Pbl On Fm

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Pbl On Fm

  1. 1. Fibromyalgia An Introduction to Problem-Based Learning Enter Tutorial
  2. 2. Help Page <ul><li>Navigation: </li></ul><ul><li>use buttons, not the keyboard </li></ul>Exit Return to previous slide Return to main menu Return to this slide End show Move to next slide (Use this now)
  3. 3. Note Taking Directions <ul><li>You will need to keep notes during the tutorial. You can do this in one of two ways: </li></ul><ul><li>Open a word document. </li></ul><ul><li>Use old-fashioned pen and paper! </li></ul>Exit
  4. 4. Tutorial Objectives <ul><li>On completion of this tutorial, students will be able to: </li></ul><ul><ul><ul><li>Demonstrate effective problem-based learning procedures </li></ul></ul></ul><ul><ul><ul><li>Identify symptoms of fibromyalgia </li></ul></ul></ul><ul><ul><ul><li>Identify relevant components of disease process </li></ul></ul></ul><ul><ul><ul><li>Choose appropriate frame of reference to treat fibromyalgia </li></ul></ul></ul><ul><ul><ul><li>Select appropriate evaluation tools </li></ul></ul></ul><ul><ul><ul><li>Write a short treatment plan including measurable, objective goals based on case study video </li></ul></ul></ul><ul><ul><ul><li>Identify possible resources for more information on fibromyalgia </li></ul></ul></ul>Exit
  5. 5. Prior Knowledge <ul><li>Content in this tutorial will build on your knowledge of: </li></ul><ul><li>Concepts of Occupation </li></ul><ul><li>Evidence-Based Practice </li></ul><ul><li>Occupation Across the Life Span </li></ul><ul><li>Interactive Reasoning and Clinical Reasoning </li></ul><ul><li>Neuroscience and Neuro-anatomy </li></ul>Exit
  6. 6. Main Menu <ul><li>INTRODUCTION TO PBL </li></ul><ul><li>Start Here </li></ul><ul><li>CASE STUDY </li></ul><ul><li>Scenario </li></ul><ul><li>Client Video </li></ul><ul><li>Client’s Chart </li></ul>Exit CLASSROOM Problem Presentation Team Research Research Reports Setting a Goal RESOURCES Web Site Journal Article START TUTORIAL OVER
  7. 7. Welcome to Problem-Based Learning! <ul><li>In PBL you construct your own knowledge base by solving complex problems with help from other students. These problems take the form of client case studies. While there are no “right” or “wrong” answers, there are reasonable and evidenced-based solutions. This tutorial will help you learn the steps to find those solutions! </li></ul>PBL: 1 of 10 Exit
  8. 8. Steps in PBL <ul><ul><ul><li>1. P resentation of the problem </li></ul></ul></ul><ul><ul><ul><li>2. Separation of F acts from unknown facts </li></ul></ul></ul><ul><ul><ul><li>3. R esearch </li></ul></ul></ul><ul><ul><ul><li>4. Group A nalysis </li></ul></ul></ul><ul><ul><ul><li>5. S olution Generation </li></ul></ul></ul><ul><ul><ul><li>6. S olution Presentation </li></ul></ul></ul><ul><ul><ul><li>7. E valuation </li></ul></ul></ul><ul><li>Hint: P roblems F or R esearchers A nd S mart S tudents E vaporate. </li></ul>PBL: 2 of 10 This tutorial will guide you through the first 5 steps later with a case study on Fibromyalgia. Exit
  9. 9. Concept Map of PBL List known facts List unknowns Generate possible solutions Meet the problem Research unknowns Select most viable solution Report solution PBL: 3 of 10 Exit
  10. 10. The Problem <ul><li>In PBL the problem is usually somewhat vague and not well defined. Like a detective, you must gather all the clues you can. Remember to consider all the client characteristics involved: age, culture, values, goals, etc., </li></ul><ul><li>not just the presenting </li></ul><ul><li>symptoms. </li></ul>PBL: 4 of 10 Exit
