MedEdPORTAL (Jul 2013)
Online Case Study: The Clinical and Pathological Differential Diagnosis of Encephalopathy (“The Mysterious Case of ‘John Doe’”)
Abstract
Abstract Introduction This online clinical case was designed to complement and reinforce material covered in the module on Nutritional/Metabolic disturbances in a second-year brain and behavior course. The goal of this exercise was to have the student apply important concepts previously presented in class to a realistic patient. It could also be utilized during the clinical years for a review of the basic science underlying encephalopathy. Methods The module was created to be an enjoyable, interactive, multimedia experience that guides the student through clinical decision making in a patient presenting with confusion. A brief discussion of this disorder concludes the exercise. Case efficacy was evaluated through a posttest and a student survey. Results The case was available to half of the class of 143 students (Group 1) for a period of 6 days following completion of the Nutritional/Metabolic Disturbances module. The remaining 72 students (Group 2) did not initially have access to the case. After the case was closed, an elective seven multiple-choice question online quiz was opened to all 143 students. The average total score (out of max of 7) for Group 1 was 5.58, while the score of Group 2 was 4.57 (p = .0004). For the survey, feedback was incorporated into an anonymous postcourse evaluation. Seven questions about the exercise were evaluated on a Likert scale from 1–5. In addition, free-text comments were solicited. Fifty-three students completed the survey. The quiz and survey results indicate that the case is both well-received and effective for short-term learning. Discussion The significance of the work is the integration of basic science/pathology and clinical medicine in the format of an engaging case review of encephalopathy. The case is appropriate both for preclinical students learning about clinical workup, as well as for students in the clerkship and post-clerkship years reviewing the underpinnings of basic science in clinical medicine.
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