When the nation was struck by the COVID-19 pandemic, the sudden need to transition to online learning highlighted not only the need for interactive learning models but the necessity for adaptable and innovative models. Based on adult learning principles, these models were explored and utilized at the Institute of Living, child and adolescent fellowship program, while teaching entirely online, in order to maximize engagement of adult learners.

At the Institute of Living, Hartford Healthcare Child and Adolescent fellowship program, we started with a work group to brainstorm about developing a seminar using Case-Based Learning models covering important topics in child psychiatry based on interactive learning methods. We conducted a needs assessment survey looking at interactive learning in child and adolescent psychiatry (CAP) fellowship programs, receiving responses from faculty at more than 50 ACGME-accredited programs. We found that  over 90% of the respondents were somewhat or extremely motivated to shift to a more interactive teaching style. We also reached out to two other institutions - Creighton University and the University of Tennessee - and collaboratively conceptualized a multi institution project and planned to start a complex case conference.

The structure of the conference is that a fellow from one institution presents a complex case followed by interactive discussion facilitated collaboratively by program faculty from three programs comprising of a multidisciplinary panel. Panelists include Child and Adolescent Psychiatrists, Psychologists, a Pharmacist, and Researchers and Scientists, leading to a very enriching and diverse discussion. At times a consultant with expertise in a specific area is also invited. A week before the scheduled case conference the fellow presenting sends out a summary of case with questions posed to the group and panel members for discussion. Utilizing a clinical case with a progressive case-based discussion stimulates conversation around neurobiology, psychopathology, prevalence, differential diagnosis, and treatment modalities.

This collaborative effort has provided a good forum to discuss challenging cases, learn from other faculty members who provide diverse perspectives, and provide a platform for academic discussion. It also offers an opportunity to get to know faculty and trainees from other institutions. Case Based Learning incorporates principles of transformative learning. This model involves the presentation of stimulus or trigger material, usually in the form of a clinical case. It utilizes progressive disclosure to encourage learners to engage in reflective practice, critical thinking, and critical analysis – important components to lifelong learning. It also provides learners with “time to struggle and define the problem, explore related issues (during and/or after sessions), and grapple with problem resolution.” In Case Based Learning, facilitators take a more active role, asking guiding questions to redirect learners back to the main learning objectives. The learning process remains active and self-directed.

This project brings together the expertise of child psychiatrists and other educators across institutions in developing this curriculum and making this project creative and innovative.


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Salma Malik

Salma Malik, MD (Leaders, ’21) is Associate Professor of Psychiatry at University of Connecticut and Adjunct Assistant Professor of Psychiatry at Weill Cornell Medical College. She is the Program Director of Child and Adolescent Psychiatry fellowship program at the Institute of Living, Hartford Healthcare, and is a distinguished fellow of American Psychiatric Association and American Academy of Child and Adolescent Psychiatry. Salma’s areas of professional interest include medical education and the treatment of psychiatric disorders. Salma can be reached via email.