2005 Scientific Session Abstracts
Interactive Web-based Clinical Case Presentation
Steve K. Landas, MD ( landas@upstate.edu) , Robert Schelper, MD, PhD and Jannie Woo, PhD, Department of Pathology, SUNY Upstate Medical University, Syracuse, NY
Context: The “traditional” lecture format presents massive amounts of data as organized cores, but suffers from relative audience passivity. Case/problem-based strategies, requiring interactive episodes and larger time investment, bring the trainee to a participatory role, but are too “time-inefficient” to be globally implemented. Recent curriculum reform has called for integration of basic science and clinical clerkship teaching to enhance comprehension of pathophysiology, an important component in patient diagnosis and treatment.
Technology: Central to the Website development is the creation of relational databases using FileMaker Pro, an application that allows search, storage, retrieval and image incorporation functions, and a built-in interface that allows display of database contents on Web templates written in HTML, CDML and JavaScript.
Design: We believe that mastery comes through student immersion/struggle with classification and resolution of the various components and their relationships and completion of assigned tasks: blending facets of both approaches may offer an improvement. To test our strategy and to work towards achieving the stated goals of curriculum reform, we created two database-driven Web-based interactive case-study modules in pathology.
Results: In each module, the all-inclusive case history is replaced with a brief initial description of clinical signs and symptoms from a patient. Questions then follow, such as constructing differential diagnoses given the observed signs/symptoms. Additional questions and further information are “meted out” in what simulates an interactive “dialogue”. Students may initiate/suggest laboratory testing/work-up to rule in/out differential diagnoses to reach the correct final diagnosis.
Conclusion: Initial student feedback has been overwhelmingly favorable; the majority feels that the modules complemented and enhanced the lecture sessions. It is apparent that an approach that is entirely traditional lecture or entirely case/problem-based is bound to fail to reach a significant segment of the class. A hybrid approach seems preferable.