An Application of Case-Based Instruction in Medical Domains

We are developing an intelligent tutoring environment to teach cardiac auscultation; it will allow students to learn by doingg, while being guided by an expert car-diologist. Auscultation is the process of listening to the body for sounds, and using those sounds as clues to diagnosis. Tutoring auscultation is a diicult task because students must be taught to hear new sounds, and to understand the underlying physiology which produced those sounds. The design of the environment is grounded in two established theories: goal-based scenarios and case-based reasoning. The principles of goal-based scenarios guide the framing of the learning task. In a typical cadi scenario, the student plays the role of an internist who is supervising her residents on rounds. Case-based reasoning suggests a pedagogical approach of teaching through the use of case presentation. In the cadi environment, a student who is having trouble with the patient in a scenario will be shown cases of similar, simpler patients. After studying the similar patients, the student will be better able to diagnose the original patient.