Lesson Plan #4 Title Performance Objective: Given 3

Lesson Plan #4 Title: The Hippocratic Oath

Performance Objective: Given 3 problem solving strategies/approaches and a case

study, students will use problem solving sub-skills to create a presentation and

accompanying justification of the group selection of the best strategy to apply to

the patient in the case study, scoring a minimum of 3 on each evaluated area of the

given rubric.

Resources or Materials Needed:

- 15 case studies

- 15 copies of EACH problem solving strategy

- 6 copies of the presentation evaluation rubric (3 complete copies for the teacher, 1

copy per group)

- 3 copies of each character and role description

- white board/chalk board (SmartBoard if preferred)

- 15 follow-through activity rubrics

- 15 white lab coats (optional)

Time: 45 minutes

Step 1: Pre-Instructional Activities:

1. Students will enter to find 3 stations. Each student will find their assigned seat

at 1 of the 3 stations with their lab coat (optional), 3 printed problem solving

strategies, a case study and copy of the evaluation rubric on their desk. Each

student’s name will be on a paper with the typed name of the House M.D.

character they will be playing and their group role assignment, with a definition

of their duties. (Evaluator - Dr. House, Scribe - Dr. Cameron, Initiator/Leader -

Dr. Chase, Researcher - Dr. “Thirteen”, Elaborator - Dr. Foreman - use role

assignments for differentiation/ modification as needed)

2. The board will read

1. “Internship Day 4 - The Hippocratic Oath”

2. “Bell Work (15 Minutes) -

1. Quickly summarize the case study given.

2. Review the problem solving strategies provided.

3. Assuming your role in the group, analyze and select the most appropriate

strategy. Be prepared to justify your selection.

4. Be prepared to present your selection to your “colleagues.”

5. P.S. Every group member will participate! See the rubric for your

individual questions.

Step 2: Content Presentation:

1. When faced with a problem, there is almost always more than one way to solve it

(Unless its algebra… then, do what the teacher says!). Many times, we can use

our peers or “colleagues” to help us consider different approaches. As you can

imagine, different approaches and strategies can lead us to very different

answers. Sometimes, like in yesterdays lesson, thinking outside the box can

expose new solutions. Other times, problems need to be addressed in a clearly

defined and systematic way.

2. Doctors have to choose which approach is the best on a patient-by-patient basis.

If they are right, the patient has a favorable prognosis (outcome). If they choose

incorrectly, it can lead to devastating prognoses and even death. In order to

fulfill the hippocratic oath, they must do no harm. That includes choosing the

right diagnostic approach to ensure that they help, not hurt, their patient.

3. As a group, you will present the problem solving approach that you selected was

best suited to solve this patients problem. Refer to your rubric BEFORE your

presentation to know what you will be graded on. Although this is a group

activity, you will be graded as individuals. Remember to use appropriate medical

terminology where needed and be prepared to justify your answers.

Step 3: Learner Participation:

1. Call each group up to present their selection and justification one at a time. Ask

them to introduce themselves as the character they were assigned. (This helps

their “colleagues” know what role they played and the teacher to know if they

participated in the group activity as they should have.)

2. Each presentation should include: (10 minutes per group maximum)

1. Dr. Cameron (Scribe) - Of the 3 provided approaches, which was eliminated

first and why? What process did the group go through and what criteria was

used in order to pair it down? Were the criteria effective?

2. Dr. “Thirteen” (Researcher) - Of the 2 strategies left, were these researched

based approaches or a unique approaches based on individual patient case?

Which did your group think was more appropriate?

3. Dr. Chase (Initiator) - What was your final selection and how did you arrive at

that decision? Provide details about your group interaction that helped you all

in your selection.

4. Dr. Foreman (Elaborator) - Using specifics from the case study for justification,

how did the information provided make the selected approach the best fit?

Were any “outside” (not in the given problem solving approaches) ideas or

criteria used in the groups decision making process?

