Abstract
The recent increase in online learning modalities due to coronavirus disease 2019 (COVID-19) has created a significant gap in real-time discussions on complex issues. This lack of enrichment from student discussions levies the concern of a deficiency in strong learning outcomes. This learning activity focused on mind mapping to facilitate small group discussions on the 2010 cholera outbreak in Haiti. Students learned about the disease triangle and cause-and-effect relationships on a large spatial and temporal scale. In this case, the three points of the triangle represented the pathogen (Vibrio cholerae), the environment (Haiti), and the hosts (Haitians). Each student in each small group was required to read a unique article to present to their group on the day of the activity. Using mind mapping, each group illustrated relationships that may have exacerbated the cholera outbreak. Learning outcomes were assessed through the evaluation of questions relevant to that week's exercise. Students were assessed on their ability to recognize relationships between the pathogen, environment, and hosts, as well as the ability to apply what they learned to the present-day COVID-19 pandemic. The disease triangle activity is readily accessible and can be easily implemented for identifying cause-and-effect relationships in large-scale systems. Importantly, this learning activity retained real-time discussion-based problem-solving for improving students' critical thinking skills and approaches to complex issues.