April 11, 2011 11:57:25 AM -0600
Inclusive Cognitive Strategies using Residual Amplification
by Jack Yensen - Saturday, 30 January 2010, 10:08 AM

I originally posted this in 2007 but received no feedback and wondered if anyone had tried it out, since it is an interesting way to include and encourage low responders. I hope to develop a research project using this approach and would be interested in collaborators.

Inclusive Cognitive Strategies

Have you ever wondered how to get more students involved in an optional activity? In one of my course sections recently, I was asked by students to provide optional case studies that focussed upon clinical lab values and their meanings with respect to the underlying disease process. Here is a strategy I devised that would work across all disciplines:

  1. Generate the case study and post in the discussion forum
  2. Ask for email responses within say 5 days
  3. Post the email responses anonymously to Zoomerang as a ranking survey and ask all students to respond
  4. Post the survey results back to the discussion board with your analysis or comments

This strategy will allow some students to contribute case study responses, and will also involve the rest of the non contributing students by asking them to review all the responses and rank them according to their degree of confidence. Interestingly enough, this causes the rest of the students to apply as much or more critical thinking to the case study responses than the original students who initially responded to the case study itself. So, not only is this strategy inclusive, it may also be more potent for students who did not respond initially (residual amplification).

Here is an example.

The students were given the following optional case study:

If you feel inclined, think about this fellow that attends your clinic and email me your responses by Thursday, July 12th. I will then post all email received but with names removed and then ask everyone to rank order them and assert a degree of confidence. Then, I will follow up with that ranked list and my own debriefing.

A 59-year-old smoker attends your clinic because he has had a recent onset of mental alterations including loss of memory. His physical examination reveals scattered sibilant rhonchi that clear with coughing. The skin turgor is normal, and the mucous membranes are moist. His biochemical profile reveals the following:

Serum BUN = 6 mg/dL Serum uric acid = 3.0 mg/dL

(normal, 7-18 mg/dL) (normal, 3.0-8.2 mg/dL)

Serum sodium 110 mEq/L Serum potassium = 4.0 mEq/L

(normal, 135-147 mEq/L) (normal, 3.5-5.0 mEq/L)

Serum chloride 79 mEq/L Serum bicarbonate = 20 mEqIL

(normal, 95-l05 mEq/L) (normal, 22-28 mEq/L)

Random urine sodium = 80 mEq/L

(normal, <20 mEq/L)

Chest x-ray: centrally located mass in the left hilar area

CT scan of the brain: no focal lesions

Questions

1. Why does the patient have hyponatremia?

2. What would be a nonpharmacologic treatment for the hyponatremia?

Here is the Zoomerang survey, which is free.

Please feel free to use this strategy with your own courses. I will be interested to hear how it goes for you. Any comments?

Jack