CASE BASED DEBATES - AN INNOVATIVE TEACHING TOOL

Interest in pursuing fellowship training in nephrology continues to steadily decline in the United States (US), especially amongst US medical graduates. Recognizing the need to increase interest in nephrology careers among US medical trainees, the American Society of Nephrology (ASN) task force made several recommendations including the need to develop innovative teaching tools. At our institution, we have developed several innovative teaching tools in nephrology. Some of these tools (crossword, anagrams etc) have been appreciated and recently showcased in peer-reviewed journals. We hereby introduce another novel teaching tool which we have used to teach issues in kidney transplantation titled:" Case Based Debates". A faculty member chooses a challenging case (transplant nephrology related) and shares brief history and preliminary set of labs with the fellows. Fellows are equally divided into two teams. Each team formulates a differential diagnosis and come up with a diagnostic plan involving minimum number of tests leading them to most likely diagnosis. Investigations/questions are graded/rewarded with points according to their relevance and diagnostic importance. Choosing a more relevant and inexpensive test gives positive points while choosing an unnecessary test fetches negative points. Proceeding straight to a renal biopsy disqualifies the team. Each test that is ordered requires an explanation of that test - how it is done, its significance and operational characteristics in terms of sensitivity and specificity. Using the least number and most relevant tests and thereby earning more points, the team that comes closest to correct diagnosis is then asked to predict the specific biopsy findings. Next, the pathology slides are reviewed which fetches bonus points to the team who reads them accurately. All the fellows and faculty who attended our conferences were surveyed and found the activity highly enjoyable agreed that it enhanced their knowledge and would want to use the same tool for other topics in nephrology. This can be applied to any field of medicine and can be specifically modified to aid teaching of many different medical fields. We encourage others to utilize this method to enhance active learning, team work and teach medicine with a component of cost effectiveness as well.