class 6 case studies

1. ADLT 672, Instructional
Strategies for Teaching in
Medical Education
October 20, 2016
Developing an Effective Case
Study

2. Agenda
 Instructional Strategy Projects - Blog (via Bb)
 Rampages accounts established?
 Look for email in Junk folder from “Wordpress”
 Need help writing to the blog? Ask me next week when we
meet
 Meetings to review project ideas – scheduled?
 Case-based teaching
 30 minutes to work with your Appendices
preso partners

3. What is a
Case?
A teaching case is a story, describing or
based on actual events and circumstances,
that is told with a definite teaching
purpose in mind and that rewards careful
study and analysis.

4. The What
Cases are stories: real events or problems so
learners experience the complexities, ambiguities, and
uncertainties of participants
Cases come in all sizes: written cases, movie
clips, radio/TV stories, pictures
Retrospective cases tell the whole story as it
unfolds over time; cases can extend beyond one teaching
session so that learners do their own research into the case
as it proceeds.

5. Your
Initial
Moves
 Provide or elicit an overview
 A brief summary of the facts of the case
 The story of the case
 Issues raised by the case
 Create an analytic framework
 The time line
 Decisions to be made/ decision-makers
 Rational analysis
 What is the problem?
 What are the alternatives?
 How should you evaluate the alternatives?
 What’s the rationale for the solution you
propose?

6. Your
Initial
Moves
 Use a Quick Question
 Pose a question to students to open the
case to elicit facts, opinions,
interpretations, or issues
 Ask students to summarize
the story of the case in one
sentence
 The subsequent discussion can pool their
ideas to create a larger, more complex
picture of the case
 Establish a baseline
 Poll students with their preliminary
judgments about the case – be sure to use
open-ended questions

7. Deploying Your Power as Facilitator
 Inquiring or badgering?
 Be sure your questions are designed in the spirit of
inquiry – open, not closed
 Avoid overly specific or skeptical questions
 Your points or theirs?
 Demonstrate that you are wide open to their ideas
and suggestions. “I like your point; let’s use it.”
 Avoid asking students to guess what you want.
Instead, use questions like, “Have we covered all the
main points?”

8. Deploying Your Power as Facilitator
 Hearing or Listening?
 Focus on sensing what they really mean when you listen to
what they say. Are you sensing their concerns or their issues?
More than “hearing” is required when you facilitate a case
discussion.
 Seeing or reacting?
 It is easy to see or react to learners who sit up front. You’ll
need to develop your peripheral vision to stay attuned to those
who have something to add from the back of the room.

9. Deploying Your Power as Facilitator
 Warm or cold?
 Avoid being the dispassionate observer. If learners think you
are unresponsive, they will “check out” of the discussion.
Warmth and enthusiasm go a long way!
 Avoid the “expert” role
 Students will often deflect the attention and pressure back to
you, insisting that you provide answers or clarifications,
putting you back in the expert role.
 Avoid the “hub and spoke” discussion in which conversation
moves back and forth from one student to you.

10. Ideally, discussion moves in multiple ways
Learner
Learner
Teacher
Learner
LearnerLearner
From
you to
the
group
From the
group into
the
“container”
space
From
learner
to
learner

11. Moving the Discussion Forward
 Consider using flip charts or a whiteboard to
establish a sense of progress
 Use transitions to mark the sequence of
stages or steps in the discussion:
 In a seque, your transition seems natural to the conversation,
“that point raises another good issue.”
 In a shift, your transition is deliberately more abrupt. “I want
to ask you a different question.”
 In an interim summary, you (or the learners) sum up what
has been said so far

12. Skillful time management is essential
Remember, that with the best case
discussions, students will all wish
there was more time!

13. David Irby, MD , UCSF Medical Educator
Three Models of Case-Based
Teaching for Rounds
• Case bedside teaching with conference room
discussion, followed by demo at bedside
• Case-lecture teaching
• Case-iterative teaching: discovery learning
using complex cases

14. SPECIAL
SITUATIONS
But what if it isn’t working?

15. Dealing with Problem Situations
 Silence / Apathy
 Premature closure
 Sitting at the teacher’s feet
 The abyss
 The problem student
 Unmotivated student
 Uninformed student
 Defector
 Compulsive talker
 Show-off
 Conflict avoider
 The rude or abrasive student

16. How do you close a case
discussion?
Ask: What’s the most important
thing to remember about this case?

17. Indicators of Success
How much did the
instructor talk vs.
how much did the
students talk?
How many students were
voluntarily active in the
discussion?
How many
questions did
the instructor
ask?
How “mobile” was the
instructor, i.e. traveling
around the classroom?
How many
times did
students laugh?
Was there a high
level of energy in the
room?
Did the
discussion
make sense?
Was it
coherent?

18. Your Turn to Develop a Case - Three Scenarios
 Organize yourselves into groups of 3-4, with
specialties/disciplines that are unrelated (science and
clinical specialties; very different clinical specialties, etc)
 Spend some time discussing areas of common
interest / focus and the type of case you might prepare
for a group of early medical students
 Develop your case, according to worksheet provided
 Practice your opening lines with another group – How
will you launch your case?

19. 30 minutes - Work on Your Presentations
 November 3
 Self-Assessment- Jordan, Anshu, Laura
 Learning Objectives – Ramzi, Patty, Soundy
 Ground Rules- Mireille, Chao
 Rubrics – Terry
 November 17
 Exam Wrappers –Ben, Michael
 Checklists – Rabia, Ross, Stacey
 Concept Maps – Reed, Scott
 Reader Response/Peer Review - Emma, Ashlie, Mary