Kasuya, Richard T.

Kramer, Kenton J.

Martell, Jon

Naguwa, Gwen S.

eVols at University of Hawaii at Manoa

Medical School HotlineHamilton to Honolulu: Problem BasedLearning Local StyleKenton J. Kramer PhD, Gwen Naguwa MD,Jon Martell MD and Richard Kasuya MDJohn k Burns School of Medicine (JABSOM)Office of Medical EducationIn I S)Si. The John A. I3unts School of \Iedici ne JA\ BSO\Iadopted the McMaster [niserit\ Hamilton. ( )ntario nodel otsmall eronp. self-direct. tntonal-hased learning as its instructionalmodel for its ntedical edttcaiion enrrmcnluiu k nder this Pmohlemn13jsed Learnine (PBL niodel. the foundation for learitnig during thepre—clmnical years is the Health Care Problems I ICP Each ‘.s eek I2 HCPs are covered in small eroLip sessions \ ith supportt\ e intor—mation presented in conferences. colloquia, and laborator\ sessions.Front the faculty’s standpoint, one of the ads antaves of PBL is thatthe HCPs can he modified and adapted to fit the proltle of the localdentoeraphics and cul tines.HCPs provide the forum for exanlining a clinical condition front4 perspectives: biolocical. clinical. populational and hehts oral.Ihus the students not only nvestigate a clinical condition, but alsoexplore the base science concepts of that condition, the epidemioloev 4 the disease and boss the disease affects the patient and hi s/herfamily in a cultural context. Therefore. a HCP written for a Canadianpopulation can be modihed to fit our local sittiation in Hawaii or newHCPs can he written for diseases more contmoiil\ found in I lawai iPBL is going into its fourteenth year at JABSOM. It might heinteresting, at this point in time, to examine how the curriculum haschanged over the years by havitig a closer look at [nit I (the firstthree months ofa PBL at both McMaster Uni\ ersitv and JA BSOM).Part of the original agreetnent between JABSOM and NlcMasterUniversity was that JABSOM would initiate its PBL program withthe HCPs developed and utilitized at McMaster University.Unit I at McMaster University is 12 weeks in length and providesan opportunity tor the students to become adjusted to the PBLprocess. It is divided into three subunits: I ) reproduction and themechanisms of early development. 2) the examination of the development of biological, social and emotional independence, and 3) anin-depth examination of behavioral aspects of subunit two. (Note:These subunit topics are covered in Unit 5 of the JAI3SOM curriculum). Unit 1 at JABSOM is a 14-week course. Dun tie the first twoweeks of the Unit. the conferences and collocluta ate des otcd to thedevelopment of the skills important to the P[3L process. The Unit i’not broken up into subunits, hut the HCPs arc arranged in the orderof a clinical examination: head and neck. ehet. abdomen andestremitics. This sequence Is coordinated with an inteerated gloss.inatont\ and ph steal examInation lahorator scssiott’ that tohlosstlte ‘linle clinical examination sequence. The coals of Unit atABS OM arc: I to bc-cm to appreciate the e’.pericnee of hem aph\ sician and the role of the ph sician in the cointitunit’ and in thedelis e r 1 healtlicare. 2 tovain a motndatticntai undcniandine oftitecomplete patient histors. basic phvstcal e\ainiilatim sequence andrelated clinical attatomv and diagnostic imaging. 3) to gain afundamental understanding of the basic sciences highlighted in theI—lCPs as an introduction to future Units, and 4 to begin to developcommunication skills important to mediciiie . From the abovedescriptions. it is apparent that Unit I at JABSOM has been modifiedfrom the N cMaster Universit ‘s design \k ith an increased integration between the HCPs, clinical skills arid clinical anatom\lit 1 989, Unit I in the MeN-laster s program contained I S cases w ith25 patients. The ethnicity ol 22 patients ss as tot st:tted but assumedto be C:tucasian. The reni:nitine patiemtts are delimied :ts a Jantaican,an Asian and aCree Indian. Fotirteen are ittale amid I I are temale. Thepaneitts range in ace front an unborn with a possible cetietic detectto :t75-vear-old female with s icual pioblemns. In 2(101. Unit I atJABSOM cos ered I 1 p emit’ and their families. The ethnicitie ofthe patients were Santoait. Southeast Asian. part-Ilaw amman i n=2LFilipino-Chinese. Caucasiait tmt=4 . Japlimmese and Filipino. Sixpatients \vere male and live were femnltle. 