3.5 Case study no. 3: Pictures in your mind

From our own experience in learning situations we know how special and important it can be to imagine something. Why then don’t we (as designers and teachers) give more attention to the use of the student’s imagination in a teaching-learning situation? Imagination can be a very powerful tool for learning. Below is a description of an S-R event in which didactic use is being deliberately made of a doctor’s imagination. It is one event in a network of events in a course on dermatology. The REO for the course is a phrase from a book entitled Read the Skin (Merck, 1979). It sprang out at me from a page of the book as I educated myself enough on the subject of dermatology to understand the needs of the learners, who were general practitioners. The phrase is: ‘Recognize, assess significance for the patient, initiate appropriate treatment’. It contains the quintessence of good medical practice in the area of dermatology, and became the leitmotiv that runs through the network of events in the course.

The S-R event described below is S-R event number 4 in the course. It is an exercise in a self-study text (Earl and Luttik, 1983) which was recommended for study prior to group discussions on dermatological cases which the participants had met in their own practices. The S-R event is taken verbatim from the self-study text.

Pictures in your mind

Conjure up in your mind a mental picture of the three skin problems named below. As you think about each, formulate an answer to three questions:

  1. How would you recognize the condition, ie what are its characteristics?
  2. What could its significance be for the patient — clinically, psychologically and socially?
  3. What treatment, if any, would you be thinking about?

In each case assume that the patient’s decision to ask or come for help is a wise one. The condition is already well advanced.

  • Problem 1: Acne vulgaris (15-year-old girl)
  • Problem 2: ‘Housewife’s hands’ (a busy, 34-year-old mother with three children under five years old)
  • Problem 3: Erysipelas (45-year-old teacher. His wife is so alarmed at his appearance that she asks you to make a house call as quickly as possible)

Make short notes for each problem under the appropriate headings.

P.1. Acne Vulgaris. RECOGNITION: ……………………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………………………………………………………………………….

SIGNIFICANCE FOR PATIENT:…………………………………………………………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………………………………………………………………………………………

TREATMENT : …………………………………………………………………………………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………………………………………………………………………..

(Note: Short notes are also invited in this format for Problem 2: ‘Housewife’s Hands’, and Problem 3: Erysipelas.)

Critical feedback information is provided for the learner in the form of notes on these skin ‘disorders and their recognition, significance and treatment. These have been put together by a general practitioner who knows the work situation of the learners, and a dermatologist with specialized knowledge.

Can you recognize how active responding (criterion 1), meaningful responding (criterion 2), assignment of control of the learning process to the reader (criterion 3), outwitting constraints relating to individual states of knowledge (criterion 4), provision of feedback (criterion 5) and shaping of the form and content of the event to the needs of a specific learner population (criterion 8), are cared for in the design of this 8-11 event? If necessary, further diseases could also be added for imaging’ and comment in this exercise. It could be extended with relative ease (criterion 7). Critical use of media (criterion 6) can be recognized in the use of pictures which the learner must conjure up in her or his own mind.

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