1 Instructor’s Guide

Instructions for Use

  1. Target audience: First-Year Medical Students
  2. Purpose: The purpose of the case is for students to understand the etiology, anatomy, and pathophysiology and key clinical information of a patient with alcoholic liver disease progressing toward cirrhosis.



Assign “Case and Learning Objectives – Student Version” assignment to students approximately 1 work week prior to the learning session. All pre-work and learning session instructions are provided in the student version.

Students will be asked to generate bullet point responses to the case learning objectives by using textbooks and current evidence-based resources in the literature and should be completed individually, not as a group. Suggested responses for faculty facilitators, as of August 2020, are found in the “Response” column below and are not provided to the students.

Learning Session

Students should be broken up into discussion groups of no more than eight students in a group. This could be done in an in-person setting or by using “breakout rooms” in an online format. The goal is for students to articulate the responses gathered individually and to generate a group response to be shared with the entire class.


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“Bad Breath”: An integrated case study of alcoholic liver disease for first year medical students. Copyright © 2020 by Omar Matuk-Villazon, MD, MBA and Kevin Rowland, PhD is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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