Clinical Correlation Workshop Using a Team Approach to Learning: Adrenal Insufficiency
|9350||February 22, 2013||1|
This workshop uses aspects of team-based learning strategies to reinforce the basic science knowledge acquired in lectures and laboratory sessions related to the endocrine system and provides an opportunity for students to apply this knowledge to clinical patient care. Upon completion of this exercise, the student will have reviewed the following: (1) the basic structure and function of the adrenal gland, (2) the specific cell types in the adrenal gland and their function(s), (3) the regulation of synthesis and secretion of the hormones produced by the adrenal gland and (4) the pathophysiology, diagnosis and management of adrenal insufficiency.
Litvin J. Clinical Correlation Workshop Using a Team Approach to Learning: Adrenal Insufficiency. MedEdPORTAL Publications; 2013. Available from: https://www.mededportal.org/adea/publication/9350 http://dx.doi.org/10.15766/mep_2374-8265.9350
Contains time-sensitive information that will likely be inaccurate, obsolete, or irrelevant by June 08, 2015
Upon completion of this exercise, the student will have reviewed the following:
- The basic structure and function of the adrenal gland.
- The specific cell types in the adrenal gland and their function(s).
- The regulation of synthesis and secretion of the hormones produced by the adrenal gland.
- The pathophysiology, diagnosis and management of adrenal insufficiency.
- Adrenal Glands (MeSH), Hormones, Mineralocorticoids, Glucocorticoids, Androgens, Pituitary Gland, Renin-Angiotensin, ACTH, Medulla, Cortex, TBL, Team-based Learning
Endocrinology, Diabetes & Metabolism
- Endocrinology, Diabetes & Metabolism
- Internal Medicine
Interpersonal & Communication Skills
Knowledge for Practice
Team-based Learning (TBL)
- Biochemistry/Cell Biology
- Medical Student
Authors & Co-Authors
Judith Litvin, PhD
Temple University School of Medicine
Effectiveness and Significance
The faculty use the workshop to reinforce information covered in lectures and in the histology laboratory. Concepts in histology, physiology and biochemistry are woven into the workshop. Most importantly, the workshop forces students to think critically about the material and apply their basic science background to the clinical scenario. Students continue their education on professionalism and working together in teams.
In general, the students reported that this was a valuable and educational experience. Specific comments from the post exercise evaluations include:
“Tests my knowledge, by trying to write it on the card and helped me to clarify what I knew and identify areas to study.”
“Workshops are more helpful than lectures because I am forced to explain it to my peers and also gives me an idea of how much I understand the material.”
“I think professor-presentation and discussion after the group discussion is very helpful. I liked how interactive this workshop was.”
The faculty also benefited from these exercises in a number of ways. First, working with faculty members across multiple disciplines helps to build collegial relationships. The exercise allows the basic science faculty to further focus lecture material on clinically relevant aspects of this disease state while allowing the clinician the opportunity to reviews basic science principles. In addition, this successful interdisciplinary workshop has led to other interdisciplinary teaching opportunities.
Data on effectiveness is presented in the manuscript.
Special Implementation Guidelines or Requirements
The case is posted on the Block 4 Blackboard (Bb) site; a web-based repository that allows faculty to upload educational resources for students to access online. The case is posted after the endocrine lecture material is presented in the classroom, approximately 3 days before the workshop; giving student’s ample time to prepare for the in-class exercise. Students are advised to review the assigned readings listed below and gather information from any available resource (text, journal, web-based) that may be of value in helping them review the clinical aspects of the case. At the beginning of the block, students are given ‘tips’ on reliable and educational web sites. They are introduced to WebMD, Clinical Center at the National Institutes of Health, eMedicine/Medscape, Pituitary.org, Mayoclinic etc.
During the workshop students work in teams to address questions while the faculty facilitate discussions and fill gaps in the knowledge base. Faculty should make every effort to avoid lecturing as this exercise is designed to promote team work and critical thinking. Additional details on implementation are found in the manuscript.
This workshop was presented in a basic science course block. This 2 hour workshop took a total of 4 hours to teach. Each faculty group (clinician, biochemist and histologist) delivers the content twice over 4 hours. The Block 4 course director was the driving force behind the project although a number of key faculty participated in the development of the case, objectives and presentation. When developing an interdisciplinary workshop such as this, there needs to be at least one of the faculty charged with moving the process forward and responsible for assuring that timelines are met. For the workshop to work, a significant commitment of faculty time and resources were needed. Six faculty members participated for a total of 24 hours of faculty time (2 of each; clinicians, biochemists and histologists). The clinical faculty will need release time from clinical responsibilities for that ½ day. Logistically, we also had to present the material to a class size of 210 students. We believe that by dividing the class into 4 sections and then further subdividing the students into groups of approximately 6 worked well. Classroom facilities, class size and faculty resources all need to be factored in when a workshop like this is offered.
From our experience with this exercise, it is important to keep on track with time set aside for answering and addressing the various clinical questions. The faculty facilitator should avoid lecturing to the students and allow the students to play an active role in the discussion. In addition, when the teams are working together to answer questions, it is helpful to have the faculty facilitators walk around the room. This serves multiple purposes. By walking around the room, the faculty can observe team interactions and can participate in the conversation helping to clear up any misconceptions or address questions that the students may have. Also, by actively participating with the teams, the faculty can better understand the knowledge base of the students allowing the faculty to bring certain questions or concepts back to the entire group. Having the faculty walk around the classroom also keeps the students actively involved and participating. In addition, the slides below are posted to Blackboard after the workshop for the students to review.
This information is made available under the Creative Commons license.
Publications, Presentations, and/or Citations for this Publication
- Adrenal Glands. In. Goodman HM. Basic Medical Endocrinology. 4th ed. Elsevier. 2009:61-90.
- Endocrine Organs. In Ross MH, Wojciech P. Histology, A Text and Atlas. 6th ed. Lippincott Williams and Wilkins. 2011:740-83.
- Team-Based Learning for Health Professions Education. A Guide to Using Small Groups for Improving Learning. Edited by Larry K. Michaelsen, Dean X. Parmelee, Kathryn K. McMahon, Ruth E. Levine. Foreword by Diane M. Billings. Stylus Publishing.
- Salvatori R. Adrenal Insufficiency. JAMA. 2005;2481-88. http://dx.doi.org/10.1001/jama.294.19.2481
- Torrey SP. Recognition and Management of Adrenal Emergencies. Emerg Med Clin N Am. 2005;23:687-702. http://dx.doi.org/10.1016/j.emc.2005.03.003