Rich-Narrative Case Study for Online PBL in Medical Education

Abstract

Case studies are the basis of a well-known medical education pedagogy called problem-based learning (PBL). Traditional case studies are paper based and contain brief medical facts about a patient's illness. The authors of this article argue for a rich-narrative PBL design, and they report on a pilot project that incorporated such a design. The term "rich narrative" in this article covers two attributes. The first is the development of case studies that are rich in narrative information (often called "thick narrative"). The second component of rich narrative is the presentation of these thick narrative case studies in a media-rich format-that is, video rather than the traditional paper-based cases. Rich-narrative case studies may provide a more robust context for learning than traditional case studies because the rich cases more accurately reflect the complex reality of patient presentation and interaction. They also may help to lay the foundation for the development of a more holistic and patient-centered awareness during the training of health professionals. The use of video as a case presentation tool adds to this robust depiction of the patient as a complete human being rather than a collection of written symptoms. The authors discuss the power of narrative in learning, the significance of rich-narrative in medical education, the steps they took to develop a video-based, rich-narrative case study for online PBL tutorials at Simon Fraser University, and the evaluation of their prototype used in 2008.