Wadowski Patricia Pia, Litschauer Brigitte, Seitz Tamara, Ertl Sebastian, Löffler-Stastka Henriette
Department of Internal Medicine II, Division of Angiology, Medical University of Vienna, Vienna, Austria.
Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Neuropsychiatr. 2019 Dec;33(4):207-211. doi: 10.1007/s40211-019-00322-z. Epub 2019 Nov 6.
Learning, competence development and scientific thinking in medicine need several strategies to facilitate new diagnostic and therapeutic ways. The optimal collaboration between creative thinking and biomedical informatics provides innovation for the individual patient and for a medical school or society. Utilizing the flexibilities of an e‑learning platform, a case based blended learning (CBBL) framework consisting of A) case based textbook material, B) online e‑CBL with question driven learning scenarios and C) simulated patient (SP) contact seminars was developed and implemented in multiple medical fields. Real-life clinical cases were anonymized and transferred into an interactive and an interdisciplinary eLearning platform.
As an example of the offered clinical teaching-case collection, an example of a psychiatric case for the disease "posttraumatic stress disorder (PTSD)" is presented: a 30-year-old man with a history of insomnia with difficulties in falling asleep and sleeping through, nightmares, nervousness and psychomotor restlessness. The students are challenged to identify possible differential diagnoses and further get to know the patient's personal history (loss of relatives due to war, torture and flight from home country). Further, the students are guided through the principles of fear conditioning including translational aspects like neurotransmitter signaling of PTSD pathomechanism (translational and research aspects like dopamine transporter gene polymorphism, long term potentiation and synaptic signaling).
RESULTS/CONCLUSION: The case presentation comprises different learning aspects: First, declarative knowledge has to be acquired and collected in basic medical sciences, knowledge that is in fact available and can be accessed on the conscious and preconscious level in long-term memory. Second, associative learning leads to the formation of neuronal connections and is an important way of learning and discovering, founded in neural associations. Third, polythematic-crosslinking thinking is needed as ability to link information in a meaningful way. These steps are a typical intellectual ability of gifted learners and researchers that combine previously seemingly unrelated areas to each other and drive innovation.
医学中的学习、能力发展和科学思维需要多种策略来促进新的诊断和治疗方法。创造性思维与生物医学信息学之间的最佳协作可为个体患者以及医学院校或社会带来创新。利用电子学习平台的灵活性,开发并在多个医学领域实施了一个基于案例的混合学习(CBBL)框架,该框架包括:A)基于案例的教材资料;B)具有问题驱动学习场景的在线电子案例学习(e-CBL);C)模拟患者(SP)接触研讨会。真实临床案例经过匿名处理后被转化为一个交互式的跨学科电子学习平台。
作为所提供的临床教学案例集的一个示例,呈现了一个关于“创伤后应激障碍(PTSD)”疾病的精神科案例:一名30岁男性,有失眠病史,入睡困难且睡眠不连贯,伴有噩梦、紧张和精神运动性不安。要求学生识别可能的鉴别诊断,并进一步了解患者的个人病史(因战争失去亲人、遭受酷刑以及逃离祖国)。此外,引导学生了解恐惧条件作用的原理,包括PTSD发病机制的神经递质信号传导等转化方面(如多巴胺转运体基因多态性、长时程增强和突触信号传导等转化和研究方面)。
结果/结论:该案例展示包含不同的学习方面:首先,必须在基础医学科学中获取和收集陈述性知识,这些知识实际上是可用的,并且可以在长期记忆的意识和前意识层面获取。其次,联想学习导致神经元连接的形成,是基于神经关联的一种重要学习和发现方式。第三,需要多主题交叉链接思维,即有意义地链接信息的能力。这些步骤是有天赋的学习者和研究人员的典型智力能力,他们将以前看似不相关的领域相互结合并推动创新。