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Title:
The Impact of Psychiatric Distress on Co-morbid Medical Illness: A Problem Based Learning (PBL) Case
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MedEdPORTAL ID#:
251
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Version:
1
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Resource Type:
PBL Materials
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Description:
This problem based learning (PBL) case has been developed to help raise medical student awareness of depression and co-morbid cardiovascular disease, to improve both assessment and management of such patients. Both student and facilitator versions of the case are included: the former includes the five narrative sections of the case, while the latter contains 24 pages of detailed process guidelines (how to facilitate a PBL group), 15 suggested student learning objectives, and substantial background information designed to make this case useful for faculty from any specialty.
Topics include how to diagnose and treat mood/anxiety disorders, and the nature of the relationship between such conditions and cardiovascular disease-- epidemiology, pathophysiology, and outcomes (e.g., the behavioral and biological mechanisms through which depression might lead to, or exacerbate coronary artery disease). Like most PBLs, this case develops in two parts:
1. case introduction (when facilitators help students discuss the case, develop learning objectives, and choose which ones to work on before the next session)
2. case resolution (where students present the results of their independent research on the learning objectives).
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Author Institution:
University of Pittsburgh School of Medicine
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Primary Author:
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Jason B. Rosenstock, MD
University of Pittsburgh School of Medicine
WPIC, 3811 O'Hara St.
Pittsburgh,
PA
15213
USA
412-246-6495
rosenstockjb@upmc.edu
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Resource File(s):
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Download File: MEP_251_1 / 124.0 KB
- This resource is comprised of multiple files that have been zipped into a single file for quick and easy download.
- Click on the above link to download the resource as a ".zip" file.
- To extract the ".zip" file you must have decompressing software installed on your computer which is available for free from any of the following sites:
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Additional Resource File Information:
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1.Depression-Cardio PBL Facilitator Version.doc
2. Depression-Cardio PBL Student Version.doc
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AAMC Hot Topics:
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Medicine: Communication Skills
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Content Last Updated:
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| 07/11/2007 |
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Specialty/Discipline:
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Medicine: Cardiology
Medicine: Psychiatry
Medicine: Skills/Doctoring
Medicine: Undergraduate Medical Education
Oral Health: Skills/Doctoring
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Educational Objectives:
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By the end of this activity, medical students should be able to:
1. Recognize depression in the context of co-morbid medical illness.
2. Appreciate depression's adverse impact on the prognosis of co-morbid medical illness and the potential mechanisms by which it might exert its effect.
3. Describe effective depression treatment strategies that can be employed by any physicians.
4. Know when to refer depressed medically ill patients to the specialty mental health sector.
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Resource Keyword/Symptom:
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Problem Based Learning Case
PBL
PBL Case
Problem-Based Learning
Depression
Cardiovascular
Cardiology
Professionalism
ACGME
Accreditation Council for Graduate Medical Education Competencies
Psychiatric Distress
Co-morbid Medical Illness
psychiatry
Skills
Doctoring
Undergraduate Medical Education
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Accreditation Council for Graduate Medical Education (ACGME) Competencies Addressed:
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Medical Knowledge
Professionalism
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Intended Learner Audience:
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1st Year Medical/Dental Students
2nd Year Medical/Dental Students
3rd Year Medical/Dental Students
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Intended Faculty Audience:
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Basic Science Faculty
Clinical Science Faculty
Basic Science Course Director
Clerkship Director / Clinical Science Course Director
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Effectiveness and Significance of Publication:
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In terms of effectiveness, we assessed medical student response after our first year of running this PBL. Nearly 40% of students participating found that the PBL contributed a "significant" or "considerable" amount to their overall learning; over three-fourths found it at least moderately helpful in this regard. Faculty facilitators consistently noted how effective this PBL was in generating student interest and discussion; qualitative review of student presentations related to PBL learning objectives showed effective knowledge retrieval/acquisition and higher-level analysis, superior to other PBLs used previously in the psychiatry course in particular.
The significance of this PBL, then, lies in the approach to teaching comorbidity--sharing course time among specialties, challenging students to think outside of traditional "silos," and reinforcing the importance of an extremely common yet under-taught clinical situation.
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Special Implementation Requirements or Guidelines:
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Facilitator training is essential. A one-hour session covering PBL process in general and the specific content of this case should be sufficient. It is useful to have faculty from both psychiatry and internal medicine present during both training and the actual PBL. The case can easily be adapted for use in either clinical or preclinical experiences, in different specialty courses.
The 15 learning objectives listed could easily be changed to meet the needs of a particular course or clerkship; in fact, the PBL process itself encourages students to develop their own learning objectives independently, so there would likely be some differences between what students choose to focus on and what we have listed.
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Lessons Learned:
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The effectiveness of this tool is heavily dependent on the quality and training of the PBL facilitators. We provided a one-hour training a few weeks before conducting the PBL. The training was run jointly by internists and psychiatrists. Faculty who received this training felt well-prepared and more at ease during the PBLs; we believe students in those groups were more likely to achieve the activity's learning objectives. Faculty who did not attend the training did not do as well with the PBL. Faculty who were unfamiliar with the PBL model of teaching also had more difficulty with this case. Although we have not yet tested this, it might make much sense to have two facilitators for each PBL group--one internist and one psychiatrist.
First-year medical students may be the ideal audience for this case; modifications to the case or process might need to be made for higher-level students.
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Publications, Presentations, and/or Citations For This Publication:
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| Rollman BL, Muldoon MF, Rosenstock J, Kalyanam RC, and Humphrey A. "Initial Development of a Multidisciplinary Curriculum to Raise Medical Students' Awareness of the Impact of Depression on Co-Morbid Medical Disease." Poster presented at November 2005 AAMC Conference, Washington DC. |
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Sponsorship (Funding Source):
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| Not Applicable |
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Citation Formats:
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NLM:
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Rosenstock J ,
The Impact of Psychiatric Distress on Co-morbid Medical Illness: A Problem Based Learning (PBL) Case. MedEdPORTAL;
2006.
Available from: http://services.aamc.org/30/mededportal/servlet/s/segment/mededportal/?subid=251
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APA:
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Rosenstock, J.,
(2006).
The Impact of Psychiatric Distress on Co-morbid Medical Illness: A Problem Based Learning (PBL) Case. MedEdPORTAL:
http://services.aamc.org/30/mededportal/servlet/s/segment/mededportal/?subid=251
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