test was negative. ADAMTS-13 activity was 3%.
Plasmapheresis with fresh frozen plasma was initiated immediately after this test. Bone
marrow examination was performed as he was unresponsive to 5 courses of plasmapheresis
with 1:1 volume. Bone marrow aspiration revealed signs of myelonecrosis and monoclonal
nonhematopoetic cell infiltration. Pathologic evaluation of trephine biopsy revealed
myelonecrosis and carcinoma metastasis (Figure 5 and Figure 2). A tumor of small intestine
was seen on computerized tomography of the abdomen. The patient was referred to the
medical oncology department.
year old man living in a nursing home applied to our Hematology outpatient unit with
complaints of fatigue, severe back pain and extensive bruises at his left hip and thigh. At
physical examination, he was pale, he had difficulty in breathing and there were ecchymoses
thigh. At laboratory examination, he was anemic (7.5 gr/dl) and
platelet count was 13.000/µl. Creatinine level was normal but lactate dehidrogenase level
was high (1827 U/l). Schistocytes, polichromasia, fragmantated and nucleated red blood
re thrombocytopenia were observed on the blood film and he was hospitalized
with a provisional diagnosis of TTP. TTP has a well-known pentad of clinical features for
diagnosis: thrombocytopenia, microangiopathic hemolytic anemia, neurologic and renal
. In recent clinical practice, the whole pentad is not prerequisite
for diagnosis of TTP. Combination of some clinical symptoms and laboratory findings leads to
diagnosis as there are no specific biological markers or symptoms. Our patient had
ns of microangiopathic hemolytic anemia on blood film, he had severe
back pain but he had no signs of renal failure.
III. Share with the
rest of the class
Objectives:
-Assemble the Medical Case Report
-Compare and evaluate classmates
work
32
13 activity was 3%.
Plasmapheresis with fresh frozen plasma was initiated immediately after this test. Bone
marrow examination was performed as he was unresponsive to 5 courses of plasmapheresis
of myelonecrosis and monoclonal
nonhematopoetic cell infiltration. Pathologic evaluation of trephine biopsy revealed
). A tumor of small intestine
was seen on computerized tomography of the abdomen. The patient was referred to the
e applied to our Hematology outpatient unit with
complaints of fatigue, severe back pain and extensive bruises at his left hip and thigh. At
physical examination, he was pale, he had difficulty in breathing and there were ecchymoses
thigh. At laboratory examination, he was anemic (7.5 gr/dl) and
platelet count was 13.000/µl. Creatinine level was normal but lactate dehidrogenase level
was high (1827 U/l). Schistocytes, polichromasia, fragmantated and nucleated red blood
re thrombocytopenia were observed on the blood film and he was hospitalized
known pentad of clinical features for
diagnosis: thrombocytopenia, microangiopathic hemolytic anemia, neurologic and renal
nt clinical practice, the whole pentad is not prerequisite
for diagnosis of TTP. Combination of some clinical symptoms and laboratory findings leads to
diagnosis as there are no specific biological markers or symptoms. Our patient had
ns of microangiopathic hemolytic anemia on blood film, he had severe
III. Share with the
rest of the class
Assemble the Medical Case Report
Compare and evaluate classmates
33
H@NDS ON
II. 1. Go to Google Docs an put all the sections you wrote together.
2. Then, discuss on the following checked list based on international standards for
Medical Case Reports publication.
Section Item Checklist item description Reported on page
Title 1 The words “case report” and the area of focus should appear in the title (such as diabetes, a therapeutic approach, an outcome)
Key Words 2 2 to 5 key words that identify areas covered in this case report
Abstract 3a Introduction—What is unique about this case? What does it add to the medical literature? Why is this important?
3b The patient's main concerns and important clinical findings
3c The main diagnoses, therapeutics interventions, and outcomes
3d Conclusion—What are the “take-away” lessons from this case?
