Linköping University One university – two cities

Linköping UniversityOne university – two cities

Norrköping

Norrköping Linköping

Håkan Hanberger prof, Div Infect Diseases, coordinator clinical stadium medical schoolAnne-Christine Persson coordinator web scenarios

Bjorn Bergdahl prof, Dept CardiologyFaculty of Health Sciences and University Hospital, Linkoping, Sweden

Web scenarios - building on reality and supporting Web scenarios - building on reality and supporting the problem-based learning structure of an the problem-based learning structure of an

undergraduate medical programmeundergraduate medical programme

Håkan Hanberger prof, Div Infect Diseases, coordinator clinical stadium medical schoolAnne-Christine Persson coordinator web scenarios

Bjorn Bergdahl prof, Dept CardiologyFaculty of Health Sciences and University Hospital, Linkoping, Sweden

•1986, Faculty of Health Sciences (FHS) at Linköping University, Sweden, introduced problem-based learning (PBL) as the main educational philosophy for all undergraduate study programmes.

Web scenarios - building on reality and supporting the Web scenarios - building on reality and supporting the problem-based learning structure problem-based learning structure

of an undergraduate medical programmeof an undergraduate medical programme

Web scenarios - http://www.hu.liu.se/lakarprogr/om_lakarprogrammet

•1986, Faculty of Health Sciences (FHS) at Linköping University, Sweden, introduced problem-based learning (PBL) as the main educational philosophy for all undergraduate study programmes.

• 2001, web-based PBL scenarios introduced by the EDIT project (Educational Development using Information Technology).




•The main aim of our project was to use information and communication technology (IT) and multimedia in scenarios to improve students’ learning.





•Another objective was to familiarise students with handling computers and accessing information from the Internet, thereby preparing them for the use of IT in health care.




•Another objective was to familiarise students with handling computers and accessing information from the Internet, thereby preparing them for the use of IT in health care.

•Today patient records, lab systems, diagnostics are on intranet in most hospitals



Revised curriculum

•subjects are integrated into mainly organ-based themes

•Within such themes, everyday situations or problems are selected as scenarios

•The theme groups are producing the web scenarios

Immune-dermathology-infection and microbiology

30 EDIT scenarios per semester.

9 EDIT-scenarios per semester

30 EDIT scenarios per semester.

9 EDIT-scenarios per semester

Role of scenarios in clinical semesters is Role of scenarios in clinical semesters is to complement the clerkships and to complement the clerkships and

to focus on

Basic science Pathophysiological mechanisms

Epidemiology Prevention

Ethics

The EDIT group room

computer (cordless mouse and keyboard) with internetaccess

projector, screen, whiteboard.



Guided Tour

EDIT-scenario

Maj-Britt 80 yearsMaj-Britt 80 yearsEDIT scenario,EDIT scenario,

semester 8 (medicine & surgery integrated)semester 8 (medicine & surgery integrated)


Maj-Britt Liljegren, 80 years old, arrives at the Emergency department because of severe abdominal pain for the last three hours. During the last six months she has experienced intermittent discomfort in the upper part of the abdomen particularly in relation to meals. However, this time the abdominal pain, which radiates to her back, is much more severe.

A scenario starts with a short and open review A scenario starts with a short and open review of a patient’s complaints and background to of a patient’s complaints and background to

encourage a broad discussionencourage a broad discussion

Maj-Britt sees her GP once a year because of hypertension. Last year she had a TIA, with temporary weakness in her right arm.

Maj-Britt´s husband died three years ago. She lives alone and has no children. She is a former office clerk and has never smoked. She consumes one or two glasses of wine at weekends.

Medication: Trombyl® (acetyl salicylic acid) 75 mg once daily, Atenolol 50 mg once daily, Simvastatin 20 mg once daily.



Scenarios develop gradually without exposing all the information at once

The EDIT base-group The EDIT base-group 11stst meeting meeting

1. Reading and understanding the vinjetto

2. Brain-storming on the principles hidden in the theme

Severe pain.. may be pancreatitis or intraabdominal

infection?




infection?

We should brainstorm on different cause of pain in upper part of abdomen





infection?


I heard that acute pancreatitis is the

worst case





infection?


