Classroom Vignette #3

Classroom Vignette #3

Looking in: Oral Medicine

Dr. Hiriam Malinksy greets his students.  “Ok, good morning everybody. Without pause he asks for two volunteers. Two students volunteer and walk up to the front of the room. One student reads a patient case aloud, while, on the board, the others student writes down the relevant details of a case. The student writes “inflammation” on the board. “When we see inflammation, what do we think of?” the professor asks.  One student replies abscess.  The professor repeats her reply and adds “cellulitis.”

Symptoms                                          Dental concerns

32 yr male                                                       abscess

increased swelling upper right eye tooth        cellulitis

Medical history                                  Clinical exam

Type 2 diabetes dialenese daily                      intra and extra oral swelling-no meds

GERD-takes prilosec

Allergic reaction to PCN and Keflex

The professor asks, “Why did the patient have the pain before the swelling? This is very important information because the patient may call you in the middle of the night before pain occurs.” The professor tells students that the patient has swelling contained in intraoral space and he states, “When you see radiolucenox what does this mean? The tooth is necrotic…it is an abscess. If the tooth is non restorable what’s the treatment?” Malinsky asks. “Extraction” the students reply. “Right”, the professor replies.  “The patient has 101.5 degree temperature. Guys, does he have a fever?”  Students reply, “Yes”

“Is it a high fever?” Malinsky asks. “We aren’t going to discuss the case right now. Look up dialenese and prilosec in the oral pharmacotherapeutics book. You can get it from your book or computer. Think about drug interaction, antibiotics, and analgesics. What about anti-hypertension drugs…then think about the effect of infection on diabetes and diabetes on infection. Remember the meaning of 2-way interaction. I expect you to be ready on Friday…[If] you have any questions raise your hand.” The class is silent. “Ok great.”

Classroom Vignette #3 Questions

1. Describe how the teacher provides instruction.

2. What are some strategies that the instructor used to promote critical thinking skills?

After you answer these questions, you may wish to review the author’s impressions in Appendix C.