All About Myocardial Infarction: A Paradigm for Integrated Course Delivery

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Guiding Medical Student Behavior to become Self-directed Learners
By Camille DiLullo and Richard M. Kriebel

Curricula have been revised to deliver integrated content rather than content in isolated disciplines

Online clinical case tutorials were developed that incorporated content from multiple disciplines

Both clinicians and basis scientists participated in case construction which brought to light that these two groups of educators had to develop a common language.

Tutorial objectives

  1. Identify basic science information relevant to patient data
  2. Guide the development of self-directed learning (focus on PBL)
  3. Demonstrate core competencies in clinical practice
  4. Provide visual examples of patient/physician interactions for reference
  5. Demonstrate the use of manipulation in patient assessment
  6. Expose users to licensure exam style questions

Interrogatory Design

Guiding students to Analyze and Integrate

  • What is the cause of this symptom?
  • What information have you gathered from this test?
  • What is the reason for this physical response?

Interrogatories posed for an example MI case

  • Could an MI be the result of a birth defect?
  • What would be indicated if the back muscles in the thoracic region were in spasm?
  • How would you explain the prognosis for repair of the damaged cardiac tissue?

Pilot study data on usage indicated that one third of students accessed the self-directed tutorials.

  • Students that accessed the tutorials were not necessarily those who performed above average in the course.
  • Highest percent of student usage predominantly correlated around two peaks in the final course grades - 75% and 90%.

Key points

  • Most integrated result if all content stakeholders contribute to the process
  • Focus the content and language to the relevant level of training
  • Case constructs should not be window dressing even at the most novice stage of learning
  • Interrogatories should require an algebraic-like integration of multifaceted material rather than a rote regurgitation of information
  • Provide support for further independent exploration


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