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Making a Case for Case Studies

In Peter D. Kramer’s New York Times piece published in the
‘Couch’ section on October 18, 2014 (
Doctors Need Stories
) he affirms the experience of learners, educators, and
researchers in his arguments that a case vignette can provide a kind of
instruction that cannot be duplicated by data collection alone. While we do
still need evidence based material to assure safety and efficacy of treatments,
the case study offers contextual material that makes the evidence come to life.

As a Clinical Ethicist each clinical encounter is rich with
substantive information that is part of an individual or family story
intersecting with the healthcare setting. When invited to provide input,
support, or recommendations in any given case, the most informative elements of
any case are the story of the patient. What was before, what is now, and what
the future may require is different for each patient, and I am often awed by
the ‘before.’ The contextual landscape of each story is often where we come to
understand the psychosocial factors that weigh heavily in how a patient,
family, or community interacts with the healthcare community. Hard data is not
as useful as hearing the story that belongs to the patient.

Medical students must learn the complex labyrinth of
physician roles, hierarchies, and politics while learning to deliver good care
to patients. It is an exhausting, fascinating, and at times a discouraging
process that students must somehow find a way to navigate. Using case studies
to start the conversations about what learning medicine is like has been an
invaluable teaching tool at our institution. With an open ended assignment to
write up a brief case summary that illustrates an ethical dilemma or otherwise
relevant learning moment, students bring it all to the table. As instructors,
we have stood in awe of what we, too, become witnesses of in these short
stories. Rather than having the goal of teaching medicine per se, the case
discussion sessions are a kind of debriefing. The openers, though, remain the
cases and without this format and a forum to discuss these often intimate
experiences I believe the learning, for all of us, would be less useful and
less powerful.

Please see, too, the letters to the editor in response to
the aforementioned article at:
York Times Opinion 10-27-2014

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our website.

This entry was posted in Clinical Ethics, Health Care and tagged , . Posted by Hayley Dittus-Doria. Bookmark the permalink.

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