| Among the variety of teaching methods available to medical educators, a promising innovation is the case method. The case method is part of what is often referred to in medical education as "problem-based learning": a case presents written information for students to analyze as they attempt to understand specific problems presented in the case. Case development and writing are essential components of problem-based learning. The case writing process has a major influence on the content and form of cases.;In this dissertation twenty-two case writers at the Harvard Medical School were interviewed, and the data were used to understand how cases were developed and written. The results showed that cases were written about patients, and generally a topic for a case was selected by a group of people who planned the course and selected case writers. The writers chose cases based on their personal and professional experiences. Two types of cases were written: real and hypothetical. Each case had one main theme and red herrings were included in some cases for more advanced students and were generally excluded for beginning students.;For real cases, the writers primarily drew data from their own memory, although they sometimes used physician notes, current references, and medical records of real patients. Most said they could write real cases without any altered data effectively and easily from their memory of their experiences. Cases began with case content as it appeared from their history when the patient had the first symptom related to their disease. Cases were generally short, from three to five pages in length. All the case writers mentioned similar characteristics of good cases. Case writers who had tutored said they thought the experience of having been a tutor allowed them to have a better understanding of the audience and the case use, which in turn affected their case development and writing.;Two recommendations were suggested. First, that case writers in medical education should work as a tutor at least once, or observe a tutorial. Second, cases should be evaluated and revised after their first use and then be repeatedly evaluated at set intervals. |