Introduction 4 One or two paragraphs summarizing why this case is unique with reference to the relevant medical literature
Patient Information
5a De-identified demographic and other patient specific information
5b Main concerns and symptoms of the patient
5c Medical, family, and psychosocial history including relevant genetic information (this should also appear in the timeline)
5d Relevant past interventions and their outcomes
Clinical Findings 6 Describe the relevant physical examination (PE) and other significant clinical findings
Timeline 7 Relevant data from the patient's history organized as a timeline
Diagnostic Assessment
8a Diagnostic methods (PE, laboratory testing, imaging, surveys)
8b Diagnostic challenges (access, financial, cultural)
8c Diagnostic reasoning including other diagnoses considered
8d Prognostic characteristics when applicable (staging)
Therapeutic Intervention
9a Types of intervention (pharmacologic, surgical, preventive)
9b Administration of intervention (dosage, strength, duration)
9c Any changes in the interventions (with rationale)
Follow-up and Outcomes
10a Clinician and patient-assessed outcomes (when appropriate)
10b Important follow-up diagnostic and other test results
10c Intervention adherence and tolerability (how was this assessed)
10d Adverse and unanticipated events
Discussion 11a Strengths and limitations in your approach to this case
11b Discussion of the relevant medical literature
11c The rationale for your conclusions (a causality assessment)
11d The primary “take-away” lessons from this case report
Informed Consent 12 Did the patient give informed consent? Please provide if requested
34
What do we need to change? What are we keeping the same?
3. Work editing your Medical Case Report Accordingly.
III. 1. Once you're ready, give access to your work to the class. Then, revise other's group work
using check list. [Work a suggesting mode (figure 1)].
2. You can also give the other group a summary of your feedback.
What you should change? What you should keep the same
THINK ABOUT IT
• Tick the box if you...
thoroughly read and cautiously edited my Medical Case Report
I gave honest and serious feedback.
What would I do differently next time?
__________________________________________________________________________
Figure 1
35
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39
Appendix A: Survey
Survey Sample
Objective: The purpose of this questionnaire is to identify medical students' previous experience with
English and with academic writing as well as to gather information about their attitudes, abilities and
interests on writing in English in specific contexts and with specific purposes.
1. How long have you been studying English?
____________________________________________________________________________________
______________________________________________________________
2. Read the following statements about the strategies used when writing in English and choose the
alternative that best represents your learning experience.
Never Rarely Sometimes Always
a) Before writing, I read and
analyze texts that are similar to the
one I am going to write.
b) Before writing, I have got a clear
idea of the structure and
conventions of the type of text I
will write.
c) Before writing, I brainstorm my
ideas.
d) I write drafts before the final
version of my text.
e) I proof read what I write.
f) I ask my classmate to read what I
write.
g)I ask my teacher for advice and
guidance.
h) I consult a dictionary.
i) I consult online translators.
40
3. Indicate your level of familiarity of the following online platforms on a scale of 1-5 (1 being "poor"
and 5 being "Excellent")
1 2 3 4 5
a) Google docs
b) Moodle
4. Read the following statements and choose the alternative that best represents your level of agreement.
I completely
disagree
I disagree I agree I completely
agree
a) I think English is important for my
future career.
b) The English courses available in my
faculty are enough for my future
career
c) The English courses available do
satisfy my specific professional needs.
d) I have time to attend to English
classes regularly.
5. Read the following statements about writing in English and choose the alternative that best represents
your level of agreement.
I completely
disagree
I disagree I agree I completely
agree
a) I feel confident writing in
English.
b) I like receiving feedback
from my classmates about my
writing
c) I like to be read in English
d) I would like to improve my
writing skills in Academic
41
English
e) I would like to work
collaboratively with classmates
in writing assignments
6. Considering your field of interest, choose the alternative that best describes your current situation
when writing in English.
Not well at all Not so well Somewhat
well
Very well
a) I can write short descriptive
texts in English.
b) I can write papers in English
for class assignments.
c) I can write medical case
reports.
d) I can write articles for local
journals in English.
e) I can write articles for
international journals in
English.
7. Select the topics you would like to address in your English classes. (Select all the topics you want)
i) Cancer___ ii) Aging-associated diseases___ iii) Neuroscience and mental health___
iv) Degenerative diseases___ v) Infections___ vi) Other___ Which one?__________
8. Would you be interested in taking an elective workshop on how to write Medical Case Reports in
English?