  11. 11. Separate the Facts <ul><ul><ul><li>Once you know the problem, the next step is to answer 3 questions: </li></ul></ul></ul><ul><ul><ul><ul><li>a. What do we know? </li></ul></ul></ul></ul><ul><ul><ul><ul><li>What do we need to know? </li></ul></ul></ul></ul><ul><ul><ul><ul><li>What are we going to do? </li></ul></ul></ul></ul>PBL: 5 of 10 It is helpful to make a list of your known facts and unknown facts at this point in the process. Exit
  12. 12. Time for Some Research <ul><li>In class, you will use text books, peer-reviewed journals, expert opinions, and the Internet. Some PBL teams divide up the work, while others choose to work together. Either way, learning to collaborate is part of the process. Research often focuses on the client variables , disease process , theories , and assessment tools . </li></ul>PBL: 6 of 10 Exit
  13. 13. Group Analysis <ul><li>Once the initial research is done, the group once again must decide what are the known facts and what needs more research. At this point, the team usually knows enough to select a frame of reference , evaluation tools , and treatment objectives . Further research is needed for treatment modalities. </li></ul>PBL: 7 of 10 Exit
  14. 14. Choosing a Viable Solution <ul><li>The team meets again, this time to finalize a solution to the problem. Everyone will bring treatment ideas to the table so this stage requires good interpersonal skills. </li></ul><ul><li>Remember to use “I feel/think . . . when . . because . . .” statements. </li></ul>PBL: 8 of 10 Exit
  15. 15. Presenting the Solution <ul><li>In real life, your team will probably present their solution to the rest of the class. This might be a: </li></ul><ul><li>PowerPoint presentation, </li></ul><ul><li>group exercise, </li></ul><ul><li>video, or </li></ul><ul><li>drama. </li></ul><ul><li>Although instructor’s expectations differ, the presentation should be professional and include your research on the disease, frame of reference, evaluation tools, a complete treatment plan and references. </li></ul>PBL: 9 of 10 Exit
  16. 16. Evaluation <ul><li>It is always helpful to have an evaluation rubric to look at even before you make the presentation. </li></ul><ul><li>There is one included in the resource section of this tutorial or your professors may have their own. </li></ul><ul><li>Let’s review what you know about PBL </li></ul><ul><li>and then go to a real case. </li></ul>PBL: 10 of 10 Exit
  17. 17. PBL Review 1 <ul><li>What are the first five steps of PBL? </li></ul><ul><li>A . problem, research, separate facts, solution, group </li></ul><ul><li>analysis </li></ul><ul><li>B . research, problem, separate facts, solution, group </li></ul><ul><li>analysis </li></ul><ul><li>C . problem, separate facts, research, group analysis, </li></ul><ul><li>solution </li></ul><ul><li>D . research, problem, separate facts, group analysis, </li></ul><ul><li>solution </li></ul>
  18. 18. Incorrect. Here are the Steps in the Correct Order <ul><ul><ul><li>1. Presentation of the problem </li></ul></ul></ul><ul><ul><ul><li>2. Separation of facts from unknown facts </li></ul></ul></ul><ul><ul><ul><li>3. Research </li></ul></ul></ul><ul><ul><ul><li>4. Group Analysis </li></ul></ul></ul><ul><ul><ul><li>5. Solution Generation </li></ul></ul></ul><ul><ul><ul><li>6. Solution Presentation </li></ul></ul></ul><ul><ul><ul><li>7. Evaluation </li></ul></ul></ul>On to Review Question #2
  19. 19. Correct! Here are the Steps in the Correct Order <ul><ul><ul><li>1. Presentation of the problem </li></ul></ul></ul><ul><ul><ul><li>2. Separation of facts from unknown facts </li></ul></ul></ul><ul><ul><ul><li>3. Research </li></ul></ul></ul><ul><ul><ul><li>4. Group Analysis </li></ul></ul></ul><ul><ul><ul><li>5. Solution Generation </li></ul></ul></ul><ul><ul><ul><li>6. Solution Presentation </li></ul></ul></ul><ul><ul><ul><li>7. Evaluation </li></ul></ul></ul>On to Review Question #2
