Practice of Oral Case Presentations (OCPs) Teaching Method Utilizing a Playful Learning Approach / 医学教育

Many papers on medical education emphasize the idea that obtaining structure through the practice of Oral Case Presentations (OCPs) is essential and efficient to brush up presentation skills. However, psychological resistance to giving a public presentation is an obstacle in learning OCPs. The aim of this survey is to evaluate the educational effect of our teaching method using a playful learning approach for presentation. This study was conducted by using an anonymous self-administered questionnaire for medical students during their clinical clerkship. One hundred twenty eight students participated in this survey.　Didactics and small group discussions took place during the first week of clerkship, and participants were asked to give presentations about their original theme during the second week. Questionnaires were distributed before and after the end of each session. The results showed that psychological resistance to presentations decreased, positive feelings increased, and students became more aware of the purpose, place, and subject of their presentations. Each parameter statistically improved at each phase. A playful learning approach is effective in teaching presentations, including OCPs.

Spontaneous Low Cerebrospinal Fluid Pressure Headache Initially Misdiagnosed as a Tension-type Headache / General Medicine

We report the case of a 34-year-old man who was initially diagnosed with a tension-type headache after complaining of a headache and nausea. His headache worsened in severity and it was exacerbated on standing in the upright position. The patient was admitted to the hospital on suspicion of spontaneous low cerebrospinal fluid (CSF) pressure headache. Gadolinium-enhanced brain magnetic resonance imaging (MRI) revealed diffuse pachymeningeal enhancement, brain sagging, cerebellar tonsillar herniation, brainstem descent and a subdural hematoma. Successful emergency surgery was undertaken.<br>Spontaneous low CSF pressure headache syndrome is characterized by orthostatic headache, and if such a headache worsens, clinicians should consider a subdural hematoma, a life-threatening complication of this unusual disorder.