# Problem-Based Learning Case of Unvaccinated Child With Measles Infection: Integrating Viral Pathogenesis, Immunology, and Vaccine Ethics

## TL;DR

This paper describes a medical education case using a measles-infected child to teach students about viruses, immunity, and vaccine ethics.

## Contribution

A novel problem-based learning case integrating viral pathogenesis, immunology, and vaccine ethics for medical students.

## Key findings

- Students met performance standards on 10 of 16 MCQs related to the case.
- The PBL case showed relevance during the COVID-19 pandemic and recent measles outbreaks.
- Formative feedback and concept maps enhanced student understanding of complex topics.

## Abstract

The resurgence of vaccine-preventable viral diseases and the emergence of novel viruses demand that practicing physicians understand viral infections, human immunity, and the impact of immunization and vaccine hesitancy on disease outbreaks. Teaching medical students these concepts is a crucial element of foundational medical education.

We used a problem-based learning (PBL) case involving a toddler who presents at a rural clinic following international travel to integrate basic and clinical science. During the assigned five curricular hours, first-year medical students were expected to analyze data and create a detailed timeline of viral infection in order to make the diagnosis of active measles, and to construct concept maps that described the pathophysiologic, immunologic, and ethical aspects of the case. Students received formative feedback on their concept maps, and content experts used multiple-choice questions (MCQs) and subsequent item analysis to assess student knowledge regarding the case educational objectives.

We delivered this PBL case to 687 medical students as part of our required first-year curriculum from 2014 to 2023. Students achieved faculty standards of performance (≥70% correct responses) in 10 of 16 MCQs analyzed in this report, and 15 of 16 questions had a positive discrimination index.

This PBL teaching case is timely and adaptable, with heightened relevance during the COVID-19/SARS-CoV-2 pandemic and recent measles outbreaks. It is effective for teaching medical students the basic science of viral infections and the ethical and public health implications of vaccine hesitancy.