  20. 20. PBL Review 2 <ul><li>2. It is always important to complete all your work on your own in a PBL class and not share your answers with others. </li></ul><ul><li>True or False </li></ul>
  21. 21. False.It is always important to work as a team. <ul><li>In class, you will use text books, peer-reviewed journals, expert opinions, and the internet. Some PBL teams divide up the work, while others choose to work together. Either way, learning to collaborate is part of the process. Research often focuses on the client variables, disease process, theories, and assessment tools. </li></ul><ul><li>Let’s get started with the case study now. </li></ul>
  22. 22. Case Scenario <ul><li>You are an occupational therapy student working in a Center for Integrative Medicine. The Center is a stand-alone out-patient clinic. You are very fortunate to have an impressive facility including a warm water pool, exercise equipment, and up to date medical technology. If needed, you can refer to any other allied health professional. </li></ul>Exit
  23. 23. Case Scenario <ul><li>Dr. Wilson has referred Ms. Karen Sanders to you for evaluation. Since this is an unusual case, you have been asked to evaluate Ms. Sanders, write a treatment plan, and present your findings as a case study to the rest of the staff by next staff meeting. </li></ul><ul><li>(Fortunately, you will have the help of your P BL team!) </li></ul>Exit
  24. 24. Meet Your PBL Team Exit Jana Blake Jenny Dr. Elaine Click on picture to learn more about your team members. You are now in the classroom section of the tutorial. Your team will offer their ideas just like in a real PBL experience. And now for the case study!
  25. 25. Problem Presentation Let’s watch the case client video first. Let’s look at the client’s chart first. Whatever you choose, don’t forget to take notes! Let’s read the scenario again. Click on the suggestion you want to try first. Exit
  26. 26. Case Study Video <ul><li>Watch the video and write down your observations. Remember to make note of symptoms and client factors. </li></ul><ul><li>Click video to start. </li></ul><ul><li>Go to the next page when you are done. </li></ul>Exit
  27. 27. Symptoms- Did you list these? <ul><li>Fatigue </li></ul><ul><li>“ All over pain” </li></ul><ul><li>Insomnia </li></ul><ul><li>Poor memory </li></ul><ul><li>Confusion </li></ul><ul><li>Depression </li></ul><ul><li>Muscle weakness </li></ul><ul><li>Tender points </li></ul><ul><li>Pain worse c exercise </li></ul><ul><li>Sensitivity to cold, light, sound, & touch </li></ul><ul><li>Personality changes </li></ul>Exit
  28. 28. Client Variables- Did you list these? <ul><li>Age/Life stage Current stressors </li></ul><ul><li>Family Adaptive responses </li></ul><ul><ul><li>Social support Leisure interests </li></ul></ul><ul><ul><li>Employment Client goals </li></ul></ul><ul><ul><li>Religious beliefs </li></ul></ul>Exit
  29. 29. So now what? What is the next step in the PBL process? A . Research B . Separate known facts from unknown facts C . Analysis Let’s decide how we are going to treat this client We still don’t know very much about this case. But what caused this condition? Where are we in the PBL process? What comes next?
  30. 30. Separating Facts Exit What are the known and unknown facts about this case? Type your answer in the text box while your team writes some general considerations on the black board. Your answer should be fairly specific. Go to the next page, when you’re done.
