Case-Based Discussion: An introduction to the benefits and its approach

Hello dear friends ! Case-based disccusions(CBD) are one of the activities we will be having throughout each semester . As the name of the activity suggest, CBD is a session where members of the society come together to discuss about the cases that we encountered in the wards. These sessions would be a platform to learn and improve our knowledge , presentation skills  and critical thinking skills.

In short , students will be selecting and presenting cases according to the theme of our month . These cases will be published on the blog. During the session, students will determine and generate learning issues. They will be divided into small groups for discussion. Representatives from the group will then present on the results  of their discussion. Queries and doubts during the session would be relayed to our lecturers and the answers would be published on the blog.

Each CBD is opened to 25 members.The session is a student-centered discussion. We may involve housemen , medical officers and lecturers to supervise us in our discussions if the first few discussions went well. 

Below is a detailed description of how the case-base discussion will be conducted.

CASE-BASED DISCUSSION

What are the aims and objectives?

1. To improve presentation and communication skills 
2. To revise the basic anatomy and physiology of human body in relation to a particular disease 
3. To encourage critical and analytic thinking skills 
4. To encourage Self-directed learning 

What students should do before attending the case based discussion session?

1. Students are encouraged to submit their case to present during the session 
2. Students will be notified via face book group page for any update of the case discussion session  
3. Cases will be posted on the IMU surgical society blog (IMUSURGICALSOCIETY.BLOGSPOT.COM)
4. Students are expected to do some basic study before attending the case based discussion session 
5. 25 places will be opened for each session

How will the case based discussion class be conducted?

Case submission is opened to all students. Fields of discussion include all surgical specialties.

Requirements:
1. Precise, clear and detail history taking.
a. Preferably complete cases ( from day 1 of admission until discharge )

2. Complete physical examination 

3. Complete day to day plan and the management of the patients
a. This includes investigations, drugs given, operative management, pre- operative and post-operative assessment, intra-operative finding.

4. Identify and prioritize the problems

a. What was the complaint, has it been issued out?

E.g.: Mr. X. 46 years old Indian, with family history of colorectal Ca presented with altered bowel movement for the past 6 weeks and alternate pr bleeding for the past 3 days. Physical examination noted mass over the right iliac fossa. Subsequent diagnosis of Caecal Ca was given.
What could have been done? When is the bowel Ca screening appropriate for one with family history of the similar problem?
(Information is to be quoted from books, preferably journal) 

b. What else can be done to benefit the patients?

c. Medication. ( Avoid using brand name but drug name instead)

5.  Revisit and revise physiology, anatomy, pathophysiology and management of the disease. Application of knowledge according to the case is important. Information used should be quoted.

6. Case summary will be posted on blog on the first / second day of each week.

7. During the session, case summaries are to be presented. Other participants are encouraged to post up questions and doubts. Learning issues will be identified throughout the discussion
a. This session is solely student-interactive based and students are encouraged to present and learn from their mistakes through constructive advices.

b. Hand to be raised before answering or proposing questions

8.   Participants will be divided into 4 to 5 small groups to present each learning issue.

a. How does the anatomical structures affect the surgical procedure?

E.g.: Caecal Ca is treated by right hemicolectomy with primary anastomosis. Which and why that particular blood supply is cut? Why is right sided Ca more likely to be asymptomatic than left sided Ca?

b. Epidemiology, etiology of the disease in relation to the case

E.g.: MR. X is only 46 but diagnosed with colon CA. Why? What is the Etiology? How is his diet? Is he a smoker? Was there previous cholecsystecomy? Was there any previous irradiation? How about family history?

Based on discussion, we conclude that MR. X’s disease is due to sporadic mutation of gene. What gene mutation is involved? What is the percentage of sporadic changes?

c. Investigations in relation to the particular case

d. Management

* Each small group will have 2 representatives during the presentation.

9. Identify what have the students learnt or benefit from the session. 

10. Compile questions and seek for lecturer’s advice. All answers will be posted on the blog.

*Any explanation or answer is best to be quoted from books or journal.

Kindly contact anyone of us if you are interested in submitting cases or attending the session: 

Sem 9 rep : Goh Chon Han Robin gch_1988@hotmail.com 010-2215270
Sem 8 rep : Koh Pei Fern kohpeifern@yahoo.com 012-3872812
Sem 7 rep : Lee Wei Rong e.alvin_wrlee@hotmail.com 017-5557125