The Motivational Case as an Integrative Problem-Solving Strategy in Oncology Medical Teaching

ABSTRACT The motivational case, also called a problem situation or case study, is a student-focused learning method that involves problem solving, with the aim of assessing students’ prior knowledge about a presented situation and identifying the learning needs, building new meaning and knowledge, and developing specific self-learning skills. Strategically, it involves the inclusion of social materials (text, audio, printed documents, videos) in the course for analysis and discussion, in order to provide a background context for the theoretical content being taught. It is a very useful tool for teaching basic and preclinical subjects in health care, leading the student through day-to-day situations that they will encounter in their future professional careers. The students’ processes of reflection and discussion of the motivational cases enable a contrast to be made between common sense and academic judgment, which creates motivational movement through the flow of practice and reality to the theoretical content being taught, and the opportunity to generate dilemmas, opinions, comparisons and controversies during the work, mediated by the teacher. Thus, it allows future skills and abilities to be discussed and anticipated, as well as providing new theoretical and practical dimensions, sometimes unforeseen. It is, therefore, an opportunity for the student to create the perspective of practice, while the theoretical content of the subject is being learned. It is a more versatile investigative methodology than PBL (Problem Based Learning) as it can be inserted within a traditional course (Lecture Based Teaching) and is not necessarily the sole teaching strategy. Our aim in this work is to report our experience of the construction, implementation and assessment of two motivational cases designed for fourth year students of the theoretical Oncology course of Botucatu Medical School (Unesp). The motivational cases were built from news media and applied to a class of twenty-seven students, divided into two groups. The first discussion session took place at the start of the course and the second session took place at the end of the course, when the students presented their final work in the form of a seminar. The motivational cases were concluded at the end of the course, through a participatory class on “Cancer Prognosis”, a theme that was common to the two motivational cases. Based on this experience, we conclude that the use of the motivational case as a pedagogical tool gives students a better understanding of the social reality, enabling them to build knowledge networks, and turning them into active subjects of the learning process, without sacrificing the depth and specificity that medical students need to develop.

摘要 激励式案例（motivational case）又称问题情境或案例研究，是一种以学生为中心的学习方法，核心环节为问题解决，旨在评估学生对给定情境的前置知识掌握情况、明确学习需求，帮助其构建全新的意义与知识体系，并培养特定的自主学习技能。从教学策略层面而言，该方法会在课程中纳入文本、音频、印刷文献、视频等社会性素材供分析与讨论，为授课的理论内容提供背景语境。其在医疗健康领域的基础及临床前期学科教学中极具应用价值，可引导学生沉浸式体验未来职业生涯中每日将面临的实际场景。学生对激励式案例的反思与讨论过程，能够实现常识与学术判断的对照，借助实践与现实的脉络将学习动力传导至授课的理论内容中，同时在教师的引导下创造工作过程中产生困境、观点、对比与争议的契机。借此，师生可探讨并预判未来所需的技能与能力，同时拓展有时难以预见的全新理论与实践维度。因此，在学习学科理论内容的同时，激励式案例为学生提供了构建实践视角的机会。相较于基于问题的学习（Problem Based Learning，PBL），该方法的应用场景更为灵活，可嵌入传统的讲授式教学（Lecture Based Teaching）课程中，并非必须作为唯一的教学策略。本研究旨在汇报我们为博图卡图医学院（Unesp）肿瘤学理论课程四年级学生设计的两款激励式案例的构建、实施与评估经验。两款激励式案例取材于新闻媒体，应用于由27名学生组成的班级，并将其分为两组。第一次讨论环节设置在课程伊始，第二次讨论环节则安排在课程尾声，届时学生将以研讨会形式展示最终成果。两款激励式案例均在课程尾声通过一场围绕“癌症预后”的参与式课堂完成收尾，该主题为两款案例的共同核心。基于本次实践经验，我们认为将激励式案例作为教学工具，可帮助学生更好地理解社会现实，助力其构建知识网络，使学生成为学习过程中的主动主体，同时不会牺牲医学生所需培养的知识深度与专业针对性。