PBL

1
PBL
Case Writing
The Office of Medical Education John A. Burns
School of Medicine University of Hawaii
2
Case
General Principles
Writing

• Tell an engaging story
• Stir emotions
• Realistic to learners
• Make us care about the characters
• Raise learning issues important to the curriculum

3
Case
General Principles
Writing
An effective case tells the story of a person who
encounters a problem, accesses valid information,
and uses their new knowledge and interpersonal
skills to understand the problem and identify
possible solutions.
4
Case
Goals
Writing

• Review principles of PBL case-writing
• Practice a method to incorporate Department of
  Education content standards into cases
• Complete a draft of your first PBL case.

5
The Anatomy of a Case
Page 1-2 The Problem and the People Page
3-4 What Happens Page 5 Closure
See appendix (page 24)
6
Case Writing Agenda
10 Steps

• Step 1 Choose the content area and topic
  of the case
• Step 2 Choose the major themes of the
  case
• Steps 3-7 Writing Pages 1-5
• Break
• Step 8 Resource list
• Step 9 Teacher notes
• Step 10 Student tips page
• Other wrinkles
• Sharing Cases

7
Step 1
Choosing the Content Area
and Topic of the Case

• Which content area will I choose and what case
  topic will I use to illustrate it?

8

• Injury and Violence Prevention
• Tobacco Use
• Alcohol and Other Drug Use
• Sexual Health
• Nutrition
• Physical Activity
• Mental Health
• Personal and Consumer Health
• Community and Environmental
• Health

Step 1
Choosing the Content Area
and Topic of the Case

• Examples
• Content Area Alcohol and Other Drug Use
  Prevention
• Topic of Case Randall Nishimoto, a 16 year old
  male high school student using
  Ecstasy
• Or
• Content Area Sexual Health
• Topic of Case Jennifer Tom, a 18 year old female
  high school senior exposed to HIV
  infection

9
Step 1
Choosing the Content Area
and Topic of the Case

• Things to check after choosing the case topic
• Is the case topic one of special need or interest
  at my high school or community?
• Will my topic be exciting to my students?
• Can I find ways to bring in my students
  environment in this case topic?

10
Exercise 1
Choose the Content Area
and Topic of the Case
5 Minutes

• Write the content area of your first case
• _____________________________
• Write the topic of your first case
• ______________________________

11
Case Writing Agenda
10 Steps

• Step 1 Choose the content area and topic
  of the case
• Step 2 Choose the major themes of the
  case
• Steps 3-7 Writing Pages 1-5
• Break
• Step 8 Resource list
• Step 9 Teacher notes
• Step 10 Student tips page
• Other wrinkles
• Sharing Cases

12
Choose the Major Themes
of the Case

• What do you hope students will learn from your
  case (Objectives)?
• These themes represent the learning issues you
  hope your students will research as a result of
  going through your case.

13
Case Writing Agenda
10 Steps

• Step 1 Choose the content area and topic
  of the case
• Step 2 Choose the major themes of the
  case
• Steps 3-7 Writing Pages 1-5
• Break
• Step 8 Resource list
• Step 9 Teacher notes
• Step 10 Student tips page
• Other wrinkles
• Sharing Cases

14
Page 1 and 2
Page 4
Page 5
Page 3
The Problem and the People What Happens Closure
An effective case tells the story of a person who
encounters a problem, accesses valid information,
and uses their new knowledge and interpersonal
skills to understand the case and suggest
possible solutions.
15
Writing Page 1

• Introduces the problem
• Provides demographic information about the key
  characters
• Defines the role of your students in the case
• Consider withholding key elements of the story so
  that students hypothesize what they think is
  going on.