Yes__ No ___
42
Appendix B: Needs Analysis
Needs Analysis
Participants
This needs analysis was conducted with 10 senior students in medical school from Universidad
Católica de Chile. These students have had at least two general courses of English and, as a
graduation requirement, they need to certify their English abilities at an intermediate level based on
ALTE (Association of Language Testers in Europe) standards (the institution offers free courses of
English for those learners that need additional instruction).
The Survey
The survey conducted for this needs analysis was designed according to Dudley-Evans and St.
John's (1998) proposal. This survey sought to gather information about students' previous
experience with English and with academic writing as well as to gather information about their
attitudes, abilities and interests on writing in English for Specific Purposes. The survey was divided
into four sections:
The first section (I) includes 3 subsections (1-2-3). The aim is to gather information about students'
previous experience with English and with academic writing. It consists of one open question about
time exposure to English instruction, a set of questions about students' writing learning experience
and a some other questions about the level of familiarity with two online platforms that can be used
for collaborative writing.
The second section (II) comprises 2 subsections (4-5). The objective is to collect data about
student´s attitudes to writing in English for Specific Purposes. It incorporates questions about
students' attitudes towards English and English courses available and about learner's attitudes about
ESL writing.
The third section (III) includes 1 subsection (6). The purpose is to obtain information about
student´s abilities on writing in English for Specific Purposes. It consist of set of questions about
some specific ESL writing abilities based on learners' own perceptions.
The fourth section (IV) incorporate 2 subsections (7-8). The aim is to gather information about
student´s interests on writing in English for Specific Purposes. It includes a question in which
43
students can choose some topics that they would like to include in the lessons and a question based
on their willingness to take an elective course on medical case report writing.
Results
Results are presented following the four sections described above. A deeper analysis of each
questions is described and illustrated with the corresponding figure.
Section I
Figure 1
From Figure 1, it can be inferred that most students were taught English from secondary school
and all of them have been exposed to the second language for more than 5 years. These results,
in addition to the university requirements lead them to certify an intermediate level, demonstrate
that students have the abilities needed to take an EAP course.
Figure 2a
0123456
Before writing, I
read and
analyze texts
that are similar
to the one I am
going to write.
Before writing, I
have got a clear
idea of the
structure and
conventions of
the type of text I
will write.
Before writing, I
brainstorm my
ideas.
I write drafts
before the final
version of my
text.
I proof read
what I write.
Read the following statements about the strategies used when writing in
English and choose the alternative that best represents your learning
experience.
Never
Rarely
Sometimes
Always
0%
25%
50%
25%
How long have you been studying
English?
4 years or less
5-8 years
9-12 years
13 years or more
44
Figure 2b
Figures 2a and 2b show that learners know and implement strategies to write; such as drafting,
brainstorming, asking for guidance, or consulting dictionaries. However, they apparently do
not have a clear idea of the type of text they are working with. Therefore, it is important to
teach the students to recognize structures and characteristics that will help them to write more
efficiently and accurately, not only inside the classroom, but in academic settings.
Figure 3
Figure 3 shows that most students are closely familiar with Google docs, but very few know
how to interact with Moodle. Tutorials will be necessary to guide the students during the process
of integrating new online tools.
0
2
4
6
8
10
12
I ask my classmate
to read what I write.
I ask my teacher for
advice and guidance.
I consult a
dictionary.
I consult online
translators.
Read the following statements about the strategies used when
writing in English and choose the alternative that best represents
your learning experience.
Never
Rarely
Sometimes
Always
0
2
4
6
Google docs Moodle
Indicate your level of familiarity of the
following online platforms on a scale of 1-5 (1
being "poor" and 5 being "Excellent")
1
2
3
4
45
Section II
Figure 4
The information presented in Figure 4 indicates that most students believe English is important
for their future. However, the courses available do not satisfy their specific needs. Therefore,
there is a need to create courses that allow learners to acquire tools to participate in their
particular field of interest.
Furthermore, many participants claim that they do not have enough time to attend regular
classes. Thus, it is necessary to build a syllabus that complements face to face interaction with
online work.
Figure 5
0123456
I think English is
important for my
future career.
The English
courses available
in my faculty are
enough for my
future career
The English
courses available
do satisfy my
specific
professional
needs.
I have time to
attend to English
classes regularly.
Read the following statements and choose the alternative that
best represents your level of agreement.
