In recent meta-analyses of the effectiveness of CME programs in changing physician behavior, several key factors are associated with successful outcomes. These include (1) the assessment of learning needs; (2) interaction among learners with opportunities to practice the behaviors; and (3) sequenced and multifaceted educational activities.1, 2 In general, interactive and mixed (didactic/interactive) educational sessions have the most significant effect on professional practice. There are 2 main types of case studies: (1) fully developed narrative approaches to guide learners through an extended discussion and exploration process; and (2) shorter case presentations that offer critical information at specific points in decision-making. The former is used primarily for social studies and liberal arts and the latter is used widely in medical education. All case-based teaching methods bring value to education and in general are more interesting for the learner than completely didactic material. Cases offer an opportunity to develop learners' analytical and problem-solving skills and allow for the pragmatic application of new knowledge and skills to challenging situations. All of these are higher-level learning skills.3 However, in order for the case discussion to facilitate learning, the case must be relevant to the learner and must contain sufficient information to lead the learner to an appropriate conclusion or result. Clinical case studies are designed to represent actual patient encounters or a series of patient encounters. By presenting clinical issues in the context of a patient's situation, case studies are an effective tool for demonstrating clinical decision-making. Case studies are widely used in teaching diagnostic and management skills to medical students and in CME activities. Case-based teaching is a valuable strategy in all areas of clinical education, and it is particularly valuable for educating practitioners about HIV disease. It is essential for practitioners to be able to individualize care given the complexity and chronic nature of HIV disease, the number of opportunistic infections and related conditions, the range of treatment options for each, and the high pill burden and consistent adherence required for effective anti-HIV therapy. The case example used throughout this guide follows a man with active heroin addiction who has been hospitalized with Pneumocystis carinii pneumonia (PCP; also known as Pneumocystis jiroveci pneumonia). This patient's drug addiction and unstable social and economic circumstances influence the direction of treatment, as often happens in a real clinical setting. Immediate feedback on a treatment decision made in the context of a case study prepares practitioners to work more effectively with patients. References| 1. | | Mazmanian PE, Davis DA. Continuing medical education and the physician as learner: guide to the evidence. JAMA. 2002;288:1057-1060. |  | | 2. | | Davis D, O'Brien MA, Freemantle N, Wolf FM, Mazmanian P, Taylor-Vaisey A. Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA. 1999;282:867-874. | | | 3. | | Bloom BS, Engelhart MD, Furst EJ, Hill WH, Krathwohl DR. Taxonomy of Educational Objectives: The Classification of Educational Goals. Handbook 1: The Cognitive Domain. New York: David McKay; 1956. | |
| Tip Box 1. Tips for Presenting Effective Case Study Slide Presentations |
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 | In general, allow 1 minute per slide (eg, for a 30-minute presentation, use fewer than 30 slides) | | | Plan strategic pauses to allow for discussion and audience voting; use "pause" slide(s) to remind yourself | | | Be prepared to expand the case discussion by suggesting a new development or a different situation | |
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Next: Six Steps for Creating an Effective Case Study: Step 1. Identify the Learners and Write Educational Objectives |
