Developing an Effective Case
Study
TEACHING IN MEDICAL EDUCATION
FACULTY FELLOWS PROGRAM

ADLT 672, INSTRUCTIONAL STRATEGI...
What is a Case?
The What
Cases are stories: real events or problems so
learners experience the complexities, ambiguities, and
uncertainti...
 Provide an overview
 A brief summary of the facts of the case
 The story of the case
 Issues raised by the case

Your...
 Use a Quick Question
 Pose a question to students to open the
case to elicit
facts, opinions, interpretations, or issue...
Deploying Your Power as Facilitator
 Inquiring or badgering?
 Be sure your questions are designed in the spirit of inqui...
Deploying Your Power as Facilitator
 Hearing or Listening?
 Focus on sensing what they really mean when you listen to
wh...
Deploying Your Power as Facilitator
 Warm or cold?


Avoid being the dispassionate observer. If learners think you are
r...
Moving the Discussion Forward
 Consider using flip charts or a chalkboard to

establish a sense of progress
 Use transit...
Skillful time management is essential

Remember, that with the best case
discussions, students will all wish
there was mor...
But what if it isn’t working?
SPECIAL
SITUATIONS
Dealing with Problem Situations
 Silence / Apathy
 Premature closure
 Sitting at the teacher’s feet
 The abyss
 The p...
How do you close a case
discussion?

What’s the most important
thing to remember?
Indicators of Success
How much did the
instructor talk vs.
how much did the
students talk?
Did the discussion
make sense? ...
The LCME definition of Active Learning


In active learning,




The learner is given the opportunity to independently
...
Goals

Are written as broad
statements of
purpose or intent

Can be considered
“broad” educational
objectives

Answer the
...
Goals Differ from Learning
Objectives
Learning
Goals


Can use verbs such as
“understand,” “know”
or “appreciate”

Object...
Example of a Course Goal

The purpose of the End-of-Life elective for 4th year medical
students is to develop the knowledg...
Traditionally, behavioral objectives
address three things:


The desired behavior



The conditions under which the beha...
A well-written objective answers
the question:

Who will do how much (or
how well) of what by when?
Hint: When writing you...
Example of a
Course Goal

and a
corresponding
behavioral
learning
objective

The purpose of this course is for medical
stu...
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Developing an effective case study

  1. 1. Developing an Effective Case Study TEACHING IN MEDICAL EDUCATION FACULTY FELLOWS PROGRAM ADLT 672, INSTRUCTIONAL STRATEGIES FOR TEACHING IN MEDICINE NOVEMBER 14, 2013
  2. 2. What is a Case?
  3. 3. 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
  4. 4.  Provide an overview  A brief summary of the facts of the case  The story of the case  Issues raised by the case Your Initial Moves  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? 
  5. 5.  Use a Quick Question  Pose a question to students to open the case to elicit facts, opinions, interpretations, or issues Your Initial Moves  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
  6. 6. Deploying Your Power as Facilitator  Inquiring or badgering?  Be sure your questions are designed in the spirit of inquiry  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?”
  7. 7. 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.
  8. 8. Deploying Your Power as Facilitator  Warm or cold?  Avoid being the dispassionate observer. If learners think you are remote or unresponsive, they will “check out” of the discussion. Warmth and enthusiasm go a long way!  Up here or out there?  Students under pressure to answer questions will often deflect the attention and pressure back to you by 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.
  9. 9. Moving the Discussion Forward  Consider using flip charts or a chalkboard 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
  10. 10. Skillful time management is essential Remember, that with the best case discussions, students will all wish there was more time!
  11. 11. But what if it isn’t working? SPECIAL SITUATIONS
  12. 12. 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
  13. 13. How do you close a case discussion? What’s the most important thing to remember?
  14. 14. Indicators of Success How much did the instructor talk vs. how much did the students talk? Did the discussion make sense? Was it coherent? Was there a high level of energy in the room? How many times did students laugh? 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?
  15. 15. The LCME definition of Active Learning  In active learning,   The learner is given the opportunity to independently identify, analyze, and synthesize relevant information   The learner is given the opportunity to self-assess learning needs The learner is given the opportunity to appraise the credibility of information resources All of this implies a new paradigm for teaching!
  16. 16. Goals Are written as broad statements of purpose or intent Can be considered “broad” educational objectives Answer the question, “What do I want my learners to be able to do at the end of my course?” Serve as benchmarks against which courses can be evaluated Serve as criteria for selection of curricular components (such as assessments & learning strategies) Clearly communicate what the learning experience addresses
  17. 17. Goals Differ from Learning Objectives Learning Goals  Can use verbs such as “understand,” “know” or “appreciate” Objectives  Use strong, actionoriented verbs in one of three domains of learning:    Are often written,  The purpose of this course is ….   Cognitive Psychomotor Affective Can also be related to process or desired outcomes of the learning experience
  18. 18. Example of a Course Goal The purpose of the End-of-Life elective for 4th year medical students is to develop the knowledge, attitudes, and skills that will enable them to become compassionate care providers to patients and their families in palliative care, sudden or traumatic death, pediatric death, transplant, and other end-of-life situations.
  19. 19. Traditionally, behavioral objectives address three things:  The desired behavior  The conditions under which the behavior is performed  The performance standards that are to be met
  20. 20. A well-written objective answers the question: Who will do how much (or how well) of what by when? Hint: When writing your objective, begin with “By when”
  21. 21. Example of a Course Goal and a corresponding behavioral learning objective The purpose of this course is for medical students to learn to identify normal from abnormal structures from pathologic gross images, glass slides, or digital images. By the end of this lesson, more than 95% of the students will have correctly connected the radiologic and microscopic images for the six bone tumors presented in the class.
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