I completely disagree
I disagree
I agree
I completely agree
0123456789
10
a) I feel
confident
writing in
English.
b) I like
receiving
feedback from
my classmates
about my
writing
c) I like to be
read in English
d) I would like
to improve my
writing skills in
Academic
English
e) I would like
to work
collaboratively
with
classmates in
writing
assignments
Read the following statements about writing in English and choose the
alternative that best represents your level of agreement.
I completely disagree
I disagree
I agree
I completely agree
46
Figure 5 shows that students do not feel confident about their writing. Nonetheless, they seem
open to work with others and to improve their performance. Taking this into account, instruction
should use collaborative work as a way to boost confidence in the process of learning to write
and in writing itself.
Section III
Figure 6
Figure 6 shows that learners know to write in English but they are not capable of writing
specific texts. A pertinent course must prepare students not only to write basic text but also
contextualized text that can be useful in their particular field of interest.
Section IV
Figure 7
0123456789
10
I can write
short
descriptive
texts in
English.
I can write
papers in
English for
class
assignments.
I can write
medical case
reports.
I can write
articles for
local journals
in English.
e) I can write
articles for
international
journals in
English.
Considering your field of interest, choose the alternative that best
describes your current situation when writing in English.
Not well at all
Not so well
Somewhat well
Very well
22%15%
17%
15% 20%
5%
3%3%
11%
Select the topics you would like to address in your English classes.
(Select all the topics you want) Cancer
Aging-associated diseases
Neuroscience and mental
healthDegenerative diseases
Infections
Diabetes
47
Figure 7 illustrates that the students' interests towards different topics are quite heterogeneous.
All topics should be included.
Figure 8
Figure 8 reveals participants' high interest in taking a workshop on Medical Case Reports
writing.
Conclusions
Based on the results analysed, it is possible to conclude that students lack skills to work with
specific texts. However, they seem interested in taking a course based on a particular genre.
In addition, they seem open to work with others and to improve their performance. Moreover, they
have limited time to attend regular classes. Thus it is necessary to implement a methodology that
not only uses time effectively but that also enhances collaborative interaction.
100%
0%
Would you be interested in taking an
elective workshop on how to write
Medical Case Reports in English?
Yes
No
48
Appendix C: Rubrics
Final Report Rubric
Name: ________________________________________ Score: ____ /____ Grade: ______
Dimension Accomplished Average Developing Beginning
Content All the contents
asked are covered
Most of the contents are
covered
Some of the contents are
covered
The some of the
contents are poorly
addressed.
Vocabulary and
formulaic
expressions
Uses a great variety
of expressions and
vocabulary
A lot of expressions are
used but some of them
are not well used.
Uses some expressions
are and poor vocabulary
development.
Poor vacbulary and
almost none formulaic
expression.
Grammar and
Mechanics
Excellent grammar,
spelling, syntax and
punctuation.
A few errors in
grammar, spelling,
syntax and punctuation,
but not many.
Shows a pattern of
errors in spelling,
grammar, syntax and/or
punctuation. Could also
be a sign of lack of
proof-reading.
Continuous errors
Abstract Writes a clear well-
structured abstract
The text written has
some flaws regarding
the structure.
Doesn't follow the
structure.
Abstract is not present
Introduction Writes a clear well-
structured
introduction
The text written has
some flaws regarding
the structure.
Doesn't follow the
structure.
Introduction is not
present or not clear at
all.
Presentation Writes a clear well-
structured case
presentation
The text written has
some flaws regarding
the structure.
Doesn't follow the
structure.
Presentation is not
clear at all.
Conclusions Writes a clear well-
structured discussion
and conclusions
The text written has
some flaws regarding
the structure.
Doesn't follow the
structure.
Conclusion is not
present or not clear at
all.
Case report Writes a clear well-
structured medical
case report
Writes a clear medical
case report with some
flaws in the structure.
Medical case report is
clear but does not
follow the structure.
Medical case report is
not clear and does not
follow the given
structure.
Sources and
citations
Demonstrate use of
a range of
appropriate sources
and incorporate
them into the text
effectively.
Some citations
integrated into the text
and most of the sources
are incorporated.
Citations inserted into
the text sometimes at
appropriate points.
Citations given at the
ends of some
paragraphs.
No citations in the
text.
No references at the
end