1.3 The evolution of teaching materials in psychiatry
Bela R. Turk et al. / Procedia - Social and Behavioral Sciences 186 ( 2015 ) 713 – 725 715
Advancements in neuro-imaging, molecular biology and the genetic disciplines have taken center stage in the
scientific investigation of brain function in mental health and illness. These developments have allowed us greater
insight in the discipline of psychiatry, while simultaneously complicating the teaching process. The didactic
endeavor of any evolving field is a tentative one, especially a realm host to a plethora of divergent sub-specialties,
from biological and molecular psychiatry to psychology, psychoanalysis and every form of psychotherapy.
The colloquially termed “5 year gap” between research paper and clinical practice is well documented, and the
larger gap between research and the textbook is further still. The need to bridge this gap in the rapidly evolving
discipline of psychiatry has been elucidated in the training of future physicians and scientists (Thomas, Pai &
Dawes, 2013). Additionally, as even brief psychiatric educational processes show significant attenuation of medical
students’ stigma towards mental illness (Papish, Kassam, Modgill, Zanussi & Patten, 2013), the imperative of
assessing the quality and modality of learning materials should be of concern.
2. Materials and methods
2.1 Creating a case-based blended-blended learning framework
In order to establish a case-based curriculum, circumstances have to be created that allow workplace-based
teaching. On the one hand, this is challenging for medical schools with high attrition rates and a great number of
students (e.g., the Medical University Vienna), on the other hand this critical dimension offers some advantages: the
documentation of cases is routinely established and may serve as teaching material.
We created a framework for undergraduate medical education in order to provide a structured approach to these
clinical cases. Additionally, we created standardized case templates for relevant interdisciplinary patient data.
The medical student at the medical university of Vienna is exposed to a series of basic chapters in preparation for
her practical clinical experience. We standardized the order of these chapters in our framework and clearly defined
which relevant material may enter each chapter. This basic structure was the backbone for both the e-learning
content and text book: Anatomy and physiology, patho-physiology and disease process, epidemiology and genetics,
presentation and communication, diagnostics and clinical reasoning followed by therapy and prophylaxis.
2.1.1 Textbook
Firstly, Case-relevant declarative knowledge is compiled into a case-based textbook publication, which is created
to work synergistically and prior to the e-learning cases in serving as a knowledge base. The textbook chapters are:
Anatomy and physiology, patho-physiology and disease process, and epidemiology and genetics. The chapter
“patho-physiology and disease process” is designed to overlap, being integrated and present in “presentation and
physical examination” in the e-learning case as well. This crucial synergy aims to foster a close link in creating the
intimate connection between morphology and clinical presentation.
The aim of the case-based textbook is in creating a solid, relevant foundation of declarative knowledge before
training procedural knowledge in clinical reasoning.
2.1.2 e-learning case
Secondly, patient data is transferred via the hospitals i.s.h. med-based Hospital Information System into an
anonymized case for data protection purposes, where it is then automatically imported into the e-learning case
template on our moodle platform. The e-learning chapters are: presentation and communication, physical
examination and instrument tests, and therapy and prophylaxis.
Following that, interactive questions are constructed to train and test learning objectives as well as create
procedural knowledge. The interactive questions focus on networking case data with previously learned textbook
knowledge while training clinical reasoning by putting the content to use. The questions focus on:
x Recognizing and recording symptom patterns and diagnostic red flags
x Clinical reasoning: Understanding modes of operation for creating and arguing diagnostic hypotheses
x Clinical decision-making: making diagnostic and therapeutic consequences.