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Continuing Medical Education

Quillen College of Medicine

Clinical Case Studies
Format
Case Scenario Examples


Clinical Case Studies

Clinical case studies provide learners the opportunity to:
  • apply knowledge and practice skills relevant to the situation they face
  • analyze, identify issues, solve problems and formulate strategies
  • learn by completing structured learning activities which resemble the challenges they are likely to face in the real world


A case study is an effective teaching tool if the case:
  • involves mentally processing and connecting the content presented to the performance of increasingly complex cognitive tasks
  • links didactic knowledge with clinical practice
  • models thinking processes that the learner has to be able to perform
  • presents problem issue(s) related to the learning outcomes
  • is sufficiently complete, complex and focused
  • presents a situation, problem, or issue
  • appears to be realistic
  • utilizes elements of a narrative style
  • events and actions are sequenced in a logical order
  • connect events with appropriate transitional signals
  • content is accurate, relevant, and appropriate in terms of subject matter
  • produces the intended learning outcomes


A strong case study is one that:
  • emphasizes and builds on only the most important points the presenter wants to communicate to the learner through making the learning more personal. Ask yourself, what specific learning objectives/take home points do you want to communicate to the learner?
  • tends to stay with the learner as an illustration of important concepts.


The Case Study should include:
  • pertinent patient characteristics, events, rationale for treatment, and associated outcomes should be described. These real-life features should be brief and clear.
    • a common error is including virtually every detail of the case or confusing verbiage, each of which can bury essential information. However, conciseness does not justify the use of medical shorthand.
  • descriptions of how the patient looked or acted and perhaps what he or she said or did, (i.e., a storytelling style, the contextual descriptions of the situation, the portrayals of the central characters, the development of a series of events, and an interesting plot evoking different perspectives).



Format

A single question or multiple questions may be asked based on the same case, each with its own set of multiple choice answer options. Questions stems that may be appropriate:
  • What is the most likely diagnosis?
  • What is the most appropriate next step in treatment?
  • Which medication would represent the be treatment option?
  • Which lab test would confirm the probable diagnosis?
  • What is the most likely cause of the symptoms?


Case Base Scenarios

Below are examples of case-based scenarios which are designed to assess if the learner can translate the knowledge/information provided into a practical application.


Case Scenario #1


A 7 yo female, in for her 7 yr well visit. BMI is 90%, no family history MI, hyper cholesterolemia. Mom has HTN & Type 2 DM, parents are obese. Diet high in saturated fats, she does not like veggies... Brianna is?


A.
At a healthy weight and does not require any counseling or intervention

B. Obese and needs referral to a dietitian and exercise physiologist with weekly follow-up until she has a BMI less than the 85th percentile

C. She is at risk for overweight and should be offered referral to a dietitian, counseling regarding activity and allowed to grow into her weight rather than pursuing weight loss

D. Should have lab work-up for hypothyroidism and adrenal gland mass




Case Scenario #2


A patient develops sudden sweating and dizziness within minutes after the flu vaccine is administered. He tells you that he is allergic to eggs and is having a reaction. His heart rate is 38 bpm and his blood pressure is 86/52 mm

The correct diagnosis is:

A.
Egg allergy

B. Anaphylaxis to a flu vaccine ingredient

C. Vasovagal reaction

D. Malingering

The correct immediate management of this patient is:

A. Administer epinephrine (1:100) 0.01 ml/Kg or 0.3 mls

B. Administer epinephrine (1:1000) 0.01 ml/Kg or 0.3 mls

C. Have the patient lay down and elevate the legs

D. Administer IV epinephrine 1:1000 0.3 mls rapid push

E. None of the above

When submitting your case please indicate the correct answer for each question.


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