MedEdPORTAL (Apr 2013)
Sandra's Dyspnea
Abstract
Abstract Introduction This case is a problem-based learning (PBL) tutorial intended for use in a first-year medical school human gross anatomy course during anatomical dissections and discussion sessions with respect to the human renal system. The case could also be used in medical school pharmacology or pathology. The focus of this case is renal cell carcinoma. Methods The ideal PBL group consists of one faculty tutor leading six students. The case is divided into three 2-hour sessions, at which pages of the case are handed out one at a time and students discuss each page, generating hypotheses, tests, and learning issues. Images are provided for discussion where indicated in the case and prior to discussion of subsequent pages. The tutor may ask the students guiding questions to assist their learning process during the case. Sessions 2 and 3 begin with students sharing information obtained through the study of learning issues and the sharing of resource materials. At the end of the case, students are supplied with the case objectives and vocabulary. If the PBL group has been successful, the students will be able to answer all of the case objectives and know all of the case's vocabulary. Results The case was reviewed for appropriate clinical and basic science content by three physicians (one a pathologist of 23 years in practice, and two medical residents), as well as one clinical education specialist and a histologist. The case was pilot-tested using 26 medical students and four faculty members, divided into four PBL groups. Both students and faculty were highly satisfied with the case, and suggested revisions were made to some objectives, learning issues, and guiding questions. Discussion This is an interesting case in that what begins as dyspnea in a patient is carried through diagnosis of renal cell carcinoma and to the death of the patient from intracranial hemorrhagic stroke secondary to metastasis of clear cell renal cell carcinoma. The ultimate goal of the case is not diagnosis but the application of the basic sciences (human gross anatomy, histology, embryology, radiology, pathology, and pharmacology) in order to reinforce material being learned during laboratory and discussion sessions.
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