Preparation and presentation of patient-management problems (PMPs)

Abstract

Summary This booklet offers some guidance to the teacher who wishes to produce patient‐management problems for use with his students for teaching or assessment. The producer should be familiar with the four phases of problems. The first phase is the provision of information about the patient, the second the request for some action from the respondent, the third the feedback to the respondent and the final phase the conclusion of the problem. PMPs simulate reality and reproduce the decisions a doctor has to make in investigating and managing a patient. The respondent has to be involved actively in the problem. This is facilitated by: the use of the personal rather than impersonal, for example, ‘You are called to see a man …’ rather than ‘Mr C. consults his doctor…’; the use of the present rather than the past tense; provision of the results of the physical examination and investigation as they relate to the patient; alteration of the patient's status according to the actions taken by the respondent. (This may be possible only with computer‐based PMPs). A range of media can be used to present problems including print, audiotape, slides, filmstrip, microfiche, overhead projector transparencies, videotape, film, computers, models and simulated patients. Each technique has advantages and disadvantages.

Ten questions to ask when planning a course or curriculum

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Again, quite a range exists. A number, as indicated, have been the subject of earlier ASME Medical Education BookletsMultiple choice questions (Harden 1979b; Lennox 1974)Essay questionsShort answer questionsPatient management problems (Harden 1983; Marshall & Fabb 1981) Modified essay questions (Knox 1975)Oral examinationsTraditional clinical examination; (Stokes 1974)Objective structural clinical examinations (Harden & Gleeson 1979)Reports by tutors or supervisors.

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“…Patient management problems (Harden 1983; Marshall & Fabb 1981) Modified essay questions (Knox 1975)…”

An oral practical examination in emergency clinical surgery

“…However, it seems from the view of the candidates that more effort is needed to standardize these emergency simulations throughout the examination boards and also to standardize the marking system for each emergency simulation. We believe that the oral practical examination as described here is different from the conventional oral examination previously criticized by Ramarajah (1985) and in a way comparable to the objective structured clinical examination described by Harden & Gleeson (1979) and the patient management problems of Harden (1983). An added advantage of our oral practical examination is that it provides a period of interactive testing of synthetic knowledge, attitude and to a lesser degree professional skills in a specified area of the surgical curriculum which is otherwise difficult to assess.…”

Análise do desempenho dos formandos em relação a objetivos educacionais da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, em duas estruturas curriculares distintas

“…Deste modo, conseguiu-se, a partir de 1995, avaliar números expressivos de formandos, que constituíram amostras representativas das respectivas turmas. Esses graduandos foram submetidos à avaliação de competências e habilidades relevantes para a profissão médica, compatíveis com os objetivos educacionais da faculdade 4 , nos domínios cognitivo, clínico, psicomotor e afetivo, empregando técnicas de reconhecida fidedignidade [5][6][7][8] .…”