optimal methods of teaching clinical pathology laboratory medicine to medical students

1. Optimal Methods of Teaching Clinical Pathology (Laboratory Medicine) to Medical Students Roger W. Geiss, M.D. University of Illinois College of Medicine at Peoria

2. Proviso IMHO

3. Problems in the teaching of clinical pathology Lack of a standard textbook Difficult topic for lecture not as amendable to pictorial illustration as is anatomic pathology Concerns that material learned may be replaced in the clinical years by less reliable information Others (?)

4. Issues in the teaching of clinical pathology WHAT to teach WHEN to teach it HOW to teach it WHO should teach it

5. Issues in the teaching of clinical pathology WHAT to teach principles of laboratory testing analytic and statistical concepts specimen processing and handling proper use of laboratory tests specific laboratory tests indications interpretation limitations

6. Issues in the teaching of clinical pathology WHEN to teach it A. preclinical years B. clinical years C. both D. neither

7. Issues in the teaching of clinical pathology WHEN to teach it A. preclinical years B. clinical years C. both

8. Issues in the teaching of clinical pathology WHEN to teach it preclinical years as part of pathology course as part of organ segments clinical years M3 in conjunction with services/patients specific sessions on lab medicine M4 rotation elective both preclinical years: teach proper utilization of laboratory tests clinical years: reinforce proper utilization of laboratory tests

9. Issues in the teaching of clinical pathology HOW to teach it (preclinical) course structure separate clinical pathology course/module integration into general and systemic pathology into systems-based curriculum textbook mode of instruction OBJECTIVES

10. Clinical pathology course/module Advantages students in lab medicine �mode� Disadvantages CP of a disease/system detached from AP and other aspects (�disintegration�) Conclusion students must incorporate lab medicine into clinical decision making CP best taught in conjunction with other aspects of disease/system

11. Issues in the teaching of clinical pathology HOW to teach it (preclinical) course structure textbook mode of instruction OBJECTIVES

12. Textbooks for clinical pathology Standard pathology texts Robbins & Cotran Rubin�s Designated clinical pathology texts designed for medical students not an encyclopedic source Systemic texts Schmaier & Petruzzelli, Hematology for Medical Students Greenspan & Gardner, Basic & Clinical Endocrinology Standard medical texts Harrison�s Cecil

13. Standard pathology textbooks for teaching clinical pathology Advantages single text for pathology course/pathology portion of organ segments close correlation with other aspects of disease/system Disadvantages emphasis is on anatomic pathology variable coverage of clinical pathology topics stronger hematopathology endocrinology weaker general principles of laboratory testing renal pathology/urinalysis minimal coverage of blood banking/transfusion medicine Conclusion: supplementation needed textbooks handouts

14. Systemic and standard medical textbooks for teaching clinical pathology Advantages texts used in other courses (ICM, organ systems) close correlation with other aspects of disease/system Disadvantages variable coverage of clinical pathology topics clinician-authored pathologist-authored frequently no coverage of general aspects of laboratory testing Conclusions choose carefully may require supplementation

15. Designated clinical pathology textbooks Dufour Widmann�s McKenna Laposata Mais

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17. Issues in the teaching of clinical pathology HOW to teach it course structure textbook mode of instruction lecture: principles of laboratory medicine small group: laboratory tests case-based problem-based laboratory independent/self-study: e.g., computer-based other OBJECTIVES (principles, tests) separate CP objectives subset of integrated objectives

18. Objectives For each session lecture small group laboratory independent study reading assignment For each unit subject area within general pathology organ system

19. ObjectivesHave them!

20. Issues in the teaching of clinical pathology Who should teach pathologists faculty residents clinicians good practitioners of laboratory medicine supervision by pathologists formal informal teaching assistants (TAs): e.g., M3, M4 students need to be well-trained less practical than in AP-based sessions

21. Summary and Conclusions WHAT to teach: clinical pathology (laboratory medicine) WHEN to teach it: throughout curriculum WHO should teach it: those best equipped HOW to teach it text (+supplemented by additional materials) lecture format works for learning general principles case study format better for learning utilization of individual tests OBJECTIVES

22. References Dufour, Clinical Use of Laboratory Data: A Practical Guide, Lippincott Williams & Wilkins, 1998. Goldman & Ausiello, Cecil Textbook of Medicine (22nd ed.), Saunders, 2004. Greenspan & Gardner, Basic & Clinical Endocrinology (7th ed.), McGraw-Hill, 2004. Kasper, et. al., Harrison�s Principles of Internal Medicine (16th ed.), McGraw-Hill, 2005. Kumar, Abbas, & Fausto, Robbins & Cotran Pathologic Basis of Disease (7th ed.), Elsevier Saunders, 2005 Laposata, Laboratory Medicine: Clinical Pathology in the Practice of Medicine, ASCP Press, 2002. Mais, Quick Compendium of Clinical Pathology, ASCP Press, 2005. McKenna & Keffer, The Handbook of Clinical Pathology (2nd ed.), ASCP Press, 2000. Rubin, et. al., Rubin�s Pathology: Clinicopathologic Foundations of Medicine (4th. ed.), Lippincott Williams & Wilkins, 2005 Sacher & McPherson, Widmann�s Clinical Interpretation of Laboratory Tests (11th ed.), F.A. Davis, 2000. Schmaier & Petruzzelli, Hematology for Medical Students, Lippincott Williams & Wilkins, 2003.

23. Thanks for your attentionQuestions? Comments?