Catalogo Articoli (Spogli Riviste)


Stories as case knowledge: case knowledge as stories
Cox, K;
Univ New S Wales, Sch Med Educ, Sydney, NSW 2052, Australia Univ New S Wales Sydney NSW Australia 2052 c, Sydney, NSW 2052, Australia
Titolo Testata:
fascicolo: 9, volume: 35, anno: 2001,
pagine: 862 - 866
case studies; education, medical/methods; curriculum; anecdotes;
Tipo documento:
Editorial Material
Settore Disciplinare:
Clinical Medicine
Indirizzi per estratti:
Indirizzo: Cox, K Univ New S Wales, Sch Med Educ, Sydney, NSW 2052, Australia Univ New S Wales Sydney NSW Australia 2052 ey, NSW 2052, Australia
K. Cox, "Stories as case knowledge: case knowledge as stories", MED EDUC, 35(9), 2001, pp. 862-866


Introduction Every case contains a human story of illness and a medical story of disease, which together cover person management, case management, health system management and self-management. Much of that management can be learned via a thorough set of stories of typical and atypical core cases compiled by clinical teachers. Stories provide a highly flexible framework for illustrating the lessons of experience, the tips and traps for young players, and the dilemmas requiring careful judgement in the trade-offs betweenbenefits and risks. Listening to real stories unfold is much more fun thanbeing lectured (and better remembered). Discussion Stories illustrate 'what can happen' in a case as a guide to 'what to do'. A story begins with a real world situation with some predicament and a (causal) sequence of events or plot in which things are resolved one way or another. Patients tell their illness story; their clinician translates that into a disease story. Stories sort out what is important in such a predicament, consider the strategy and tactics of what to do, and speak about the outcomes. Each local situation provides relevance, context and circumstantial detail. Stories about case management can encapsulate practical knowledge, logicaldeduction, judgement and decision making, sharing with the student all theingredients that develop expertise. Sometimes it is the plot that is important, sometimes the detail, sometimes it is the underlying message, the parable that resonates with the listener's experiences and feelings. ' Stories can also accommodate the complexity of multiple variables and the influenceof other stakeholders, the uncertainties and dilemmas within the trade-offs, and the niceties of 'informed judgement'. Conclusion This paper makes four points. First, clinical stories recount pointed examples of 'what happened' that expand our expertise in handling 'acase like that'. Second, cases are the unit of clinical work. Case storiesexpand the dimensions and details of case knowledge, case-based reasoning and case management. Carefully collated case stories can comprise the 'reallife' clinical curriculum. Third, stories provide a framework for 'web' or'net' thinking that links all the objective and subjective details within the multifaceted complexity of case management. Fourth, personal stories explain how both numerical and non-linear influences determined what decisionwas actually made in that case.

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Documento generato il 16/07/20 alle ore 19:08:22