  31. 31. Known Facts <ul><li>Basics like age, gender, dg </li></ul><ul><li>Symptoms and co-morbidities </li></ul><ul><li>Variables like family, spirituality, personal goals </li></ul><ul><li>Medical hx: current meds, surgical hx, precautions </li></ul><ul><li>Some leisure interests, work hx, ADL issues </li></ul><ul><li>Some social hx, marital status, support system </li></ul><ul><li>Some psychosocial hx, feelings, affect, cognition </li></ul>Exit
  32. 32. Unknown Facts <ul><li>Client Specific Information: </li></ul><ul><li>Details of daily occupations and habits (e.g., sleep habits, nutrition, exercise, work, self-care tasks) </li></ul><ul><li>Functional performance level of occupations </li></ul><ul><li>Physical, temporal and social environment </li></ul><ul><li>Objective measurements of strength, ROM, coordination, etc. </li></ul><ul><li>Subjective measurements of pain, fatigue, depression, self-efficacy, self-esteem, etc. </li></ul><ul><li>Non-client Information : Disease process of FM, treatment, OT frames of reference, assessment tools </li></ul>Exit
  33. 33. Unknown Client Facts How are we going to find the client unknowns in a pretend case study? We could just make up some of the client Information. Don’t worry about the client information for now -focus on the non- client information. How can we know how a real client might answer these questions? What would you do? Your PBL instructors will probably have their own preferences on client unknowns. For now, let’s take Dr. Elaine’s suggestion. Exit
  34. 34. Research the Unknowns Let’s all go to the library and do some research Let’s divide everything up and meet back here tomorrow These are all good suggestions, but you must agree on one plan. Everyone should write up a report on all of the unknowns What do you want to do next? Can you offer a compromise? Type your answer in the text box, then go to next page. Exit
  35. 35. Team Research Let’s check out a web page. Remember the unknowns that you are researching. I bet the library has some good journal articles. Looks like your team has voted to do research together as a team. Click on the above suggestions to get the resources, or go to the main menu. Exit I’ll take notes and keep track of our references.
  36. 36. Research Reports What treatments are available and what works best? What would be our frames of reference and eval tools as O.T.s? Good! How does this all relate to our client? What is the disease process? And how does that affect tx? You and your team have finished with your research. Click on the questions above to compare your answers with your team’s answers. Exit
  37. 37. Frames of Reference <ul><li>There are several approaches to treatment that are </li></ul><ul><li>appropriate. Here are some OT models we might </li></ul><ul><li>consider: </li></ul><ul><li>1. Canadian Model of Occupational Performance </li></ul><ul><li>2. Model of Human Occupation </li></ul><ul><li>3. Model of Person, Environment, and Occupation </li></ul><ul><li>Other theories and concepts that would be helpful: </li></ul><ul><li>Cognitive Behavioral Therapy or REBT </li></ul><ul><li>Client-centered Therapy </li></ul><ul><li>Pain Management: Pain Gate and Mind/Body theories </li></ul><ul><li>Cognitive: Learning theories and Self-efficacy </li></ul><ul><li>Central Nervous System Sensitivity theory of fibromyalgia </li></ul><ul><li>What assessment tools go along with these theories? </li></ul>Exit
  38. 38. Disease Process According to Dr. Wood’s research, fibromyalgia is a result of the the neurological changes that occur when the hippocampus is overly stressed. The function of the hippocampus includes transfer of short term memory into long term memory and dampening down of stress signals as they enter the limbic system. When the hippocampus atrophies, the signals come into the brain without being processed properly. This causes an increase in CRH and cortisol. Eventually, dopamine levels decrease and the symptoms of fibromyalgia begin to appear: pain, fatigue, and insomnia. Click here to see picture of limbic system Exit
  39. 39. The Limbic System Exit Location of the Hippocampus in the Human Brain.The figure shows the underside (ventral view) of a semi-transparent human brain, with the front of the brain at the top. The red blobs show the approximate location of the hippocampus in the temporal lobes of the human brain. Note: the hippocampus is entirely covered by the ventral temporal cortex (i.e., the hippocampus is inside the transparent brain). The Limbic System
