A user’s guide to teaching the C-POP series

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The following section of this supplement to the American Journal of Preventive Medicine contains the eight Case-Based Series in Population-Oriented Prevention (C-POP) modules, seven of which were developed at the State University of New York (SUNY)–Upstate Medical University to enhance the teaching of preventive medicine. Most of the cases begin with a clinical vignette and then progress to a population perspective. The cases are based on actual data provided by the Onondaga County Health Department in Syracuse, New York. In this guide we present practical recommendations on how to teach these cases and information on how the cases can be adapted to suit the needs of existing curricula, learners, and preceptors. The cases were developed for a class size of 20 to 30 students, although they have been taught in classes with fewer than 10 students and, on rare occasion, in classes with 50 or more students. Splitting the class into subgroups is frequently recommended to facilitate more detailed discussions about specific points or to divide time-consuming tasks, such as the calculations in Racial and Ethnic Disparity in Low Birth Weight in Syracuse, New York. After adequate preparation time, the subgroups reconvene to share and discuss their information with the larger group. Just as the cases can be taught to a variety of class sizes, they can be taught to a variety of students at different stages in their medical education. Four of the cases—Racial and Ethnic Disparity in Low Birth Weight in Syracuse, New York, Community Health Assessment, Outbreak of Tuberculosis in a Homeless Men’s Shelter, and A Critical Look at Prevention: Colorectal Cancer Screening—were developed for firstand second-year medical students. Three of the remaining cases—Sexually Transmitted Disease in Adolescents, Bicycle Helmet Effectiveness in Preventing Injury and Death, and Adolescent Suicide Prevention—were developed for third-year medical students. The last case, Maternal Mortality, was developed for residents in preventive medicine. All of the cases can be adapted for learners at any point in the medical school curriculum or resident education. The cases are typically taught in one 2-hour session (except for Racial and Ethnic Disparity in Low Birth Weight in Syracuse, New York, for which two 2-hour sessions are recommended). Section A is given to students in advance. Students are expected to complete this part of the case before class such that they come prepared to engage in group discussion. Extended discussion points are integrated into each of the cases. The facilitator may choose which points to focus on, depending on the time available, the facilitators’ comfort with the subject matter, and the learners’ clinical orientation and experience. For example, a clinician teaching thirdor fourth-year medical students the tuberculosis (TB)/homeless shelter case may devote more time to discussing the complexities of the interactions of human immunodeficiency virus and tuberculosis. A preceptor teaching second-year preventive medicine residents the same case may choose instead to spend more time discussing the nuances of screening procedures in a contact investigation involving a hardto-reach population. Similarly, in the adolescent sexually transmitted disease (STD) case, a preceptor teaching public health students or medical students who are in their preclinical years, may opt to spend less time on the clinical aspects of the case and more time discussing issues of domestic violence or statutory rape. As is evident from these examples, there is considerable content presented in each case. Although all of the objectives of each case can be covered in a 2-hour time frame, it is not feasible to expect to be able to have in-depth discussion of every point. Facilitators must, therefore, choose to conduct focused discussions on selected sections as mentioned earlier, to extend the session time per case, or to teach a case over more than one session. The flexibility of the cases is apparent in the content as well. As noted earlier, most of the cases presented in this supplement are based on actual data from a local health department. Faculty members at other institutions are encouraged to substitute local data if possible. Although this is not necessary, it will likely increase the relevance of the learning situation for the target audience. Because the cases present numerous opportunities for extended discussions and because they have a significant local health department presence, preceptors may initially feel they need to be experts in the field before teaching a particular case. However, as is good practice with small group–discussion cases, the From SUNY–Upstate Medical University, Syracuse, New York Address correspondence and reprint requests to: Lloyd F. Novick, MD, MPH, Preventive Medicine Program, Department of Medicine, State University of New York, Upstate Medical University, 714 Irving Avenue, Syracuse NY 13210. E-mail: PMP@upstate.edu.