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FACILITATOR’S GUIDE

“Cut and Paste” Clinical Pathology: Neurodevelopmental Disorders Tara Buck, MD, and Ashley Walker, MD

OVERVIEW

A central challenge in teaching and learning neuroscience is the depth and complexity of the material. In this regard, we are in good company: for thousands of years and in various contexts people have faced similar challenges. The ancient Greeks are well known for having developed mnemonic de- vices to assist with complex memory tasks. A lovely review of some of these techniques can be found in Joshua Foer’s article: “Secrets of a Mind-Gamer: How I trained my brain and became a world-class memory athlete” (http://www.nytimes.com/ interactive/2011/02/20/magazine/mind-secrets.html?_r=0). As Foer describes, memory can be significantly enhanced “by con- structing a building in the imagination and filling it with imagery” of what needs to be recalled. This imagined building has since been referred to as a “memory palace”. Moreover, in developing a memory palace, “the funnier, lewder and more bizarre, the better.” He goes on to explain, “When we see in everyday life things that are petty, ordinary and banal, we generally fail to remember them…. But if we see or hear something exceptionally base, dishonorable, extraordinary, great, unbelievable or laugh- able, that we are likely to remember for a long time.” The following module is designed to apply these principles to the teaching and learning of neuroscience topics. This particular “Cut and Paste” session is designed around neurodevelopmen- tal disorders, but the same approach could be used for other disorders or for a wide range of other topics in neuroscience. Of note, we would emphasize the dual role that such a session can play: both for enhancing memory for specific content and also helping train participants in the process of applying mnemonic devices – the more one practices these techniques, the easier they become to apply to future content! Goal: To create a space in which participants can apply classic mnemonic approaches to enhance memory for core neuroscience content. Learning Objective: By the end of this session, participants will be able to describe clinical presentations of major neurode- velopmental disorders.

RESOURCES REQUIRED

• Facilitator • Table space to work • Magazines featuring people (models, celebrities) • Paper or poster board (14in. x 22in. is a pretty good size) • Colored pencils or markers • Scissors • Tape or glue sticks

SESSION OUTLINE

This session is intended for a 45-60 minute class period depending on how many collages each learner makes. The session can be expanded to 90 minutes by having participants also discuss recommendations for treatment of their assigned syndromes. Learners may work individually, or in small groups. 1. “Cut and Paste”

• Working individually (or in pairs), each person is assigned one of the clinical syndromes in Table 1. It is not neces- sary for all syndromes to be assigned in class, especially in smaller groups or shorter timeframes.

• Each learner is instructed to put together a collage of pictures from magazines that demonstrate the “clinical features” of the illness (shown in column 2).

2. “Show and Tell”

• Learners share with the large group their collage and how the features of their syndrome are represented.

• Alternatively, collages can be displayed at the front of the classroom and learners can guess which is which, based on the clinical features represented.

• In order to consolidate learning, in large groups where multiple participants have the same assignment, we recommend that once the collage from one of the syndromes is presented, that everyone with that same assigned syndrome shows their collage as well.

ADDITIONAL/ALTERNATIVE LEARNING OPPORTUNITIES:

In Table 1, participants will also find a description of the pathology and brain changes that are known to be associated with each neurodevelopmental condition. This section could be reviewed by participants on their own or in a classroom set- ting as a companion “Find it, Draw it, Know it” module, in which participants draw and map out the associated pathology on pictures of the brain. Table 1 also includes links to educational videos of patients with some of the clinical features described (see links in first column). These could be shown in the classroom setting to con- solidate learning. Alternatively participants could be instructed to review them on their own outside of class time. This session can be run with both residents and child psy- chiatry fellows, and could also be used for medical students. Advanced trainees could be further challenged to provide a description of treatment recommendations when presenting their collages to the group. As there are multiple profiles that can cause intellectual dis- ability, a session (especially shorter or with fewer participants) could be run focusing solely on intellectual disability (Table 2). Each participant/pair creating a collage could be assigned a specific etiology of intellectual disability.

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AUTHOR CONTRIBUTIONS:

Drs. Buck and Walker are Assistant Professors of Psychiatry, as well as Associate Program Directors for the Child and General Psychiatry training programs, respectively, at the University of Oklahoma School of Community Medicine in Tulsa. The National Neuroscience Curriculum Initiative is a collaborative effort with the American Association of Directors of Psychiatric Residency Training (AADPRT) and the American Psychiatric Association (APA) Council on Medical Education and Lifelong Learning and receives grant support from the NIH (R25 MH101076 02S1 and R25 MH086466 07S1) ©National Neuroscience Curriculum Initiative.

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