5. Dr. House (Evaluator) - Did your group conclude that this approach for solving

the medical problem was in compliance with the “do no harm” of the

hippocratic oath? Would your patient’s prognosis have been different if you

had selected another strategy? Was this strategy just the lesser of the evils

you had to choose from or was it in fact the best fit?

Step 4: Assessment:

Formative assessment of this objective will be based on teacher observation and

student-teacher interaction. By moving about the room, listening to group discussion

and listening to student questions (answering as few as possible, unless about the

directions) will provide the instructor with valuable information about student

readiness and mastery. The summative assessment will be in the form of a rubric-

graded (see appendix D) presentation and homework activity (optional). The questions

for each group member, not only ensures their active participation, but also requires

that they offer justification for part of the selection process, allowing students to

show mastery of selection by justifiable means on an individual bases.

Step 5: Follow-Through Activities:

Students will be assigned a reflection essay on their groups decision making process.

It should include an opportunity for students to express their attitude toward the

group activity, if they agreed with the groups decision, what if any modifications

should be applied to the selected strategy and justification for another selection if

they were to make a different choice. The rubric should be provided to students to

clarify instructions and ensure all elements to individually demonstrate mastery, for

the entire process, are present.

Lesson 4 Case Study

Case 4: Just a Bruise?Author: Adam L. Hartman, MDPreceptor: Anne M. Comi, MDDISCLOSURESNovember 21, 2003

IntroductionA 20-month-old girl presents to the emergency department after falling from her couch, hitting her head on a coffee table, and then becoming sleepy. Her parents deny any history of epistaxis, hematuria, hematochezia, or melena.

They witnessed no seizure activity and state that she is not a particularly clumsy child.

The family history is significant for a paternal aunt who underwent surgery to "remove some bleeding around her brain" and a paternal grandmother who suffered a hemorrhagic stroke at the age of 35 years. A choroid plexus cyst had been noted in the child in utero, and the mother's pregnancy, labor, and delivery were significant for borderline hypertension. The patient was born at 41 weeks by induced vaginal delivery with a birthweight of 4290 g and Apgar scores of 9 at 1 minute and 10 at 5 minutes. Her development has been normal.

On examination, the child was alert and very active, and all growth parameters were noted to be normal. The findings of her general exam were unremarkable. Neither cutaneous vascular skin lesions nor organomegaly was found. Her neurologic exam revealed normal cranial nerves, motor function, reflexes, coordination, and gait.The child's complete blood cell count and prothrombin and partial thromboplastin times were normal for her age.

javascript:showModal('authordisclosures');

P R O B L E M S O LV I N G S T R AT E GY 1

Scientific Method1. Identify the Problem2. Form a Hypothesis3. Test the Hypothesis4. Analyze Data5. Communicate Results


KWL Chart


Creative Approach1. Recognize/Identify Problem2. Get the Facts - What exactly happened?3. Explore What Happened and How it Connects with Your Prior Knowledge4. Brainstorm Possible Hypotheses (more than 1)5. What Do You Need to Prove Your Hypothesis Right?

Know Want/Need To Know Learned

What information were you given?

What information do you need or want to know?

What conclusion did that information lead you to?

Student Name:__________________________________________

Role: Dr. Cameron - ScribeCharacteristics: Documenting the problem solving selection process. Detailing the group’s sequence in arriving at conclusions.

Questions You Will Be Asked:1.Of the 3 provided approaches, which was eliminated first and why? 2. What process did the group go through and what criteria was used in order to pair it down? Were the criteria effective?

………………………………………………………………………………………………………………………………..

Student Name:__________________________________________

Role: Dr. “Thirteen” - ResearcherCharacteristics: Responsible for identifying research based problem solving approaches vs. creative approaches. Responsible for giving a detailed account of the group decision and justification for research based vs. creative selection.

Questions You Will Be Asked: 1.Of the 2 strategies left, were those researched based or unique approaches based on individual patient case? 2.Which did your group think was more effective?

