Reviewer: Susan Skaff Hagen, MD, MSPH, MME (Boulder Valley Surgery)
Description: This unique book uses a problem-based learning approach to present various medical and surgical patient scenarios that medical students will encounter on the wards or in the clinic. The book melds together the many intricacies of medicine in a multidisciplinary format.
Purpose: The introduction by the editors states that this book is designed to "bring out important problems and issues, and to aid in the process of self-assessment." The goal is in line with the concept of teaching medical students the art of life-long learning. The emphasis throughout is on providing readers with a self-directed approach to a broad selection of clinical cases as well as teaching points. Each scenario guides readers in a logical manner, similar to how a case would be worked up in the hospital or in the clinic.
Audience: The book is clearly written for medical students or for those doing their junior clerkship rotations. It is not intended to be comprehensive, but rather a review for self-assessment or a stepping stone for continued self-directed learning. It is clearly written for students in the U.K., which could prove confusing to U.S. students as some laboratory units and terminology differ between the countries. The authors include consultants, attending physicians, house officers, and medical students. The cases are all based on real patients and written in a conversational tone, which makes them easy to read.
Features: The 30 case scenarios are based on common medical and surgical problems. Each chapter starts with a scenario followed by open-ended questions prompting readers to think about the answers or to write in the space provided, using the book as a workbook. Additional information is provided which may narrow or broaden the spectrum of disease or treatment plan. Some of the cases also include clear radiographic imaging studies or EKGs. Many scenarios delve deeper than the basic science, encouraging readers to think about psychological, ethical, or social issues that surround total patient care. Each scenario is followed by a section entitled "answers and teaching points." Each author focuses on signs and symptoms of the disease process, risk factors when appropriate, interpretation of tests, and information regarding the differential diagnosis. Some of the authors even provide insight into how the particular disease affects those living in the U.K., with current statistics. The teaching notes provide a clear explanation of the pathophysiology and are unique in that they also encourage readers to seek more information. Finally, each chapter lists web resources and citations for additional reading. The cases are short enough for readers to learn the material in short blocks of time, yet they cover enough issues to provide hours of self-directed learning. The shortcomings deal with the fact some of the terminology, medications, and laboratory units differ between the U.S. and the U.K., which could be confusing for a junior U.S. medical student. Although the editors have done a wonderful job of correlating the disease process with current British Public Health statistics, the prevalence and approach to treatment may differ in the U.S.
Assessment: This is a good companion for medical students embarking on problem-based learning or those wishing to have a template for self assessment and self-directed learning. Each scenario is well written. The format allows readers to first assess the situation, draw conclusions, and then check answers. The authors describe the pathophysiology of each disease in a clear and concise manner while considering other aspects that patients and physicians face such as psychological, ethical, and social issues. This book fills a unique niche with its combination of descriptive, illustrative, and tabular styles with open-ended questions to test knowledge and prompt future learning.