  40. 40. Implications for Tx A few implications for treatment include: 1. Strengthening and stretching without causing an increase in pain. 2. Nurturing the nervous system through proper nutrition, pain management, and energy conservation. 3. Teaching conscious control of the autonomic nervous system through mind/body techniques. 4. Encouraging better organizational skills, stress management, assertiveness, and positive self-talk. Exit
  41. 41. Assessment Tools Based on the theories we chose these would be good evaluation tools to use: 1. Comprehensive Occupational Performance Measure 2. Beck Depression Inventory 3. Dysfunctional Beliefs Inventory 4. Pain Analog Scale 5. Fibromyalgia Impact Questionnaire 6. General Perceived Self-Efficacy Scale Exit
  42. 42. Treatment of FM <ul><li>Evidence-based practices for tx of FM include: </li></ul><ul><ul><ul><ul><ul><li>Warm water exercise </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Gentle stretching, especially for the spinal mm </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Therapeutic yoga, Feldenkrais, Tai Chi </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Low Level Light Therapy, Alpha Stim, hot packs </li></ul></ul></ul></ul></ul><ul><li>Education in nutrition, energy conservation, body mechanics </li></ul><ul><li>Practice in stress and pain management, relaxation skills, assertiveness, guided imagery, meditation </li></ul><ul><li>Use of cognitive behavioral and rational emotive techniques </li></ul><ul><li>Facilitation of organizational skills and cognitive compensation </li></ul><ul><li>Possible use of adaptive aids: reachers, kitchen devices, raised toilet seat, built up handles, tub chair, safety bars in bath, etc. </li></ul><ul><li>Manual therapies such as craniosacral and myofascial release </li></ul><ul><li>Home evaluation and ADL training may also be needed </li></ul>Exit
  43. 43. Group Analysis Let’s all go home and come up with modalities we want to use. Maybe we should write a problem list first. What is the logical sequence to writing a treatment plan? We need to decide on our goals first. Your team has decided it has all the information it needs to proceed. Next, your team will need to write a treatment plan (the solution). Click on the most appropriate suggestion above. Exit
  44. 44. Setting a Goal I think her pain is a good place to start. She needs some relief fast! I think we need to work on building strength. Good ideas. Would these be short term or long term goals? I think self-efficacy is going to be important too. Choose one of the goal areas above and write a measurable, observable objective in your text box, then click on the suggestions above for examples. Exit
  45. 45. Solution Generation For each of the goal areas, name several treatment modalities appropriate for this case study, then click next page to see if your answers match. Don’t worry if they don’t- there are many different treatment approaches. Pain Weakness Self-efficacy Exit
  46. 46. Problem List <ul><li>Pain </li></ul><ul><li>Fatigue </li></ul><ul><li>Insomnia </li></ul><ul><li>Anxiety </li></ul><ul><li>Depression </li></ul><ul><li>Poor memory </li></ul><ul><li>Weakness </li></ul><ul><li>Poor ROM </li></ul><ul><li>Reduced IADL function </li></ul>Exit
  47. 47. Elaine Davis, LOTR, Ph.D. Elaine is your clinical supervisor. She has been an OT for 12 years and specializes in the treatment of chronic pain. She cares deeply for her client’s and often puts in overtime. Although she is respectful and pleasant with students, she drives you nuts because she never gives you a straight answer. Her favorite response is, “What do you think?” Exit Exit
  48. 48. Jenny INTJ Visual Learner Age: 25 Jenny was valedictorian of her small college graduating class. She has always been very concerned about academics but has had difficulty applying her “book” knowledge to the real world. She worries about her performance in this fieldwork assignment and doesn’t sleep well. Exit Exit
  49. 49. Jana ENFJ Auditory Learner Age: 29 Jana is married to a computer programmer, Steve, and has a 3 year old daughter, Rose. She wants to specialize in pediatrics, partially because Rose has been diagnosed with an autistic spectrum disorder. Jana works hard and yet has a smile for everyone. Exit Exit