Student Name:___________________________________________

Role: Dr. Chase - InitiatorCharacteristics: Responsible for initiating group conversation. Responsible for contributing and encouraging idea contributions from your group members.

Questions You Will Be Asked:1.What was your final selection and how did you arrive at that decision?2.Provide details about your group interaction that helped you all in your selection.

……………………………………………………………………………………………………………………………

Student Name:___________________________________________

Role: Dr. Foreman - ElaboratorCharacteristics: Responsible for providing justification for group decisions and decision making processes.

Questions You Will Be Asked:1.Using specifics from the case study for justification, how did the information provided make the selected approach the best fit?2.Were any “outside” (not given in the problem solving approaches) ideas or criteria used in the group’s decision making process?

Student Name:___________________________________________

Role: Dr. House - EvaluatorCharacteristics: Responsible for critically analyzing the efficiency and outcome of the group selection process. Offer insight into what other factors contributed and possible modifications to the problem solving selection process.

Questions You Will Be Asked:

1. Did your group conclude that this approach for solving the medical problem was in compliance with the “do no harm” of the hippocratic oath?

3. Would your patient’s prognosis have been different if your group had selected another strategy?

4. Was this strategy just the lesser of the evils you had to choose from or was it, in fact, the best fit?

Lesson 4 - The Hippocratic Oath - Group Presentation Rubric

Objective: Given 3 problem solving strategies/approaches and a case study, students will use problem solving sub-skills to create a presentation and accompanying justification of the group selection of the best strategy to apply to the patient in the case study, scoring a minimum of 3 on each evaluated area of the given rubric.

Group Feedback:

Lesson 4 - The Hippocratic Oath - Group Presentation Rubric

Group #: Presentation Time:

Group Members

1 2 3 4 5

1. Student Name:

Role

Dr. House - Evaluator Dr. Cameron - Scribe Dr. Chase - Evaluator

Dr. “Thirteen” - Researcher Dr. Foreman - Elaborator

Area of Evaluation 1. Not Evident 2. Approaching Competency 3. Competent

1. Of the 3 provided approaches, which was eliminated first?

Student response did not include an answer for this question and/or provided an inaccurate representation of the group’s decision.

N/A

Student response included an accurate representation of the

group’s primary elimination.

What process did the group go through and what criteria was used in order to pair it down?

Student response did not include and/or

contained 1 or fewer steps of the group process used to

eliminate one approach.

Student response included a 2-3 steps of the group process used

to eliminate one approach.

Student response included a

comprehensive account of 4 or more steps of

the group process used to eliminate one

approach.

3. Were the criteria effective? Please justify.

Student response did not include an answer

for this question and/or 1 of fewer justifications

for criteria effectiveness.

Student response included a response to effectiveness of criteria

and included 2-3 justifications for criteria effectiveness. (answer

lacked confidence)

Student response included a well thought

out answer to effectiveness of criteria

and 3 or more comprehensive

justifications for criterial effectiveness.

4. Group Participation

Student did not participate and/or did

not positively contribute to the group process.

Student was attentive to group activity but

contributed 2 or fewer ideas and/or was unsure of group

process.

Student was attentive to group activity,

positively influenced group process and

contributed 3 or more ideas.

6. Presentation Skills

Student presentation did not include

appropriate 2 or more of the presentation skills including preparedness,

appropriate speaking voice, eye contact and professional behavior.

Student presentation included 3 of the presentation skills

including preparedness, appropriate speaking

voice, eye contact and professional behavior.

Student presentation included EACH of the

presentation skills including preparedness,


Feedback:

2. Student Name:

Role




1. Of the 2 strategies left, were these research based approaches or

unique approaches based on the individual patient

case.

Student response did not include an answer for this question and/or did not

provide a research based justification for this

determination.

Student response included an accurate

answer to the question but did not offer sufficient

research used for the justification for their

determination.

Student response included an accurate and comprehensive answer to

the question along with well researched

justification for their determination.

