Changing the Culture Preparing for the Case Discussion Importance of questions and non-question techniques Setting the stage for Case Discussion Initiating Case Discussion Continuing the Case Discussion Barriers to Discussion Closing the Case Discussion Being a "reflective" practitioner of the Case Method

Facilitating Case Discussion: Changing the Culture

Many physicians and other health care providers use case-based teaching in clinical settings, but until recently, case discussions were not commonly used in conference settings. Although clinical vignettes are sometimes inserted into lectures as enticing introductions to provide clinical relevance, the most common conference teaching style has been the “traditional” lecture approach. Over the past few years, increased interest has focused on enhancing learning through case-based discussion, interactive technologies, and other learner-centered strategies. Case discussions can “come alive” and promote critical thinking by participants. Changing the culture from didactic lectures to case teaching presents a number of challenges. The case method is not innate or easy to develop, and requires reflective practice by clinical educators. Augmenting teaching repertoire with more learner-centered, case-based discussions will be hard work, but tremendously rewarding.

This guide provides a brief overview of case-based teaching strategies and techniques. In addition to reviewing some of the “basic” principles of facilitation, practical tips for application to clinical conference settings will be presented.

This guide has resulted from a review of educational literature, feedback from facilitators across the U.S., and observations of the majority of 125 pre-continuity clinic, case-based sessions at Children’s Hospital Boston (Pediatric Health Associates). While problems and their solutions will still be encountered locally, we hope to provide some guidance and suggestions for use of these cases. Opportunities to apply the experiential process of action, observation, reflection, and incorporation of findings will continue to abound!