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Sharing Our Thinking about Clinical Cases: Clinical Case Reporting—“Getting the Best Information from Just One Case or from a Fistful of Cases or Events?” 1
Published in Milos Jenicek, How to Think in Medicine, 2018
In essence, any clinical case report is an exercise in argumentation and communication. Communicating a case report in a medical journal requires a structured presentation, usually in sections such as “Summary,” “Introduction to the Case,” “Presentation of the Case,” “Discussion of the Case Experience,” and “Conclusion” that may be drawn from such an experience. From the perspective of argumentation, claims (conclusions) made as part of the argument about the case are integrated with the other most important building blocks in the case report format. These are illustrated below. Note that while any oral or written version of a clinical case report is limited in time and page space, the following elements (which should also be part of the case research protocol) must be available and ready to share on request with any interested party.
Ethics: History and Theory
Published in Mark V. Boswell, B. Eliot Cole, Weiner's Pain Management, 2005
Casuistry is the method embraced by some leaders in the field of health care ethics, particularly Albert Jonsen (Arras, 1991; Jonsen & Toulmin, 1988; Jonsen, Siegler, & Winslade, 1998). Casuistry is the view that past cases are the repository of ethical knowledge. One decides a current case by judging that it is similar in all relevant respects to an earlier case and applying the decision from the earlier case to the current case. This is essentially the system of identifying precedents used by judges in the legal system. This type of ethical reasoning requires careful analysis of the similarities and differences between cases, and judgments about which similarities and differences are ethically relevant and which are not. Casuistry has a number of features to recommend it. First, health care providers may already use this form of reasoning in their clinical practice, comparing a current patient with earlier ones. Second, case presentation is typically an interesting and effective type of learning. Third, it is de facto the way in which much of health care ethics is taught. Consider Tarasoff, Quinan, Cruzan, Donald “Dax” Cowart, Timothy Quill’s patient Diane, Barney Clark, Kimberly Bergalis: each name brings to mind a set of issues and lessons learned. Casuistry has a number of limitations, however. First, knowledge of a wide range of cases in health care ethics takes some time to acquire. Second, casuistry is somewhat conservative (i.e., resistant to change and reform), since it relies on the assumption that past cases were decided correctly. Third, federal, state, and institutional policies cannot merely reference past cases, but must be written in the form of rules, thus reintroducing principles into health care ethics. Nevertheless, casuistry may be an important supplement to a methodology that also includes ethical principles (Toulmin, 1981).
Use of Project ECHO to promote evidence based care for justice involved adults with opioid use disorder
Published in Substance Abuse, 2022
Zachary W. Adams, Jon Agley, Casey A. Pederson, Lauren A. Bell, Matthew C. Aalsma, TiAura Jackson, Miyah T. Grant, Carol A. Ott, Leslie A. Hulvershorn
These case discussions are thought to be an important learning mechanism through which participants can consider how best practice principles may be applied to complex, real-world cases. Whereas the topics for the didactic presentations were predetermined, the content of the case discussions was not. That is, the topics or themes or questions raised in the cases were not required to correspond directly to the didactic sessions presented the same week, though often times the points addressed reinforced topics addressed in previous sessions. Consistent with a general inductive approach,22 case presentation forms were reviewed by two raters to identify topics that were addressed over the course of this series related to patient characteristics and questions raised by case presenters. This thematic analysis23 involved detailed review of text-based case presentation and case recommendation forms to identify themes and categories for patient characteristics, questions raised by the case presenters, and recommendations made by panelists and participants over the course of this series. The rates reviewed the forms separately, then conferred to verify consensus about primary themes.
Determining presentation skills gaps among healthcare professionals
Published in Journal of Visual Communication in Medicine, 2022
Martina A. Clarke, Faye L. Haggar, Chad E. Branecki, Tedd J. Welniak, Michael P. Smith, Sami Vasistha, Linda M. Love
Communication is a fundamental skill in any organisational setting. Research has shown that (Institute for Healthcare Communication, 2011) there is a strong positive correlation between healthcare team members’ communication skills and patients’ capacities to follow through medical recommendations and adopt positive health behaviours. Patients’ perceptions of quality of healthcare that they receive are highly dependent upon their ability to communicate and interact with the healthcare team. Furthermore, the ability of healthcare team members to communicate among their peers to collaborate and present a case is equally as important to ensure patient safety and continuum of care throughout the course of the disease. Traits to effectively present a case to colleagues or patients is a skill that is not easily acquired by many medical students or professionals. According to an article by Hammer et al. (2011), the clinical case presentation is one of the most daunting tasks for future doctors. This skill requires the ability to elicit simultaneous information, while eloquently tell the story of the case with utmost insight and logic. According to the article, their prompts, gestures, and questions must be swift and attention grabbing.
Medical students’ perception of behaviors in the clinical learning environment evolve with increasing clinical exposure as measured with situational video vignettes
Published in Medical Teacher, 2020
Howard B. Fleit, Wei-Hsin Lu, Doreen M. Olvet, Latha Chandran
In the case of the Late Student as students progress through medical school and have more clinical experience, they are less likely to consider being reprimanded in front of other students as acceptable. Our survey results show that compared to graduating students, matriculating students were more likely to perceive reprimanding a student on being late as appropriate behavior (80.5% vs 53.3%, p = 0.001), whereas a significantly higher proportion of the graduating students (15.3%, p = 0.001) perceived it as mistreatment. Conversely, as students evolve and become more clinically mature, being asked to prepare a patient case presentation for the following day is something that they perceive as appropriate. As demonstrated by the survey data, a majority of the matriculating students (84%, p = 0.001) considered the Eager Student case as mistreatment, while a significantly higher proportion of the graduating students (59.5%, p = 0.001) did not think it was mistreatment.