  50. 50. Blake ISTP Visual/Kinesthetic Learner Age: 26 Blake is fairly quiet. He enjoys sports and he would like to specialize in sports rehabilitation. He became interested in OT because he tore his ACL in high school playing football. He gets along well with the clients and is known for his practical jokes. Exit Exit
  51. 51. <ul><li>10/15/06 Patient seen for fu </li></ul><ul><li>Continues to c/o pain all over </li></ul><ul><li>D/C Ambien CR Dg: s/p hysterectomy </li></ul><ul><li>Start Lunesta 30 mg OA </li></ul><ul><li>Cont DHEA cervical radiculopathy </li></ul><ul><li>Cymbalta FM </li></ul><ul><li>Mobic Depression </li></ul><ul><li>Lyrica </li></ul><ul><li>Referal to CIM OT eval and tx </li></ul><ul><li>Cynthia Wilson MD </li></ul>Sanders, Karen DOB 9/16/63 Cynthia Wilson MD The Family Physicians Exit
  52. 52. Immune Support .com <ul><li>Understanding Fibromyalgia (Compiled by the National Institute of Arthritis and Musculoskeletal and Skin Diseases) </li></ul><ul><li>What Is Fibromyalgia? Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal pain, fatigue, and multiple tender points. &quot;Tender points&quot; refers to tenderness that occurs in precise, localized areas, particularly in the neck, spine, shoulders, and hips. People with this syndrome may also experience sleep disturbances, morning stiffness, irritable bowel syndrome, anxiety, and other symptoms. </li></ul><ul><li>How Many People Have Fibromyalgia? According to the American College of Rheumatology, fibromyalgia affects 3 to 6 million Americans. It primarily occurs in women of childbearing age, but children, the elderly, and men can also be affected. </li></ul><ul><li>What Causes Fibromyalgia? Although the cause of fibromyalgia is unknown, researchers have several theories about causes or triggers of the disorder. Some scientists believe that the syndrome may be caused by an injury or trauma. This injury may affect the central nervous system. Fibromyalgia may be associated with changes in muscle metabolism, such as decreased blood flow, causing fatigue and decreased strength. Others believe the syndrome may be triggered by an infectious agent such as a virus in susceptible people, but no such agent has been identified. </li></ul>Diagnosis &Treatment Exit Team Research
  53. 53. Immune Support .com <ul><li>How Is Fibromyalgia Diagnosed? Fibromyalgia is difficult to diagnose because many of the symptoms mimic those of other disorders. The physician reviews the patient's medical history and makes a diagnosis of fibromyalgia based on a history of chronic widespread pain that persists for more than 3 months. The American College of Rheumatology (ACR) has developed criteria for fibromyalgia that physicians can use in diagnosing the disorder. According to ACR criteria, a person is considered to have fibromyalgia if he or she has widespread pain in combination with tenderness in at least 11 of 18 specific tender point sites. </li></ul><ul><li>How Is Fibromyalgia Treated? Treatment of fibromyalgia requires a comprehensive approach. The physician, physical therapist, and patient may all play an active role in the management of fibromyalgia. Studies have shown that aerobic exercise, such as swimming and walking, improves muscle fitness and reduces muscle pain and tenderness. Heat and massage may also give short-term relief. Antidepressant medications may help elevate mood, improve quality of sleep, and relax muscles. Patients with fibromyalgia may benefit from a combination of exercise, medication, physical therapy, and relaxation. </li></ul>What is Fibromyalgia? Exit Team Research
  54. 54. Solution Presentation Exit How would you want to present this case to your class? Here are some ideas: Dramatization of a client interview and treatment A task group or self-expression activity PowerPoint Presentation A video documentary An “infomercial”
  55. 55. Evaluation Exit A good presentation should include: Overview of the case study Referenced, evidenced based research A complete treatment plan Interaction with the audience Participation by all PBL team members Handouts/notes for the class
  56. 56. Congratulations! Exit You have completed this tutorial. Remember that the examples of resources and research reports were abbreviated in this tutorial due to space and time constraints. Your instructor will probably expect your work to be more extensive. Check out the tutorial resource page next to make your real PBL experience a little easier!
