A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Case based instruction (CBI) in medical education is a well established alternative to lecture format in the training of first and second year medical students. There have been previous documented attempts to include technology in CBI that have received positive feedback from students. Electronic health records are now being mandated by 2014 and historically there have been many barriers to adoption including lack of EHR technical skills by physicians. As a result, biomedical informatics education is being integrated into medical school curriculum with hope that better understanding of medical applications will prepare future physicians to utilize them. There has been no documented evidence of successful utilization of a commercial grade EHR within CBI despite many potential benefits in doing so. Previous attempts at accomplishing this task have been discovered but multiple challenges were encountered in developing a suitable educational EHR and as a result the attempt was unsuccessful. The following is a design project with the aim of highlighting specific design requirements, as well as, a theoretical usage scenario of a commercial grade EHR in CBI. Outlined as well is experimental design for future evaluation of such a system. There will be many 4 technological challenges that will need to be overcome and numerous resource requirements to get such a project functional. Despite this, all aspects of such a system are technologically feasible. Completion of such a system could result in potential commercial benefit and provide a platform for further investigation of early EHR training effect on physician-EHR acclimation.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / This pilot project explores medical student preference regarding simulation education in case based instruction (CBI) compared with the traditional Power Point lecture CBI. The study population consisted of volunteer first, second, third, and fourth year medical students. The subjects were randomized into control (traditional CBI) and intervention (simulation CBI) groups and preference data was collected via pre‐ and post‐survey administered before and after the activity. Preference was limited to enjoyment of learning activity and opinion of benefit on exams of the learning activity. T‐tests were applied to the data in order to determine statistical significance. Enjoyment of the simulation activity was determined to be higher post‐simulation activity in the intervention group compared to the control group. While opinion that simulation CBI may be beneficial in regard to exam scores and knowledge retention was above neutral for the two groups, this study did not determine a significance in opinion between the control and intervention groups. The study results suggest that students who have experienced a simulation CBI enjoy them more compared to the traditional CBI and are more in favor of changing the current model of case‐based instruction.

The results of the U. S Census provide evidence that our population is becoming more varied and that diversity is most salient in our schools. This demographic shift will continue to have a significant impact on the curriculum, students, teachers, and other aspects of education as we have historically known it. One of the most challenging aspect is that while our students are becoming more diverse, our teacher population is not. Eighty to ninety percent of the teaching population is White, heterosexual, middle class females, with little experiences with people from diverse backgrounds. (Lowenstein, 2009; Sleeter, 2001). The academic achievement gap continues to widen between culturally diverse students and their White peers. This disparity in achievement along demographic lines indicates a clear and present need to more fully prepare teachers on how to educate children of diverse backgrounds--a crucial component of developing a culturally responsive pedagogy. "As our society changes, so must our teacher education practices" (Lee, Summers, & Garza, 2009, p.1). This mixed method study was developed around the hypothesis that teaching cases and student-written postcard narratives using an empathetic identity (Wiseman, 1978) should be used in a literacy course to foster a culturally responsive literacy pedagogy. This study took place over one semester at a four year college, in a preservice education literacy course. Five teaching cases were written or modified to be aligned with this particular course’s content. I examined 20 preservice teachers (n=20) and a professor as they engaged in case-based instruction. Immediately following the teaching case discussion, the preservice teachers engaged in a writing exercise where they used an empathetic identity to imagine having the person in the teaching case’s experience (Wiseman, 1978).  This study employed a mixed method design. Interviews with the professor, a professor’s journal, a researcher reflective journal, a pre and post teaching case, nonparticipant observation notes, preservice teacher written narratives, and the statistically significant results from the CDAI (Henry, 1991) at the alpha .05 level demonstrated that teaching cases effectively influenced preservice teacher’s perceptions and insights leading to a culturally responsive literacy pedagogy. Three major conclusions were drawn from this study. First, the implementation of teaching cases that feature diversity and literacy issues made an impact on the professor of this literacy course. The professor found that using teaching cases motivated her students, fostered a deeper discussion of the weekly topics, and created more transfer power of important topics to the classroom discussion than reading scholarly articles. Secondly, teaching cases that feature diversity and literacy issues influenced many of the preservice teachers’ insights and perceptions related to a culturally responsive pedagogy. The contextualization and alignment with the course content made them powerful tools to motivate and foster an entrance for preservice teachers to engage into a critical inquiry about culturally responsive teaching practices. Finally, the third conclusion drawn from this study is that utilizing activities which allow preservice teachers to use an empathetic lens can be a very powerful experience that may lead to developing a culturally responsive literacy pedagogy.  Three recommendations to teacher education are suggested based on the conclusions drawn from the data. First, teacher education curriculum should include experiences that can foster a culturally responsive pedagogy. The use of teaching cases featuring diversity and literacy issues is strongly suggested, as well as cultivating experiences that allow the preservice teachers to use an empathetic identity. Secondly, these experiences should be viewed as valuable tools for professors in higher education, as the teaching population of higher education mirrors that of our teaching population (Lowenstien, 2009; Sleeter, 2001). During the case-based discussion the professor and preservice teachers can draw upon their shared knowledge of theoretical, cultural, cognitive, and experiential knowledge of teaching children from diverse backgrounds (Nordoff & Kleinfeld, 1992) as a conduit for a culturally responsive literacy pedagogy.  Finally, teacher education has a responsibility to the well-being of their preservice teachers when purposely creating cathartic experiences. Culminating discussions should be designed to balance these emotional experiences (Ellis, 1995; Shulman, 1992). Several areas were identified for future research, encompassing the implementation of teaching cases and preservice teacher curriculum.

It has been widely discussed that current practices of preservice teacher education are still far away from utilizing contemporary methods and strategies in its curriculum practices in Turkey. Preservice teachers are not provided enough classroom experiences connecting theory to teaching practice. As a result of this, many senior teachers need further guidance and supervision to transfer their knowledge into school environments. In order to address this failure in bridging what is learned and practiced in preservice teacher education to that of real class happenings, an experimental study was conducted with the application of an alternative method namely video-case based instruction. This research study aimed to examine the differences between traditional lecture based instruction and video-case based instruction in terms of their effectiveness of presenting the content at &ldquo / Introduction to Teaching Profession Course&rdquo / delivered to the preservice teachers. Additionally, the study also aimed to evaluate the attitudes of students toward video-case based instruction to which they were exposed. In this study, video-case based instruction and lecture based instruction were applied in three sessions of application and they were compared in terms of delivering the course content. Data were collected from two sections of EDS 119 Course during 2005-2006 fall semester by administrating pretests, posttests, questionnaires and interviews. Data analysis was carried out through both quantitative and qualitative analysis techniques. Results demonstrated that video-case based instruction demonstrated achievement of course content and support significant difference overall between video-case based instruction and lecture based instruction in content achievement. The participants of the study reported positive attitudes towards video-case based instruction both for its current application and future uses. The results revealed that using video-case based methods in preservice teacher education programs may be a viable alternative for allowing students connect real teaching practices with what they learn in their pedagogy courses.