Problem Based Learning
edicsProblem based learning (PBL) is a popular method of learning, currently used by most health professional courses in the UK.
The aim of PBL is for you to read through a complex and broad series of information, to identify areas of interest and areas you would like to explore further, in order to further your knowledge of specific topics, through self-directed learning.
The questions our mentors have provided offer ideas of topics to explore and are written in three streams for aspiring medics, dentists and veterinarians; focus on all three or simply what interests you!
Skin Conditions
THE Dental PBL Case
Jim is a 25 year old mechanic. He is a smoker with no allergies and is not on any medication. He has come for an appointment this afternoon, because he has a lump inside his mouth. He first noticed the lump whilst having his coffee with crisps this morning.
The image above is what you see during your examination.
Jim comes back a few days later and this is what you see. Should you be worried?
Questions:
- Describe what you can see.
- Based on the limited history you have on this patient, what could have caused this?
- How is the skin in the mouth different from other parts of the body?
- How are blisters formed in skin?
- What can be other causes of blood blisters in the mouth?
- How do you treat blisters in the mouth?
Jim comes back a few days later and this is what you see. Should you be worried?
THE Medic PBL Case
While she was cooking pasta for her family, she knocked the pot on the stove, which fell and tipped boiling water onto her exposed leg. In a huge amount of pain, she runs upstairs to the bath to run her leg under cool water but gets concerned when it begins to blister.
She calls the ambulance and is admitted to the emergency department.
When she arrives, the doctors carry out an A to E assessment. They note that Deborah has second-degree burns covering the whole of the front of her leg and some of the back. After considering the rule of nines, the junior doctor decides to start her on some IV fluids. Another doctor, realising Deborah’s pain, starts her on some IV morphine.
When Deborah is more comfortable, the doctors debride the burn site and cover it with antimicrobial salve and a dressing.
Deborah is kept in for observation and fluids for a few days but is later discharged home with more dressings, salve, and some advice on wound care.
Questions
- What are the different functions of skin?
- What is the first aid for a burn, and why do we do this?
- What are the different layers of skin, and how does this change over the body?
- How do you assess burn severity in terms of depth and distribution?
- What is the rule of nines, and how is this adapted for children?
- Why did the doctors put antimicrobial salve on the burn and start IV fluids?
- Describe the three zones of a severe burn.
- In a severe burn, what are the possible systemic effects on the body?
- Why might severe burns need to be treated surgically?
- What else might you need to consider if this was a child with a burn?
Appendix 1
THE Vet PBL Case
Case 1:
You are a small animal vet presented with a cat who is ‘constantly itching her skin’. The cat is a 9yo, FN Domestic Short Hair called Gypsy and is mainly outdoors. The owner has treated her with some herbal flea treatment drops she bought online. The image Appendix 1 is what her skin looks like during the consultation.
Case 2:
You are an ambulatory equine vet and are called to see a horse with ‘twitchy’ legs see Appendix 2. It is December and Daisy, the 13yo Welsh Cob is out on pasture in hopes to lose some condition she has gained over summer. You notice patches of the field are water logged and it has been particularly wet this week. The owner is concerned about Daisy’s pastern area.
Case 3:
You have been called to look at a young Angus stirk who has facial skin lesions. The farmer is concerned about the lesions and if they may spread amongst the heard. Appendix 3 is a picture of the cow in question
- Name 3 licensed medications for flea treatment in cats
- What condition, mainly seen in cats, could be causing this skin lesion?
- What treatment options are there for this cat?
- Do we need to consider the environment this cat lives in when creating a treatment plan?
Case 2:
- Label the above diagram of the equine forelimb and hindlimb.
- What is Mud-fever and why does this fit with Daisy’s presentation?
- What are some of the main risk factors for developing mud fever in horses?
- What are the treatment options available for Daisy?
- Do you have any tips for the owner to prevent Daisy suffering from this in future?
Case 3:
- What diagnostic tests could you perform to determine what is causing these lesions?
- What external parasites affect cattle?
- What type of worm is ringworm?
- Should the farmer be concerned about spread amongst the heard? What risk factors should you consider when managing spread?
- What treatment options are available for this animal?
Apendix 1
Apendix 2
Apendix 3
Answers will be covered in the Virtual Veterinary Society Meeting in October 2021.
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