2. Which did your group think was more

appropriate and why?

Student response did not include an answer for this

question, inaccurately represented the group consensus and/or 1 or fewer justifications for groups determination

process..


group consensus and 2-3 justifications that aided in the groups determination

process..


group consensus and 4 or more justifications that

aided in the groups determination process.


Student did not participate and/or did not

positively contribute to the group process.


contributed 2 or fewer ideas and/or was unsure

of group process.

Student was attentive to group activity, positively

influenced group process and contributed 3 or more

ideas.


Student presentation did not include appropriate 2

or more of the presentation skills



Student presentation included 3 of the






Feedback:

3. Student Name:

Role




1. What was your groups final selection?

Student response did not included an answer to this question or inaccurately represented the group’s

final selection of problem solving strategy.

N/A


group’s final selection of problem solving strategy.

2. How did you arrive at that decision?

Student response did not include an answer to this

question and/or 1 or fewer steps of the

process the group used to make a final selection for

a problem solving strategy.

Student response included 2-3 steps and

moderate level of detail of the process the group used to make a final

selection for a problem solving strategy.

Student response included 4 or more

detailed steps the group used to make a final

selection for a problem solving strategy.

3. Provide details about your group interaction

that helped you all in your selection.

Student response included 1 or fewer

details of how group interaction assisted in the determination of the final problem solving strategy

selection.

Student response included 2-3 details of how group interaction

assisted in the determination of the final problem solving strategy

selection.

Student response included 4 or more details of how group interaction

assisted in the determination of the final problem solving strategy

selection.

Group Participation





of group process.



ideas.

Presentation Skills











Feedback:

4. Student Name:

Role




1.Using specifics from the case study for

justification, how did the information provided make the selected

approach the best fit?

Student response included 1 or fewer

ACCURATE details from the information found in

the case study that was a key determining factor in

selecting the best problem solving strategy and/or did not provide a

response to this question.

Student response included 2-3 ACCURATE

details from the information found in the

case study that was a key determining factor in

selecting the best problem solving strategy.

Student response included 4 or more

ACCURATE details from the information found in

the case study that was a key determining factor in

selecting the best problem solving strategy.

2. Were any “outside” (not in the given problem

solving approaches) ideas or criteria used in the

groups decision making process?


question and/or inaccurately represented the inclusion of outside ideas or criteria in the

decision making process of the group.

Student response included a an incomplete representation of outside ideas or criteria and/or an

apparent lack of group decision making process.

Student response included a comprehensive and accurate inclusion of

all outside ideas or criteria used in the group

decision making process.






of group process.



ideas.












Feedback:

5. Student Name:

Role




1. Did your group conclude that this

approach for solving the medical problem was in compliance with the “do

no harm” of the hippocratic oath?


question and/or presented an inaccurate conclusion of the groups

determination of compliance with the

hippocratic oath.

N/A

Student response included an accurate representation of the groups conclusion of compliance with the

hippocratic oath.

2. Would your patient’s prognosis have been different if you had selected another

strategy?

Student response did not include an answer for this question and/or included 1 or fewer hypotheses of

how the patient’s prognosis would have

been effected had another problem solving

strategy been used.

Student response included 2 reasonable hypotheses of how the

patient’s prognosis would have been effected had another problem solving

strategy been used.

Student response included a logical

discussion of 3 or more reasonable hypotheses of

how the patient’s prognosis would have

been effected had another problem solving strategy had been used.

3. Was this strategy just the lesser of the evils you

had to choose from or was it, in fact, the best fit for this specific problem?

Student response did not included an answer to this

question.

Student response included a single yes/no answer for this question

but did not include justification for their

conclusion.

Student response included a logical and

comprehensive discussion to answer the

question along with a justification for their

conclusion.

4. Group Presentation





of group process.



ideas.






Student presentation included 3 of the presentation skills






Feedback:

Documents

Lesson Plan #4 Title Performance Objective: Given 3