Preparation and presentation of patient-management problems (PMPs)

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Abstract
This booklet offers some guidance to the teacher who wishes to produce patient-management problems for use with his students for teaching or assessment. The producer should be familiar with the four phases of problems. The first phase is the provision of information about the patient, the second the request for some action from the respondent, the third the feedback to the respondent and the final phase the conclusion of the problem. PMPs simulate reality and reproduce the decisions a doctor has to make in investigating and managing a patient. The respondent has to be involved actively in the problem. This is facilitated by: the use of the personal rather than impersonal, for example, 'You are called to see a man...' rather than 'Mr C consults his doctor...'; the use of the present rather than the past tense; provision of the results of the physical examination and investigation as they relate to the patient; alteration of the patient's status according to the actions taken by the respondent. (This may be possible only with computer-based PMPs). A range of media can be used to present problems including print, audiotape, slides, filmstrip, microfiche, overhead projector transparencies, videotape, film, computers, models and simulated patients. Each technique has advantages and disadvantages.