Disruptive Behavior Disorders and ADHD: A Problem-Based Learning Activity for Psychiatry Clerkship Students

Clinicians are challenged when differentiating the symptoms of attention deficit hyperactivity disorder from those of disruptive behavior disorders such as oppositional defiant disorder and conduct disorder, as many of the core symptoms overlap. Without a correct diagnosis, it is difficult to create an effective treatment plan. This progressive disclosure case was developed with the intention of helping medical students learn the process of clinical evaluation. The purpose of this resource is to provide a lesson plan to teach intermediate/advanced learners how to systematically approach a case with symptoms of disruptive behavior and attention and focus problems in order to improve their ability to establish the correct diagnosis.

Students were assigned readings, including relevant sections of the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) and a textbook chapter. During a 1-hour class, a child psychiatrist facilitated students in the progressive disclosure case. The learning process included a pre- and posttest.

Students positively perceived the emphasis of important points and showed increased motivation to learn more. Participant evaluations overall were positive, although some students still preferred learning from straight lectures.

Feedback led to modifications of the pre- and posttests to reflect a greater emphasis on factual material. Progressive disclosure cases can be used to facilitate structured exposure to clinical topics in child and adolescent psychiatry.