Core Clinical Problems

How do you want the core clinical problems taught?

Core clinical problems are, erm, core to the curriculum here in Dundee.  We are encouraged across the specialities to link together all the core clinical problems, to integrate our teaching into the CCPs.  But how should we teach this to you?

We do ‘interactive lectures’ with the handsets, because that’s what we think you like.  But we’re probably wrong (Going on this morning’s ITA session, certainly).

Reply to this post with comments on how you want the next core clinical problems session to be run, and I’ll see what I can do.

But get back to me in the next 48 hours, so I have some time to prepare stuff.  Please respond – I’ve had well over 2000 visitors to the site now, but only 30 comments.  Can you generate 50 more comments by the end of the day?

Ideas:

More handset stuff.

A 2 hour lecture on causes of chest pain/cough/breathlessness/haemoptysis etc

I stand at the front and just answer questions as you fire them at me for 2 hours.

Do the whole thing on line – loads of CCP cases and links to find more information.

A single case run through in infinite detail.

Combination of the above.

Or I could read The Great Gatsby.  (Joke for one person, probably).

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12 Comments on “Core Clinical Problems”

  1. Andrew Says:

    Hi,

    Personally I would find it useful if we were told the CCPs that are relevant to the system and then have them expanded upon, like how the can present and when/in what conditions they present.

    • dundeechest Says:

      Thanks Andrew,

      We can provide a list of the Core Clinical Problems relevant to the system: Cough; Breathlessness; Haemoptysis; Chest Pain; Wheeze. How do you want me to expand on them? As a lecture? Do you want to be in small groups? Do you want to be in the ITA? Do you want a document to read, as other blocks do for their CCPs? Do you want me to run through a load of different cases explaining the different presentations? Do you want an on-line repository?

      Let me know more.

      Tom

  2. Ross Says:

    I thought the format of the CCP session today was fine, but seemed a little rushed. A series of CCP patient scenarios with a detailed walkthrough and discussion of history taking, diagnosis, possible treatments, investigations, etc for each, would be a useful way to learn. Slides of CXRs and CT scans are always good for familiarisation.

    I’d be quite happy with The Great Gatsby though. Or a rendition of Mighty Mouse.

    • dundeechest Says:

      Good knowledge, Ross. You can be in my gang.

      I can certainly go through another CCP more slowly, and in more detail. We have 2 hours, so we could do breathlessness, and then haemoptysis. Actually, haemoptysis is dead quick, so perhaps we can do three?

      I’m goofin’ on Elvis.

  3. Joel Schneider Says:

    Just my opinion, not necessarily representative of other student’s opinions!

    (Firstly: thanks for all the work you’ve been putting into the course, dundeechest etc. and listening!)

    There are no doubt plenty good ways to teach CCPs. I found today’s good. Probably best not to get bogged down with learning CCP lists for each system? Cases make it “relevant”, easier to remember and apply one day! CXR, ABG results etc. all make it more “useful”/”integrated” – seeing the whole picture. Hopefully then we’ll end up knowing and applying CCPs without even realising it!

    On handsets: good for dynamic (pseudo-offline Web 1.5?) feedback, but possibly slow things down a bit? I suppose it means if we’re all lost on a different wavelength, we can be re-aligned.

    Q&A sounds interesting too, but then it depends on the right sort/number of questions being asked! Perhaps backup/starter questions if there was a Q&A lecture?

    Thanks again!

  4. Lucy Says:

    I liked today’s CCP session and think a similar format on Wednesday would be great. I agree with Ross though in saying that todays session was a bit rushed, but the idea of teaching though interactive case studies does make the theory we are learning more clinically relevant.
    However I would ask that the reasoning behind the answers to the interactive quetions be explained more clearly. For example in todays session one of the interactive questions was “what test would you carry out in this patient with COPD?” The answer was spirometry with reversibility. I had chosen spirometry and am still not sure what spirometry with reversibility exactly is. I should have asked the lecturer to explain it at the time…but it’s too late now. Perhaps you can explain this?
    Also thanks for all the work you have put into this block so far.