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Writing Page 1
Examples
Brandon Char Brandon Char, an 18 year-old senior
is sent to talk with you, the school counselor,
because he has seemed more depressed and
withdrawn since a fight at school. Joel
DeMello Its been a long day of work and youre
glad to finally get home to your family. Things
have been going well with the kids lately, but
Joel, your 14 year-old son looks a little tired
this evening. He eats three servings of dinner
in silence. You empty the hamper to start a load
of laundry. Youre shocked to see a plastic bag
fall out of one of Joels shirt pockets. Its
filled with marijuana.
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Exercise 3
Write Page 1 of Your Case
10 Minutes

• Begin the story (Content Area and Topic)
• Introduce the problem
• Identify the role of the student
• Provide key demographics

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Writing Page 2

• Tell us more about the problem
• Answer some of the What do we need to know
  questions of the group.
• Give some key clues to the likely problem.
• Tell us more about the characters
• Help students care about them.
• Add something about their personal lives.
• Personalize the case to your setting to make it
  more meaningful to students

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Writing Page 2
Example
When the coaches arrive Ashleigh starts to wake
up. The trainer gives her water to drink and her
father arrives later to take her to see her
doctor. The next day you see Ashleigh in the
cafeteria. Geez, Ash! Are you OK? Im
fine, she says. You notice Ashleigh looks as
though shes lost weight.  Have you been eating
anything? You are soooo skinny! you tell
her.  Thanks. she proudly replies. My doctor
says Im too thin. Shes so wrong! You and
Ashleigh have been friends for years ever since
the fifth grade. Shes a good student and on the
cross country and track teams with you. She has
always been thin, but lately she appears
unhealthy her legs look like toothpicks! She
now weighs 90 pounds. Ashleigh gobbles down the
chili con carne. I love this, she says, but
not as much as the wieners in a roll on Fridays.
Are you going to eat yours? You can have it,
you say, sticking a finger in your mouth and
pretending to gag. Ill just have the fruit,
salad, and milk. After finishing off your lunch,
you notice Ashleigh swallow a pill, then walk to
the bathroom. Funny, she always goes to the
bathroom after eating. When she doesnt return,
you decide to go in and check on her.
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Exercise 4
Write Page 2 of Your Case
10 Minutes

• Tell us more about the problem
• Tell us more about the characters
• Personalize

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Writing Page 3

• Tell us what happens
• Raise or model the access of valid information
• Finding a web site
• Talking to a community organization
• Talking to a trusted advisor
• Personalize the case to your setting to make it
  more meaningful to students
• Consider Learning Cues

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Writing Page 3
Example
In the bathroom you hear Ashleigh vomiting in a
stall. Ash, are you OK? Are you sick? Want me
to get help? NO! DONT! she replies. Ill
be fine. After a minute, she exits the stall,
washes her face and turns to you. Promise me
you wont tell anyone about this,
pleeeeeeaaaasssee? Reluctantly, you agree. But
as you look at her reflection in the bathroom
mirror, you notice how thin her face looks, how
discolored her teeth have become recently, and
how sickly your once vibrant friend now appears.
Inside, you feel like youre not doing whats
best for your friend You know, says Ashleigh,
all the really good models in magazines are
thin. The camera alone adds ten pounds. If I
want to make it big, Ill have to be thin, too.
Its not like Im just acting crazy or
something Looking at Ashleigh again in the
mirror, you remember hearing about something
called bulimia and wonder if Ashleigh has it.
You decide to find out more about bulimia.
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Sample Learning Cues

• You wonder if...
• You try to recall the reason for...
• Your friend asks you...
• You make a mental note to review...
• You decide to look up the web site for

24
Exercise 5
Write Page 3 of Your Case
10 Minutes

• Tell us what happens
• Raise or model the access of valid information
• Personalize the case to your setting to make it
  more meaningful to students
• Consider Learning Cues

25
Writing Page 4

• Tell us what happens
• Interpersonal Communication Skills
• Model talking to friends or family
• Use quotations
• Model body language and tone
• Goal Setting and Decision-Making
• Raise the setting of goals for health
• Personalize
• Consider Learning Cues

26
Writing Page 4
Example
After talking to the school counselor about a
friend and checking out some resources on the
web, including On the Teen Scene, a site hosted
by the US Food and Drug Administration (FDA), you
make some decisions about your own health and go
to talk with Ashleigh.  Ashleigh, Im kinda
worried about you.  Why? Im fine, she
says.  Well, all I know is Ive seen you eat a
lot of food and go barf it up later. I know
youre getting really thin.  Im not
thin.  Ashleigh, I read that Jane Fonda had
bulimia since she was 12. She would eat then
vomit up to twenty times a day. I know it can
kill you. You gotta go talk to the school
counselor!  Theres nothing wrong with me!
Ashleighs eyes begin to tear.  Ash I The two
of you sit silently together for a long time.
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Exercise 6
Write Page 4 of Your Case
10 Minutes