Which are the mechanisms behind

pancreatitis?


worst case





infection?



pancreatitis?


worst case

Obstruction of pancreatic

outflow may be due to alcohol or

gallstone




release of pro-inflammatory mediators

from pancreatic macrophages is the

mechanism


Back to practice! What about radiology – which methods do you suggest CT,

Ultrasonography?


pancreatitis?


worst case to encounter



gallstone

I know Leakage of enzymes into the

pancreatic tissue causes release of pro-inflammatory mediators from pancreatic

macrophages


1. Reading and understanding the vinjetto• Brain-storming on the principles hidden in the theme• Grouping suggested ideas into categories




mechanism


Back to practice! What about radiology – which methods do you suggest CT,

Ultrasonography?


pancreatitis?


worst case to encounter



gallstone

I know Leakage of enzymes into the

pancreatic tissue causes release of pro-inflammatory mediators from pancreatic

macrophages


3. Grouping suggested ideas into categories3. Grouping suggested ideas into categories

Different cause of pain in upper part of abdomenAcute pancreatitis Acute cholecystitis - gallstones

Mechanisms behind pancreatitis?Obstruction of pancreatic outflow may be due to alcohol or gallstone Leakage of enzymes into the pancreatic tissue causes release of pro-inflammatory mediators from pancreatic macrophages

DiagnosisRadiology – which methods do you suggest CT, Ultrasonography?Laboratory tests

To stimulate discussions on a general and detailed level more information is added in a stepwise fashion about:

• diagnostics• treatments, • mechanisms


Elevated P-amylase

Suspected pancreatitis

!Confirmed!

Elevated P-amylase

Suspected pancreatitis

!Confirmed!

Yes!

We should go a little deeper into radiology – and check the links CT,

Ultrasonography!

Time for new brainstorming!!Time for new brainstorming!!

The EDIT base-group The EDIT base-group 1st meeting1st meeting

1. Reading and understanding the vinjetto• Brain-storming on the principles hidden in the theme• Grouping suggested ideas into categories• Producing questions based on each category

• Specifying study goals

• Individual studies• Presenting acquired knowledge – testing general level• Applying revised knowledge on the specific case

The EDIT base-group The EDIT base-group 2nd meeting2nd meeting

1. Reading and understanding the vinjetto• Brain-storming on the principles hidden in the theme• Grouping suggested ideas into categories• Producing questions based on each category

• Specifying study goals

• Individual studies• Presenting acquired knowledge• Applying revised knowledge on the specific case




mechanism

What did you learn about the mechanisms of

pancreatitis and how to prevent development of pancreatic necrosis ?

7. Presenting acquired knowledge




mechanism



7. Presenting acquired knowledge – testing general level

I did a Medline search and I will summarise the main

message in 5 minutes based on a recent review




mechanism



7. Presenting acquired knowledge – testing general level

I did a Medline search and I will summarise the main

message in 5 minutes based on a recent review

OK, I found an algoritm for treatment of pancreatitis with different severities scores on the hospital intranet it is on

your email…..


I have checked why this patient was not

accepted for surgery,

8. Applying revised knowledge on the specific case


I have checked why this patient was not

accepted for surgery,

Fine, and I can summarise the

conservative treatment she successfully responded to

8. Applying revised knowledge on the specific case

Each step & meeting should be evaluated!

EDIT- web scenarios

• Simple, robust technical solutions• Integrated part of undergraduate education

programmes• Scenarios are easy to revise and reuse• Well received by students and teachers• About 600 regular users in medical school• More than 150 teachers involved in scenario

construction

Powerful tool for change• Review scenarios• Review semesters• Review programmes• Use in other contexts• Open source?

EDIT- web scenarios

”Base Group” appliedin Clinical clerkships

• Students are trained to be responsible for their own learning also in the clinical training

Student education ward- first in the world

Student education wards

• In 1996, the first student training-ward in Sweden started in Linköping.

• Several clinical education wards have later started both in Sweden and abroad.

• In Linköping, and later in Norrköping, students at the end of their education in the nursing, occupational therapy, medicine and physiotherapy programmes form inter-professional teams with 5-8 members at orthopaedic wards and recently also at a geriatric ward.


• Two or three teams are in charge of a ward, in alternating turns, and supported by clinical tutors.

• The teams organise and carry through care, rehabilitation and treatment within the expected level of competence.

• The majority of the patients are elderly having complicated medical records apart from their orthopaedic-surgical problems.


• The two-week placement ends with a seminar.

• Reflecting on actual experiences, each team selects a problem, makes a presentation and leads a discussion for 30-45 minutes.

• Finally, they summarise the issue with special attention to differences and similarities between professions, and make conclusions relevant for their professional practice to come

Håkan Hanberger, coordinator clinical education

•EDIT - finalist in the European Academic Software Award (EASA) competition in Switzerland 2004.

•The medical program in Linköping has a top position in the national evaluation and was awarded for excellence in higher education in 2007

Linköping University One university – two cities

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