Case Discussion (case + discussion)

Distribution by Scientific Domains


Selected Abstracts


How would I manage a case of essential thrombocythaemia presenting with an ischaemic toe

HEMATOLOGICAL ONCOLOGY, Issue 1 2008
DP McLornan
Abstract Essential thrombocythaemia (ET) is an acquired myeloproliferative disorder. The phenotypic and biological heterogeneity of ET can make management of individual cases problematic, especially in the era of changing ideas on the molecular pathogenesis of this disease process. This case discussion will explore the evidence base and rationale that guides treatment of a 46-year-old individual with ET presenting with an ischaemic episode. Copyright 2007 John Wiley & Sons, Ltd. [source]


The impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancer

INTERNAL MEDICINE JOURNAL, Issue 12 2009
S. Bydder
Abstract Patients with inoperable non-small cell lung cancer diagnosed and managed at a single institution over a one-year period were identified. Those whose case had been discussed at a multidisciplinary meeting had better survival than those whose case was not discussed (mean survival; 280 days vs. 205 days, log-rank P= 0.048). [source]


Teaching paediatric residents about learning disorders: use of standardised case discussion versus multimedia computer tutorial

MEDICAL EDUCATION, Issue 8 2005
Carolyn Frazer Bridgemohan
Background, We developed a standardised case-based educational exercise on the topic of childhood learning disorders, and a multimedia computerised adaptation of this exercise, as part of a national curriculum project based on the Bright Futures guidelines. Objective, To explore resident perceptions of the facilitated case discussion (FCD) and the computerised tutorial (CT). Design, Quasi-randomised comparison of two educational interventions. Setting, Preclinic teaching conferences at a large urban children's hospital. Participants, A total of 46 paediatric residents years 1,3 assigned to either FCD (n = 21) or CT (n = 25). Interventions, FCD residents met in groups of 8,12 with a trained facilitator for a structured case discussion, while CT residents worked in groups of 2,3 at a computer station linked to an interactive website. Outcome Measures, Participant responses during semistructured focus group interviews. Analysis, Focus group transcripts, field notes and computer logs were analysed simultaneously using qualitative grounded theory methodology. Results, Residents experienced CT as fun, offering flexibility, greater auditory and visual appeal and more opportunities for active learning. FCD allowed greater contact with expert faculty and made the material more relevant to clinical practice. FCD participants emphasised the clinical skills gleaned and stated that the learning experience would change their future patient management. Both groups reported that case discussion was more interactive than computer learning. Median time spent on learning was slightly shorter for the CT group. All groups of learners arrived at the correct final diagnosis. Conclusions, FCD and CT stimulate different types of learning among paediatric residents. Future studies are needed to determine how to integrate these two techniques to meet the learning needs of residents in diverse settings. [source]


Effects of a distance learning program on physicians' opioid- and benzodiazepine-prescribing skills

THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2006
Deana Midmer BScN
Abstract Introduction: Opioid misuse is common among patients with chronic nonmalignant pain. There is a pressing need for physicians to increase their confidence and competence in managing these patients. Methods: A randomized controlled trial of family physicians (N = 88) attending 1 of 4 continuing medical education events helped to determine the effectiveness of e-mail case discussions in changing physician behavior. Before random assignment, participants completed a pretest and attended a 3-hour didactic session on prescribing opioids and benzodiazepines. The intervention group participated in 10 weeks of e-mail case discussions, with designated participants responding to questions on cases. An addictions physician facilitated the discussion. Several months after the e-mail discussion, participants took part in a mock telephone consultation; a blinded researcher posing as a medical colleague asked for advice about 2 cases involving opioid and benzodiazepine prescribing. Using a checklist, the researcher recorded the questions asked and advice given by the physician. Results: On post-testing, both groups expressed greater optimism about treatment outcomes and were more likely to report using a treatment contract and providing advice about sleep hygiene. There were no significant differences between pretesting and post-testing between the groups on the survey. During the telephone consultation, the intervention group asked significantly more questions and offered more advice than the control group (odds ratio for question items, 1.27 [p = .03]; advice items, 1.33 [p = .01). Discussion: Facilitated by electronic mail and a medical expert, case discussion is an effective means of improving physician performance. Telephone consultation holds promise as a method for evaluating physicians' assessment and management skills. [source]


