Case Studies in Medical Education - Scenarios and Questions

Tutorial 1 Scenario

Two 1st year medical students are visiting the family of a new-born baby for the first time as part of their course. One student (a female, 18 years old, first time living in Ireland) is from Malaysia and the other student (a male, 20 years old, living at home with parents) is from Clonskeagh. The family involved in the case study live in an estate in Tallaght. The mother (aged 22 years) and father (aged 23 years) are parents for the first time and are living with the maternal grandparents until they hear from the Social Housing Agency. Their name has been on this list since the mother fell pregnant. For this particular visit, both parents are present.

However, the mother is clearly upset about something and eventually breaks down crying. She says that she’s finding it hard to cope. The father doesn’t say anything but clearly feels uncomfortable".

1. What sort of issues, if any, might arise from this situation?

2. What would you do in this situation?

Jessica is a 28 year-old married woman. She has a very demanding, high stress job as a second year medical resident in a large hospital. Jessica has always been a high achiever. She graduated with top honours in both college and medical school. She has very high standards for herself and can be very self-critical when she fails to meet them. Lately, she has struggled with significant feelings of worthlessness and shame due to her inability to perform as well as she always has in the past.

For the past few weeks Jessica has felt unusually fatigued and found it increasingly difficult to concentrate at work. Her co-workers have noticed that she is often irritable and withdrawn, which is quite different from her typically upbeat and friendly disposition. She has called in sick on several occasions, which is completely unlike her. On those days she stays in bed all day, watching TV or sleeping.

1. What problem is Jessica suffering from?

2. How could the cognitive model explain why she is feeling this way?

3. How could psychological therapies help Jessica?

Michael is a 17 year old 5^th year student. While he has several good friends in school, he rarely socialises outside of school.

He used to enjoy being in big groups with his friends but lately he has been feeling uncomfortable in these types of situations. He won’t take part in group activities that he used to enjoy, such as football and skateboarding, and refuses to talk to his parents about the problem.

At home he is quite relaxed, and even with his close friends he is fairly comfortable, but the

problem seems to arise once he is in a group situation. His friends are outgoing and don’t understand what the problem is- this only exacerbates the problem as he feels even less like talking to them about it.

1.  What could be the source of Michael’s discomfort in social situations?

2. How could he overcome his difficulties?

3. Is there a psychological model which could be applied to understanding this situation?