Abstract Manager

Oral

OG3-1-3

Accept

I declare I have no actual or potential conflict of interest in relation to this program.

no

General Call (Workshop, Oral Presentation, Poster Presentation)

Oral

Education Innovation

Other

Faculty

yes

Using case-based learning to teach biopsychosocial complexity and adaptive expertise to third-year psychiatry residents

Supporting the recovery of individuals with severe and persistent mental illness (SPMI) requires clinicians to flexibly apply a diverse set of knowledges ranging from neuroscience through psychodynamic theory to issues of stigma and racism. While some of this work is routine, much of it occurs in the grey zones of practice, where empirical evidence offers few directives and clinicians must therefore innovate solutions to complex problems. Theories of adaptive expertise emphasize the need for practitioners to learn to both efficiently apply known solutions to known problems as well as generate novel solutions to novel problems by acquiring both factual (what?) and mechanistic (why?) information in training (Mylopoulos et al. Med Teach 2018). Adaptive expertise thus offers a helpful framework for teaching in the SPMI context.

We developed a series of case-based learning (CBL) tutorials, designed to foster adaptive expertise, to serve as the curriculum for the 3-month PGY3 SPMI block in our residency program. Nine fictional cases were developed in collaboration with 17 content experts and iteratively improved over the past and current academic years with a total of 53 resident participants and 4 tutors. The learning objectives span both medical and non-medical CanMEDS roles. Residents meet weekly in small groups with their tutor, applying prior knowledge to build a tentative understanding of the issues in each case, and, after reading the provided resources, they return the following week to discuss the case again, filling in knowledge gaps. Tutors promote the residents' capabilities as future experts by posing both 'what' and 'why' questions and encouraging them to wrestle with areas of uncertainty and ambiguity.

While there are few examples in the literature of case-based learning in postgraduate medical education, our experience to date suggests that CBL is a highly feasible way of engaging residents in learning about and through complexity, while supporting their development as adaptive experts.

Case-based learning

Adaptive expertise

Complexity

Post Graduate

Teaching and learning

Postgraduate

Yes

Yes

Yes

Yes

Yes