  57. 57. Resources Exit Problem-Based Learning Samford University’s Center for Teaching, Learning and Scholarship www.samford.edu/ctis/pbl_process.html Elizondo-Montemayor, L.L. (2004) Formative and summative assessment of the problem-based learning tutorial session using a criterion-referenced system. JIAMSE. (14) 8-14. http://www.iamse.org/member/article/volume14-1/14-1-8-14.pdf Fibromyalgia National Fibromyalgia Association http://www.fmaware.org/ www.myalgia.com includes the Fibromyalgia Impact Questionairre www.lifebeyondpain.com Dr. Patrick Wood’s web site on fibromyalgia
  58. 58. References and Credits Exit Journal Article Wood, P.B. (2004). Fibromyalgia syndrome: A central role for the hippocampus- A theoretical construct . Journal of Musculoskeletal Pain ,12(1),19-26. Graphics Tenderpoints graphic accessed on 10/19/06 from www.um-jmh.org/ body.cfm?id=1554 Limbic system: diagram of the brain's limbic system, brainstem, and spinal cord. Governmental source:accessed on 10/30/06 from http://teens.drugabuse.gov/mom/mom_opi5.asp Hippocampus diagram: Public-domain: copyright disclaimed Washington Irving, 2/6/2004 (UTC). From Wikimedia Commons accessed on 10/3006 from: http://en.wikipedia.org/wiki/Image:Hippocampus.png All other graphics from Microsoft Office Clip Art from www.microsoft.com Video Robin Steed, portraying a client with FM
  59. 59. Journal Article Exit Wood, P.B. (2004). Fibromyalgia syndrome: A central role for the hippocampus- A theoretical construct . Journal of Musculoskeletal Pain ,12(1),19-26. The article will open as a pdf file in Adobe Reader. It may take a few seconds. Click here to open article: You can read the article and return to the tutorial whenever you are ready by clicking back on the tutorial icon. Team research Team research
  60. 60. Correct! <ul><ul><ul><li>1. P resentation of the problem </li></ul></ul></ul><ul><ul><ul><li>2. Separation of Facts from unknown facts </li></ul></ul></ul><ul><ul><ul><li>3. R esearch </li></ul></ul></ul><ul><ul><ul><li>4. Group A nalysis </li></ul></ul></ul><ul><ul><ul><li>5. S olution Generation </li></ul></ul></ul><ul><ul><ul><li>6. S olution Presentation </li></ul></ul></ul><ul><ul><ul><li>7. E valuation </li></ul></ul></ul><ul><li>Hint: P roblems F or R esearchers A nd S mart S tudents E vaporate. </li></ul>Exit
  61. 61. Incorrect. The next step is: <ul><ul><ul><li>1. P resentation of the problem </li></ul></ul></ul><ul><ul><ul><li>2. Separation of Facts from unknown facts </li></ul></ul></ul><ul><ul><ul><li>3. R esearch </li></ul></ul></ul><ul><ul><ul><li>4. Group A nalysis </li></ul></ul></ul><ul><ul><ul><li>5. S olution Generation </li></ul></ul></ul><ul><ul><ul><li>6. S olution Presentation </li></ul></ul></ul><ul><ul><ul><li>7. E valuation </li></ul></ul></ul><ul><li>Hint: P roblems F or R esearchers A nd S mart S tudents E vaporate. </li></ul>Exit
  62. 62. Solution Generation For each of the goal areas, name several treatment modalities appropriate for this case study, then click next page to see if your answers match. Don’t worry if they don’t- there are many different treatment approaches. Pain ultrasound, alpha stim, cold laser, hot packs, guided imagery Weakness Self-efficacy Exit
  63. 63. Solution Generation For each of the goal areas, name several treatment modalities appropriate for this case study, then click next page to see if your answers match. Don’t worry if they don’t- there are many different treatment approaches. Pain ultrasound, alpha stim, cold laser, hot packs, guided imagery Weakness warm water exercise, yoga, tai chi, exercise ball, ROM dance Self-efficacy Exit
  64. 64. Solution Generation For each of the goal areas, name several treatment modalities appropriate for this case study, then click next page to see if your answers match. Don’t worry if they don’t- there are many different treatment approaches. successful task completion, journaling, positive self-talk, peer feedback Pain ultrasound, alpha stim, cold laser, hot packs, guided imagery Weakness warm water exercise, yoga, tai chi, exercise ball, ROM dance Self-efficacy Exit

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