An algorithm for evaluating the ethics of a placebo-controlled trial

INTERNATIONAL JOURNAL OF CANCER, Issue 5 2001
Robert J. Amdur M.D.
Abstract The purpose of this article is to clarify the decision points that are important to consider when evaluating the ethics of a placebo-controlled trial. The ethical requirements for research involving human subjects are reviewed, and the rationale for and potential problems with concomitant placebo control are explained. A series of case discussions are used to illustrate each decision point. The critical decision points in the evaluation of the ethics of a placebo-controlled trial are as follows: (i) Is placebo being used in place of standard therapy? (ii) Is standard therapy likely to be effective? (iii) Is the toxicity of standard therapy such that patients routinely refuse this treatment? (iv) Could the use of placebo result in severe suffering or irreversible harm? (v) Is the variability in the placebo response such that it is reasonable to consider other options for the control group? (vi) Would a reasonable person with an average degree of altruism and risk aversiveness agree to participate in this study? The algorithm presented in this article gives researchers and research monitors (such as Institutional Review Board members) the tools they need to evaluate the ethics of a study that uses concomitant placebo control. 2001 Wiley-Liss, Inc. [source]


Facilitated web-based case discussions in surgery

MEDICAL EDUCATION, Issue 11 2007
Melanie Ann Dance
No abstract is available for this article. [source]


Effects of a distance learning program on physicians' opioid- and benzodiazepine-prescribing skills

THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2006
Deana Midmer BScN
Abstract Introduction: Opioid misuse is common among patients with chronic nonmalignant pain. There is a pressing need for physicians to increase their confidence and competence in managing these patients. Methods: A randomized controlled trial of family physicians (N = 88) attending 1 of 4 continuing medical education events helped to determine the effectiveness of e-mail case discussions in changing physician behavior. Before random assignment, participants completed a pretest and attended a 3-hour didactic session on prescribing opioids and benzodiazepines. The intervention group participated in 10 weeks of e-mail case discussions, with designated participants responding to questions on cases. An addictions physician facilitated the discussion. Several months after the e-mail discussion, participants took part in a mock telephone consultation; a blinded researcher posing as a medical colleague asked for advice about 2 cases involving opioid and benzodiazepine prescribing. Using a checklist, the researcher recorded the questions asked and advice given by the physician. Results: On post-testing, both groups expressed greater optimism about treatment outcomes and were more likely to report using a treatment contract and providing advice about sleep hygiene. There were no significant differences between pretesting and post-testing between the groups on the survey. During the telephone consultation, the intervention group asked significantly more questions and offered more advice than the control group (odds ratio for question items, 1.27 [p = .03]; advice items, 1.33 [p = .01). Discussion: Facilitated by electronic mail and a medical expert, case discussion is an effective means of improving physician performance. Telephone consultation holds promise as a method for evaluating physicians' assessment and management skills. [source]


Experiential Education In New Product Design And Business Development

THE JOURNAL OF PRODUCT INNOVATION MANAGEMENT, Issue 1 2002
Richard N. Cardozo
We describe an experiential approach to teaching new product design and business development in a year-long course that combines intensive project work with classroom education. Our course puts together up to six teams of graduate students from management and engineering who work on projects sponsored by individual companies. Student teams work with faculty from multiple disciplines and personnel from the sponsoring companies. The year-long format and involvement with company personnel provide opportunities for students to gain hands-on experience in a real product development project. Time constraints, coupled with students' determination to demonstrate what they can accomplish, stimulate teams to learn how to compress the design and development cycle. To help students generalize from their own projects to a wider universe of product design and business development phenomena, students participate continuously in constructive critiques of others' projects; and in presentations, case discussions and workshops that help them learn about the product and business development process itself. This article describes course objectives, syllabus, projects, sponsors, faculty, students and our course administration. In an effort to move towards a "paperless" course, we have put as much of the course material as possible on the World Wide Web; relevant websites are referred to in the article. At the end of the course each team presents a prototype and a protoplan to the sponsoring company in a final report, which in many cases includes suggestions for the sponsor on how to improve its design and development process. Students' positive evaluations, along with their comments, indicate that they are attaining their educational goals. Course projects have resulted in commercialized products, patents, continuing development projects in sponsoring companies, and placements for students. The course has generated public relations value for the units involved and for the university as a whole. 2002 Elsevier Science Inc. All rights reserved. [source]