Submission ID 78129
| Code | OG-3-2 |
|---|---|
| At the end of this workshop, participants will be able to: | |
| Category | Medical Education |
| Type | Oral |
| Will the presenter be a: | Other |
| Presenter Other | Faculty member |
| Title | Encountering Death in Case Based Learning: an Ethnographic Discourse Analysis |
| Background/Purpose | Case studies are fundamental to medical education. As the primary mechanism through which problem-, case-, and team-based learning occurs they set the foundation for future practice. We explored how death appears in case-based learning during the first two years of undergraduate medical education, by asking: "How is death discursively constructed in formal curriculum?" |
| Methods | We used a critical discourse analysis theoretical frame and ethnographic methods to conduct 31.5 hours of observation, 45 longitudinal interviews with learners (12 students, 4 interviews each), and a critical discourse analysis of a full set of CBL cases (n = 5). This presentation highlights the data identified through the discursive analysis of the cases themselves. |
| Results | We identified five discourses prevalent in CBL cases: 1) death as epilogue; 2) death as end to gradual decline; 3) death as a plot device; 4. death as a cautionary tale; and 5) death as inevitable. With the diagnosis often overtaking the patient as the protagonist, death was often written about as background information, in ways that obscured the human experience of death and dying. |
| Discussion | The way we write and think about cases, including their format, content, and purpose, provides not-so-subtle clues about the types of information medicine takes to be real: fact, evidence, procedure. The discursive construction of death and dying in CBL cases is far from neutral; it permeates our curricular materials in ways that teach becoming-physicians how they should respond to death. We propose the concept of "ontological fidelity" as a way forward. |
| Keyword 1 | case-based learning |
| Keyword 2 | death and dying |
| Keyword 3 | qualitative research |
| Abstract content most relevant to: (check all that apply) | Undergraduate Medical Education |
| Abstract Track - First Choice | Curriculum |
| Curriculum | Case-Based |
| Authors | Anna MacLeod Victoria Luong Paula Cameron Olga Kits Sarah Burm Simon Field Stephen Miller Wendy Stewart Anna MacLeod |
