Learning approaches of medical students in a case-based learning curriculum in pre-clinical year

Objective: To determine the learning approaches of medical students in their pre-clinical years in a case based learning curriculum

Study Design: Descriptive [Quantitative] study

Place and Duration of Study: Army Medical College Rawalpindi Pakistan, from Jan 2017 to Jul 2017

Materials and Methods: Two hundred students from 2nd year MBBS participated in the study by filling a 52 items questionnaire-Approach and study skills inventory for students. Students' scores were measured separately for surface, deep and strategic approaches. Gender difference regarding the preferred approach of students was also found out. Analysis was carried out by using student t-test on Microsoft Excel Sheet

Results: There is a significant difference [p-value <0.05] between the number of surface learners when compared with number of deep and strategic learners. A preference for the deep or strategic approaches has been noticed in both female and male students

Conclusion: The study provided evidence that even in very initial years of medical studies where case based learning has been introduced as a student-centered strategy, it is promoting a deep or strategic learning approach in medical students. These approaches have been considered helpful in making students lifelong learners. It also helps in identifying the surface learners at the same time. Their identification will help and guide teaching faculty and the curriculum planners about the scope of different teaching modalities to be used in the best interest of the students

Severe recurrent oral ulceration secondary to erosive lichen planus

A case of recurrent progressively severe ulceration secondary to erosive lichen planus is reported. The patient developed marked malnutrition as a result of extensive involvement of the oral cavity. In addition to the oral ulcerations, she also had violaceous spots present over her forearm. Treatment administered in view of histopathological report and clinical presentation, resulted in marked improvement in symptoms and weight gain

Cholecysto-hydatid cyst fistula

We present a case of recurrent hydatid cyst liver in a 32-year-old female. Previous surgery was performed 8 years ago elsewhere. Pre-operative assessment at presentation revealed a 110 x 105 mm hydatid cyst in the right lobe of the liver. On exploration, a 5 mm fistulous communication was found between the hydatid cyst and the gallbladder. Patient was subjected to endocystectomy [partial cystectomy], cholecystectomy and closure of the fistula followed by obliteration of the cavity with omentum. Postoperative recovery was uneventful

Retroperitoneal masses: different clinical scenarios

We present two cases of retroperitoneal masses with different presentations and outcomes. The first case was a 22 years old primigravida lady who underwent emergency caesarean section for preterm premature rupture of membranes with breach. On the operating table, a large retroperitoneal mass was identified and the biopsy confirmed Burkitt's lymphoma. Post operative chemotherapy did not have a favourable result and the patient had a fatal outcome. The other case was a 15 years old boy who had a progressively increasing retroperitoneal mass. Exploratory laparotomy revealed a hard, fixed, unresectable tumour extending into the mesentery of the small gut, biopsies were taken which showed tuberculosis. Post operative antituberculosis treatment had a marked response and the tumour disappeared after 6 months