Theme
Basic Sciences and Clinical Integration
INSTITUTION
Faculty of Medicine, University Goce Delcev, Stip, Macedonia
California Northstate University College of Medicine: http://www.cnucom.org
In an attempt to enhance the learning experience in Clinical Immunology and to bring relevance to the basic scientific concepts that are taught, we introduced a novel CASE-BASED RESEARCH strategy to second year medical students at the Faculty of Medicine, University 'Goce Delcev' Stip, Macedonia. The Clinical Immunology course is an elective course and was chosen by 57 students.
Briefly, at the beginning of the course students were given an option to choose their peers (maximum of three working on the same project) and to choose a medical practice/clinic, polyclinic and a physician that they would like to work with. They were given a list of immunologically mediated diseases and were instructed on how to conduct case-based research. The CASE-BASED RESEARCH consisted of two parts.
The first part was to select and shadow a physician for at least a month and to write a patient contact diary on one of the immunologically mediated diseases from start until resolution. Physicians could be chosen from the affiliated clinical faculty at the Medical School but also from community physicians in the area. Students were instructed on the proper informed consent procedures and confidentiality issues. A list of immunologically mediated diseases, letter for the medical doctor and blank form for permission to be photographed were provided at the beginning of the course. Students were taught the proper consent procedure.
The second part was to summarize their findings and to research and describe the underlying immunological disease emphasizing the mechanisms that led to the presenting clinical symptoms. This resulted in generation of a written paper. The submitted papers were accompanied with the certification from the collaborating physician that the student fulfilled the criteria of shadowing the physician for at least a month and that the patient described is indeed one of their patients.
This activity was optional and could bring up to 15 bonus points. Students needed to achieve a minimum 10 points in order to obtain the bonus points. The following criteria were used for grading:
Extent of details that describe the medical condition
Ability to link the clinical presentation with the basic immunological mechanism
Extent and accuracy of details describing the underlying immune mechanism
Following proper consent procedures
Appropriate and current references
Participating in this project was optional but participation did offer a possibility to earn a maximum of 15 bonus points. The passing mark was 10 points. Students earning less then 10 points did not receive any bonus credit points. Thus, the number of bonus points that one could earn was from 10 to 15.
This activity was well received by the students. Majority of the students opted to pursue this activity (82.45%). Support was offered from the medical doctor that mentored them in the clinic and the faculty at the university. Some students required help in allocating a suitable clinic. The project offered a possibility to involve not just physicians at the faculty clinics but also community physicians and this was well received. The greatest challenge for the faculty was the process of guiding the students to proper resources to research and reference the literature. Because of very limited resources it was virtually impossible in many cases to provide them with full text of the articles or books. This is why referencing also web links finally had to be approved. Most of the Case Based Research papers required at least one correction with about 6% requiring multiple corrections.
An example of a Case Based Research paper generated this way is shown under Details. Please, note that photographs used in this paper are not original photographs from the case described but are taken from textbooks, publications and internet. Sources of images are listed in the Bibliography.
Case-Based Research (CBR) achieved bringing case studies early in the curriculum and it combined practical experience, teamwork and learning the basics of writing a research paper. It also brought relevance to immunological concepts as it connected them with real life diseases.
CBR could be implemented in several pre-clinical courses. Students enjoy it and it is a valuable, active learning experience. The greatest value of this approach is that it brings relevance to basic scientific concepts.
Caifornia Northstate University College of Medicine is a new medical school based in Sacramento area, California, USA that uses integrated curriculum. We anticipate our first class of medical students to start in 2014. We are currently hiring both clinical and basic science faculty. Interested individuals may apply on our web site http://www.cnucom.org and/or contact Prof. Liljana Stevceva at liljana.stevceva@cnucom.org.
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