• Tell us what happens
• Interpersonal Communication Skills
• Model talking to friends or family
• Use quotations
• Model body language and tone
• Goal Setting and Decision-Making
• Raise the setting of goals for health
• Personalize
• Consider Learning Cues

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Writing Page 5

• Closure
• Personalize

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Exercise 7
Write Page 5 of Your Case
10 Minutes

• Closure
• Personalize

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Page 1 and 2
Page 5
Page 3
Page 4
The Problem and the People What Happens Closure
An effective case tells the story of a person who
encounters a problem, accesses valid information,
and uses their new knowledge and interpersonal
skills to set understand the problem and identify
possible solutions.
31
Case Writing Agenda
10 Steps

• Step 1 Choose the content area and topic
  of the case
• Step 2 Choose the major themes of the
  case
• Steps 3-7 Writing Pages 1-5
• Break
• Step 8 Resource list
• Step 9 Teacher notes
• Step 10 Student tips page
• Other wrinkles
• Sharing Cases

32
Case Writing Agenda
10 Steps

• Step 1 Choose the content area and topic
  of the case
• Step 2 Choose the major themes of the
  case
• Steps 3-7 Writing Pages 1-5
• Break
• Step 8 Resource list
• Step 9 Teacher notes
• Step 10 Student tips page
• Other wrinkles
• Sharing Cases

33
Writing a Resource List

• Be selective
• Get permission, then contact information for
  resource people
• Consider web-sites, computer-aided instruction

34
Writing Teacher Notes

• Teacher Notes
• Gives some content or processing background
• Possible Teacher Prompts
• Questions the tutor may ask his students
• Possible Learning Issues
• - Select to fulfill objectives

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Information about the content area or suggestions
for facilitation.
Questions teachers can ask the students during
processing.
Possible learning issues (themes) relevant to the
page that students may wish to choose as learning
issues.
36
Writing a "Student Tips" Page

• Precedes the first page of the case
• Reminds students of certain learning skills
• Focuses attention
• Sets the tone

37
Case Writing Agenda
10 Steps

• Step 1 Choose the content area and topic
  of the case
• Step 2 Choose the major themes of the
  case
• Steps 3-7 Writing Pages 1-5
• Break
• Step 8 Resource list
• Step 9 Teacher notes
• Step 10 Student tips page
• Other wrinkles
• Sharing Cases

38
Additional Wrinkles

• Consider videotaped segments for some cases
• Consider longitudinal threads, recurring
  characters to increase meaningfulness
• Experiment with time course
• Consider cases that take place over 5 minutes and
  some that take place over 50 years
• Case Nodes

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Case Nodes

• A dilemma is presented to the case reader at the
  end of a page.
• Students must choose a course of action.
• Their choice determines which page they will
  receive next.

40
Case Nodes
Example
7
...On this home visit she looks particularly bad.
She reaches for your hand and holds it tightly.
Doctor, she said, I cant take the pain
anymore. Will you help me end it all? Student
Note This page represents a node in the case.
There are two versions of the next page. The
page you receive will be determined by your
groups answer to Mrs. Stillners question.
After discussion, please inform your tutor
whether or not you will or will not provide
physician-assisted suicide and you will receive
the appropriate page. After completing the next
page, which is the last page of the case, you
will receive both versions to review. (Edna
Stillner HCP Unit 2)
41
Case Nodes

• We must make choices.
• Our choices have consequences.
• Students can see the consequences of our actions.
• The node is a powerful cue
• The node generates discussion
• Use nodes strategically

42
Case Writing Agenda
10 Steps

• Step 1 Choose the content area and topic
  of the case
• Step 2 Choose the major themes of the
  case
• Steps 3-7 Writing Pages 1-5
• Break
• Step 8 Resource list
• Step 9 Teacher notes
• Step 10 Student tips page
• Other wrinkles
• Sharing Cases

43
Congratulations
on writing your first case