13 Clinical case studies
Dr Raquel Nogueira Arjona
Raquel uses clinical cases to bring the theories to life, encourages students to draw on their existing knowledge and gives them interactive exercises every 20 minutes. As well as engaging students in lectures, she provides ways for students who do not attend to engage with the materials.
Teaching area
Lectures
Course
Optional module for Clinical Psychology in Practice Level 6 and Level 7. Diverse cohort of 220 students, including some international students, both undergraduate and Masters.
Description
I am an international staff member, and shared experiences of moving to the UK and feeling different help me to bond with the students. It’s the third year I’ve taught this module. I approach the module as a transition between the final year of study and working, so the focus is on clinical practice. We have two-hour lectures: 50 minutes, then a break and another 50 minutes. I invite guest lecturers who are working in psychology services to bring their practical experiences to the group. This can be challenging – each speaker has their own style of speaking – and of course, they are not always lecturers. But it’s important to help the students to see themselves in the place of a practitioner.
Clinical case studies
My lectures have a theoretical component that it is a little dry: we talk about models and intervention. To bring the theories to life, I always start the lectures with a clinical case, so the students understand what I am talking about. I talk about the diagnosis and treatment of a clinical case. I start by introducing the case, for example, Post-Traumatic Stress Disorder (PTSD), and encourage the students to think about what they already know about the condition from previous study or general knowledge. I ask them questions about the case to help them to think about the content during the lecture.
Diagnosis model
We use the same three questions in all the lectures:
- What do you think the person is thinking?
- How do they behave?
- How do you think they feel?
Then I ask: ‘Why do you think this is a disorder rather than a normal emotion?’
We then bring in diagnostic criteria – what are the symptoms of PTSD? For example, is this person experiencing anxiety or feeling that their body does not belong to them? We go back to the lecture, and I explain what we need to know to diagnose the condition.
Interactive exercises
Because students get tired in a long lecture and start disconnecting, we do an exercise every 20 minutes. Students talk to each other, then feed back to the class. In this way, we have a conversation with the whole group in the lecture theatre. When students respond, I repeat what they say so everyone can hear. I move around the lecture theatre, running up and down and going to them. I think the idea of me going to them instead of them just watching me is fun and interesting. Then I continue with the lecture. If I run out of time because the discussion has overrun, I upload the missing content. It is difficult to have an interactive lecture with so many students, but it is working – although it is different each year, depending on the group. And there are some students who prefer traditional lectures.
I am careful about the examples I use because they could be triggering for some students. I try to use examples that are very general and not too emotive. I always warn the students about potentially triggering content. If I notice that a student is having a hard time, I contact them afterwards to check if they need any support.
Outcomes
Student engagement
Students who contribute to the lectures are pleased that people are listening to their ideas and feel validated. However, although attendance is high among Masters students, undergraduate attendance tends to drop off as the term goes on. I therefore provide a range of opportunities for engagement both for students who attend the lectures and those who don’t.
- In lectures, students can ask questions whenever they want. Some cohorts are keener to ask questions than others.
- Many students come and talk to me after the lecture if they are not comfortable talking during the lecture.
- As well as the lectures being recorded, all the teaching materials are on Canvas, our Virtual Learning Environment.
- There is a discussion board on Canvas, which some cohorts use more than others.
- If students don’t understand the models very well, I add more information on Canvas to explain them.
Comments
Students enjoy the guest lectures from clinical psychologists. They like the structure of the lectures, discussing clinical case examples and allowing for comparison across disorders. Using case studies from the beginning is good preparation for the exams, and the real-life examples provide a good bridge between university and working life.
I am always working to improve my communication with the students. Every year, I find that I need to use different strategies to improve that communication, depending on the cohort. The strategies are usually a combination of conversations with student representatives, informal discussions with students, tutoring meetings and engagement through the discussion board. These methods help me to understand what the cohort needs, what is clear, what is less clear and what may or may not be working well.
It is also important to me that the students think beyond the assessment and engage with the topic in a meaningful way, to reflect on the kind of professionals they want to become and on how what they are learning now will help shape their future practice.