1. PBL Case Scenario Writing for 2 nd Class students Prepared by Dr. Aminullah Hamkar Chief Department Pathology Kabul Medical University

2. Background PBL program was started in 2006 as a pilot program in the KMU In all semesters only three case scenarios were developed The scenarios’ objectives were not identified All three case scenarios covered narrow areas or only single subject…

3. Background (Cont.) Weak integration of contents in scenarios for all preclinical subjects 1 hour x 2 days for each scenario

4. Goal Improvement of teaching methods in KMU Student Motivation Improvement of education level

5. Objectives Standardization of Scenarios for 2 nd year Medical students Setting Objectives of the Scenarios Timeline for each Scenario Integrated Scenario (Contains all related Preclinical Subjects) Preparation of Tutor guide for each Scenario

6. Standardized Scenario consist Set learning objectives first Have key words Describe clinical situation Stimulate discussion among students Motivate students toward learning

7. Strengths Motivation of our team members for implementation of PBL Strong team Support from KMU Leadership

8. Weaknesses Insufficient experiences in Scenario writing Lack of supportive materials (Guidelines, Textbooks….) Discipline Based Curriculum

9. Methodology Identifying topics for each scenario based on curriculum Based on the objectives preparation of 14 scenarios 14 tutor guide for each scenario Preparation of questions for biweekly PBL Class exam.

10. Sample Case Scenario A 62 year old woman presented with Stridor, due to a neck mass, which was clinically suspicious of Multinodular goiter. The patient was placed on Euthyroid; however the gland continuously enlarged, over the course of three weeks as evidenced by increased Stridor and Dysphagia. She lost a 15 Kg weight loss in the last six months. Additional symptoms included Chronic Fatigue, and occasional Chills. She was a smoker. Thyroid Studies are as follows: Total Thyroxin = 19 ng/dl (Normal Range: 4.5-10.9 ng/dl) TSH = 0.004 IU/dl (Normal Range: 0.4-6) Due to compression of trachea, Total Thyroidectomy was done. The gland measured, 14x12x8cm and weighed 450 grams

11. Sample Case Scenario (Cont.) Key Words – Stridor – Dysphagia – Chronic Fatigue – Chills – Euthyroid – Multinodular goiter Objectives of the Scenario – At the end of analysis of this scenario, the students will be able to explain the following topics: Thyroid gland Anatomy Thyroid gland Histology Physiology of thyroid hormones

12. Thank You Arigatu Guzaimasu