1 lie patients ramtged in agefrt on a I -month-old new born male w i tIm a possible genetic ahnormal its to a 62—y- ear—old part HItw liii ait nan w i th chest pam it andshortness ot breath -8cr en of the cases fmomtt botlt progrltmns xs crc easily mnlmtcited andw ill he compared here. In the \Ic\laster prenitm Charles Brossnss Its a 60-year-old chemical plamtt worker w ith chest paul amidshoitness of breath lifter exertion. At J-\ BSO\I. the slmnte issuesss ore exltmined with Charles Bri mw mime, a o2— olin—old part Hass am—an warehouse foreman ss mth a lo\ e or plate lunches. In the\lcN laster s progrant. .Ilmmte Es aims was an I 8—I ear—old high schoolstudent ins olved in a motor vehicle accidemtt NI VAt. At JABSONIJlmne became Jtthia Httane. a I 7— ear—old Punahotm student ss ho inltddition to chest injttnies stmffered in the NI \A also has problemssvith alcohol, hem’ parettts and bo Iniend. In mIte NicMaster’s program. Kim Namer was a I 2—ear—old female with a sore throat thatprogressed to bacterial pneuntonia .. \t JABSONI Kmnt hecrtme EseSaipaia. a 16—year—old Slimoan female svith a sore throat and whos-vas non—compliant with her prescribed medications. In theMcMaster’s program Mary Cornell was a 27—mnonth—old toddlerwho suffered accidental brim injntries at home. Child developmentand issues of child neglect and abuse at J,\BSOM were examinedusing Kihi Kahipa, a 30—month—old female toddler. The psychological consequences of a patient finding an new subcutaneous lump onher body rtnd the medical procedures for diagnosing the problemwere explored at McMaster using Doreen Cooper. a 57-year-oldnurse and lit JABSOM using Doreen Cooperson, a 57—year—oldFilipino-Chinese hank executive. Issntes of s\ stetnic infectionswere examined at McMaster using Joseph Smith. a 67—year—oldoffice worker, rvhile at JABSOM the issue of iitfectioit and accessto quality- health care were examined using Phil Collins. a 62-year-old homeless individrial, Issues of genetic ahnorntahities and childhood development were explored at \-Ic\Iaster umsimtg the ChengFamily, Mrs Cheng was 40 years old aitd lOss eeks preenant. Shehas tsvo living children with genetic sllsahil tie’ and ss a cottcenttedabout her unborn child. At .JABSO\l these unes ss ems’ examitimiedtisitig ‘lenny Shomnlt. a new born bo brought to the his pediatrician tana one ntontn sr-eli baby check by his iti’ciit si ho ss crc conccnttesiltbottt his des-oiopmeitt.‘vlaiiy- of the cases at ,tAI3S( )NI its ohs ed patients or taini lmnenibers. svhich i’eappcar in other Units. .lulia Huamme’s lather atid175mother appear in Units 2 and 3 respectively. Esa Saipaia’ s relativesalso appear in subsequent Units. Introducing fimily membersthroughout the first year of medical sc hoot reinforces this concept oftreating both the patient and family. Fina11 Gerhard Ganiron wasa 23-year-old Filipino male who has rcceni1 immigrated to Hawaii.He comes to the clinic complaining of numbness and tingling is hishands, This case \\ as written by the Co—Chairs of Unit I to introduceneurolog\ c.\amination of extremities and to pros ide the opportu—nit to explore the historical aspects of a disease.An academic advantace of PBL is ihe students’ early exposure toclinical situations and patients. Using c mi—cal situations set up iii the HCPs. the studentslearn to integrate know ledee through thepractical application of concepts in the basicsciences. epidemiology and behaviorial sciences as ss elI as to begin to understand aculturall sensitis e approach to medicine.These skills at McMaster and JABSOM arelearned and refined using HCPs, simulatedpatients and real patients heftwe studentsbegin their clinical years. HCPs written withlocal patients in mind can smooth the transition from the pre—clinical years to the clinicalyears. On the other hand, a perceived weakness of PBL is the lack of traditional discipline-based structure and progression. How-csci appropri’std oioani,cd Lnits ssell—ssiitten HCPs. combinedi th thc proper approach to PBL h thc studLnts alone v ith auidancch\ thL faculty cm oscrcome this obstacle and pins idc a challengingand coins’ hIL prL-clinical cxpLi ien.ReferencesA A ““r— “‘---,.____________—, ‘‘“DC i-. :‘ r’ -- ‘-‘ .-, --— . ‘- — ..—..,-.. ,—i1o_. ‘,— —‘i’D —IMIGITTM is YOUR AnswerPatient Records a Problem? Call Us Today!> Capture and store patient records digitally• Scan existing records• Direct digital capture of new records> Provides Security, Control and Access• Available on your office LAN or on CD-ROM* Maintains file integrity> Flexible and Easy to UseExperienced- Immediate access to patient files• Quick and easy search and retrievalLaboratory documentsPatient recordsAccounting records• Print, fax, email from your desktop• Annotate with digital notes, highlightingHospitalsLaboratories‘ HawaiiClinics & Drs. OfficesMainland28 yrs. Serving HawaiiPROFITABILITY OF HAWAII, INC.1000 Bishop Street. Suite 701‘ 536-6167176

Hamilton to Honolulu: problem based learning local style.

http://evols.library.manoa.hawaii.edu/bitstream/10524/53683/1/2002-08p175-176.pdf

Hamilton to Honolulu: problem based learning local style.

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