MedEdPORTAL (Apr 2013)
Applied Medical Sciences in Endocrinology: A 23-Year-Old Woman With Amenorrhea
Abstract
Abstract Introduction The intent of this resource is to use a detailed, authentic clinical presentation to extend and reinforce students' comprehension and application of medical science content; topics in female reproductive endocrinology are specific to this exercise. The case enables learners to integrate aspects of physiology and pathophysiology with clinical medicine (e.g., diagnosis). Following this approach, the learning process is engaged by using large-group discussion based on a clinical scenario. This method has the potential to addresses some important areas in early medical training: introduction to the level of knowledge necessary to provide quality patient care, the importance and significance of a firm understanding of basic science content in providing accurate diagnosis (and ultimately treatment), and better preparation of medical students for the integrated thinking that enables success on the United States Medical Licensing Examinations. Methods This case-based exercise explores the etiology of secondary amenorrhea in a 23-year-old woman. This athletic woman has been using anabolic androgenic steroids for performance enhancement, which explains her amenorrhea. However, this diagnosis is not immediately obvious given her history, physical, and blood lab results. Certain paradoxical findings are meant to help students realize that an endogenous pathology cannot fully account for her signs and symptoms. The exercise begins with the case presentation; discussion topics and questions are inserted throughout for the purpose of having the students describe the essential elements of normal female reproductive endocrinology, develop a differential diagnosis, and narrow the differential with their knowledge of endocrinology, using the data provided. An online three-item self-assessment is provided following the session. Results On an anonymous, web-based, end-of-course survey, students were asked to rate the following statement: “Applied Medical Sciences, Female Reproductive Endocrinology: Overall, in terms of integration of the course material, clinical correlation, and delivery, this session met my learning needs.” On a 5-point scale (1 = strongly disagree, 5 = strongly agree), students gave the statement a rating of 4.5. Discussion This exercise is designed for a large-group format and should be considered for use after students have been presented with the fundamentals of general and reproductive endocrinology. The exercise can easily be adapted for a small-group setting.
Keywords
