My experiences with general cellular and neural cellular pathology in a case based blended learning ecosystem (CBBLE)

Greetings, I am Ritika Polisetty, a final year MBBS student, and welcome to my account of clinical experiences regarding clinical based blended learning.

Clinical-based learning serves as a fundamental pillar in the development of a competent and well-rounded clinician. Through immersive patient encounters and hands-on experiences, medical students gain invaluable insights into the diagnostic process, clinical reasoning, and the importance of weighing evidence and considering differential diagnoses.

As a medical student, my journey towards becoming a clinician has been filled with invaluable experiences. Case taking and clinical-based learning have played a pivotal role in shaping my skills and knowledge. Through a series of challenging cases, I have witnessed firsthand the transformative power of these learning approaches. In this blog, I will share the experiences and growth I have gained as a medical student, highlighting specific cases that have had a profound impact on my development as a clinician.

Before delving into my experiences, I would like to extend a special thank you to the patients whose cases I have encountered throughout my clinical experiences. Their willingness to share their stories, symptoms, and concerns has not only contributed to my understanding of medicine but also reminded me of the profound trust patients place in healthcare professionals. It is their resilience and bravery that inspire me to approach each case with compassion and dedication.

I am also deeply grateful to the professors and mentors who have guided me during my medical education. Their wealth of knowledge, expertise, and unwavering commitment to teaching have empowered me to become a diligent and thoughtful diagnostician and clinician. Their support, constructive feedback, and encouragement have been instrumental in my growth, instilling in me the values of lifelong learning and evidence-based practice.

One of the first cases that left a lasting impact on my diagnostic abilities was that of a 48-year-old patient complaining of abdominal distension. As I began taking the patient's history, I learned that he had been experiencing gradual weight loss, loss of appetite, and generalized discomfort. Upon physical examination, I noted the presence of ascites and hepatomegaly.

This case taught me the importance of thorough history-taking and the significance of paying attention to subtle clinical clues. By asking specific questions regarding the duration and progression of symptoms, associated factors, and potential risk factors, I was able to narrow down the possible differential diagnoses. Moreover, the physical examination findings helped me consider possible etiologies and formulate a preliminary differential diagnosis, including liver disease, malignancy, and cardiac dysfunction.

Through collaboration with my clinical preceptor and further investigations such as liver function tests, ultrasound, and paracentesis, we arrived at the diagnosis of acute decompensated liver disease with portal hypertension. This case not only highlighted the value of a comprehensive approach to history-taking and physical examination but also underscored the importance of interdisciplinary teamwork and the role of investigative procedures in arriving at a definitive diagnosis.

https://ritikapolisettyrollno201.blogspot.com/2023/04/48-year-old-with-abdominal-distension.html

Another case that had a significant impact involved a 42-year-old male who presented with fever, headache, and neck stiffness. The urgency and potential severity of this case exposed me to the complexities of diagnosing a patient with a potentially life-threatening condition. It required immediate action, coordination with the healthcare team, and prompt intervention.

Through this case, I learned the importance of recognizing red flags and differentiating between urgent and non-urgent situations. My skills in neurological examination were put to the test, and I honed my ability to assess the severity of a patient's condition quickly. Furthermore, this case emphasized the significance of collaboration with senior physicians. Recognizing the need for guidance and expertise, I actively sought their insights and opinions, understanding that teamwork plays a crucial role in providing the best possible care to the patient. Working hand-in-hand with experienced professionals taught me valuable lessons about effective communication, interdisciplinary cooperation, and leveraging collective knowledge.

In tackling this challenging case, I also came to appreciate the importance of utilizing available resources. By leveraging imaging techniques and laboratory investigations, I was able to gather vital information that guided the diagnostic process.

Through this case, I not only developed a deeper understanding of the intricacies of diagnosing life-threatening conditions but also cultivated a heightened sense of responsibility as a healthcare professional. I witnessed firsthand the critical role that quick thinking, effective collaboration, and resource utilization play in achieving positive patient outcomes. This experience served as a powerful reminder of the impact we can have on patients' lives and reaffirmed my commitment to continuous learning and improvement in the pursuit of excellence in diagnostic practice.

https://ritikapolisettyrollno201.blogspot.com/2023/01/a-42-yo-male-with-fever-headache-and.html

The next case that profoundly influenced my clinical skills involved a patient with multiple complex medical issues. This case provided a comprehensive and in-depth assessment opportunity, exposing me to a diverse array of symptoms, clinical findings, and diagnostic challenges.

Clinical Reasoning and Weighing Evidence:

Through this case, I witnessed the indispensable role of clinical reasoning in navigating complex patient presentations. As I analyzed the patient's history and examination findings, I had to consider multiple possible diagnoses and weigh the evidence carefully. It became apparent that each piece of information, no matter how seemingly insignificant, could contribute to the diagnostic puzzle.

For instance, the patient's complaint of persistent fatigue and unexplained weight loss, combined with the physical finding of hepatomegaly, prompted me to consider various etiologies. I weighed the evidence, considering both common and rare conditions, and engaged in critical thinking to formulate a list of differential diagnoses. This process not only enhanced my analytical skills but also reinforced the importance of maintaining an open mind and considering all possibilities.

Considering Differential Diagnoses:

This case emphasized the significance of exploring a wide range of differential diagnoses and avoiding premature closure. Through meticulous analysis of the patient's symptoms, laboratory results, and imaging findings, I developed a comprehensive list of potential conditions. This exercise not only expanded my knowledge base but also reinforced the importance of thoroughness in the diagnostic process.

For example, when faced with a patient presenting with generalized joint pain and swelling, I had to consider various etiologies, such as rheumatoid arthritis, systemic lupus erythematosus, and gout. By actively exploring multiple possibilities and assessing the patient's clinical features against each potential diagnosis, I refined my ability to develop well-informed differential diagnoses.

Utilizing Examples for Learning:

Throughout this case, real-life examples played a vital role in solidifying my understanding of clinical reasoning and diagnostic skills. By observing the thought processes of experienced physicians and discussing their approaches, I gained insights into their decision-making strategies. These examples demonstrated the importance of integrating clinical findings, patient history, and evidence from investigations to arrive at the most accurate diagnosis.

Moreover, the case discussions provided an opportunity to critically analyze the limitations of different diagnostic modalities, encouraging me to consider the specificity and sensitivity of various tests. This experience highlighted the value of evidence-based medicine and informed decision-making.

https://ritikapolisettyrollno201.blogspot.com/2023/03/1801006146-long-case.html

Through case taking and clinical-based learning, I have grown significantly as a diagnostician and a clinician. The challenges posed by complex cases have sharpened my critical thinking skills, expanded my medical knowledge, and instilled in me the importance of observation, persistence, collaboration, and ethical considerations. Each case has contributed to my development as a medical student, providing valuable lessons and insights that will shape my future practice as a physician. As I continue on this journey, I am grateful for the opportunities to learn and improve, knowing that the knowledge gained from these experiences will enable me to provide the best possible care for my future patients.