    • dundeechest Says:

      No worries, Lucy.

      Reversibility testing is simply carrying out spirometry before and after bronchodilation, usually with salbutamol. The theory being that the salbutamol shows up any reversible component to the airflow obstruction – helping you to distinguish between asthma (the hallmark of which is reversible airflow obstruction) and COPD (typically irreversible airflow obstruction). The argument over the usefulness of reversibility testing in COPD carries on in the upper echelons of respiratory medicine, but for you (and me), if there’s reversibility in the airflow obstruction, it’s likely to be asthma, if there’s no reversibility, it’s likely to be COPD.

      So, for next wednesday, you’d like more cases, but perhaps with more explanation of why the answers are right, or wrong. Any agreement from others, or other ideas?

  5. Ashley Says:

    I’m more of an old fashion gal when it comes to my learning!

    I prefer a problem based format. For example being given a few case scenario’s around the CCP (like today) and then being asked questions about mechanisms of disease, investigation, treatment/ management before the session. Then maybe having a 1 hour interactive session (like today) to go through the answers with a tutor.

    I felt the problem with todays session was that it was mainly guess work on our part. There are still a lot of gaps in our knowledge with concerns to Respiratory and so having a chance to read up on a partciular Problem/ Scenario before this kind of session would be really helpful.

    Ashley

    • dundeechest Says:

      Thanks Ashley

      So if I tell you that the CCP session next Wednesday will be on Breathlessness, Haemopysis and Headache, you can go and read up about them, and be fully prepared for the session? Sounds like a plan.

      Any more input from you guys?

      • Andrew Says:

        People have made some good points here. We were asked quite a lot of questions which we just didn’t really know the answers to, and once that was factored in with the key pads, so much time was taken up asking a question and eventually giving the answer that the explanation was rushed and not fully explained before you had moved onto the next question. Then towards the end there was no time to even ask the question, and the “chest pain” part was totally skimmed over. I felt like I just didn’t take anything from that session.
        Maybe if they were given say an hour each: for the first hour go over the CCP’s and then for the next ask questions or give clinically relevant scenarios and give answers with the interactive key pads. That way the learning isn’t rushed and the keypad sessions are not interrupting anything.
        I like the keypads, interactivity is good, just not interactivity for the sake of it. When almost forced into “interactivity” it doesn’t really work and just creates large time gaps in the lectures. Ironically my interest then starts to wander.

  6. Stuart Says:

    I also agree with Ross and Lucy, the format of todays session was good. However some of the questions were about conditions that we have not been taught on fully yet and we were given no basic overview.
    Perhaps it could be something along the lines of “Patient A has Symptoms X, K, C & D with a history of Y. What could this be?” followed by a brief explanation of the condition and why those symptoms lead to those symptoms and the relevance of the history. Then maybe something similar for investigations and treatments, briefly explaining after the answers why those particular investigations/treatments would be used and how.
    The only problem though with the format I’ve suggested is that unless it was only a few patients it may take some time but I feel that it would give us all a chance to understand the basic principles of the CCPs and to build upon them as well.

    The Great Gatsby would be a good alternative though, as long as the film version is not involved in any way, shape or form.

  7. dundeechest Says:

    For some reason I can’t reply to Andrew’s comment, so I’ll just reply.

    Thanks for the feedback – I agree with a great deal of what you have said. Although it may seem that I want to push the interactivity/e-learning bits, I am all for whatever gets the message over best.

    I think I have a good idea of what you (all) want – description of what the CCPs actually are, info on how to differentiate them, then some interactivity, few questions, answers, not too much. Time for questions, non-threatening environment to air your queries, and a stimulating lecturer. I’ll try to sort it, apart from the last bit; you got me.

    I think we’ll do breathlessness, and headache, so you can read up on them before hand.


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