Mr. Samuel

Abstract

Abstract This module includes a case featuring a young man with progressive asthma refractory to initial therapy. It was written as a case-based learning course for third-year medical students, designed to integrate basic science learning into the clinical year and to create opportunities to face diagnostic error and/or reflect on the diagnostic reasoning process. With the final diagnosis being that of occupationally-induced asthma, one of the most common occupational diseases in developed countries, the case also addresses curricular mandates to include occupational health as part of the broadening focus on social and behavioral health. This case is designed for the small-group format. It has been used with groups ranging from four to eight students. When possible, groups have been facilitated by one basic science and one clinical faculty member. A clinician well-versed in the case and familiar with basic pulmonary physiology can run the session alone. The primary learning goals of the case are arguably the two fundamental competencies for undergraduate medical students in the area of occupational health and medicine: to elicit a basic occupational history, and to consider occupational exposures in the differential diagnosis of disease. This case has been implemented in our third-year medical student curriculum. A formal immediate postsession survey of 19 third-year students showed 18 agreeing that the case improved their understanding of the basic science concepts. Sixteen agreed that the case was believable, and 17 that it improved understanding of asthma treatment. Eighteen agreed or strongly agreed that as a result of participation in the case, “I will ask more of my patients about occupation.”

Keywords

• Asthma
• Diagnostic Reasoning
• Case Based Learning
• Undergraduate Medical Education
• Third-Year Medical Students
• Occupational Medicine