2. Donald W. Reynolds
Foundation
Dedicated to Geriatrics Education
Teaching Geriatrics broadly so that care of the
older patient is improved
Emphasis on Quality of Life
Interprofessional Education
3. Objectives
Upon completion of the TCTP regarding care and transitioning of the
hospitalized older adult, students should be able to:
Relate general geriatric principles of care
Recite at least three potential pitfalls that can occur with hospital
discharge
Explain critical minimum steps that need to occur for safe transition
from hospital to skilled care
Cite examples of common rehabilitation management issues
Discuss benefits of interdisciplinary team care for older adults
Appraise contributions that can be made from the other healthcare
disciplines (other than one’s own) for improved geriatric care
Describe impediments to interdisciplinary discharge planning
communication
Demonstrate ability to manage clinical problems in this unfolding
4. Geriatric Competency Domains
Cognition
Falls
Atypical presentation
Health care planning
Defining care goals
Medication
management
Hospital care
Self-care capacity
5. Orientation
The interactive case system is designed to engage teams composed of individuals from
multiple disciplines in an extended web-based unfolding case exercise.
At the start of each segment of the unfolding case, each discipline receives information
specific to the typical role of that discipline.
Team members from other disciplines each receive different, discipline-specific
information, thus mirroring real life.
To succeed, team members must share their clinical information through the system’s
electronic chart and then problem solve together.
Learners will be provided instruction, through the case system, on addressing functional
impairments, quality of life issues, behavioral issues, and family concerns for a simulated
older female patient as she is followed through her hospitalization for a hip fracture,
transition of care to a skilled care facility, and the subsequent skilled care stay.
6. Case
Collaboratively “manage” the care of an
elderly woman through three episodes of care
(modules of case).
Week one/inpatient module
Week two/module transitioning from hospital to a
skilled nursing facility (SNF)
Week three/module in SNF as the patient is
preparing to be discharged home
7. Teams
Senior Nursing students
Medical students in Internal Medicine sub-I
Pharmacy students
Social Work student
OT students
PT students
8. Tasks
1: Chart
2: Learn from other
disciplines. Interact!
3: Review
questions, read and
ask to learn more
4: Complete
answers as able
9. Grading
Pass-fail
Determined by proctor in your discipline
Proctor will be viewing interactions
“Adequate interaction with team”
You are expected to log on twice daily and
contribute at least 2 substantive posts or
replies daily
10. Module Closing Dates (2015)
Module Close Date (11:59 PM)
1 Tuesday, November 3rd
2 Tuesday, November 10th
3 Tuesday, November 17th
11. Feedback session
Set optional time to come give feedback at the
end of session.
Evaluations must be completed for you to
pass.
Online or in person
12. Access case on Blackboard
https://bb.kumc.edu/
Log in using your KUMC user name and
password
Blackboard support: dmehling@kumc.edu
20. “Outside my profession's usual
practice”
If able, would like you to try to answer
questions, even if it is challenging.
21. Answers to test questions
Final answers to be submitted, then, after
midnight of the due date, the acceptable
answers to these questions will appear.
22. Time Management, Review
Meet team/introductions
Decide responsibilities
Each unit lasts 1 week – use time well
Number of questions
Add clinical material to case
Answer questions by midnight of the next
Monday.
23. Questions for your team
How will you engage team members who are
absent today?
How about engaging team members who are
not active during ongoing case work?
How will your team communicate?
Defined dates for entering clinical information?
Dates for entering individual answers?
How will you decide about group answers?
Who will enter group answers?
24. Ground Rules
You may use any method of communication you like
Case forum is required for team dialogue
We will evaluate based on what we see in forum
If external dialogue is created
Document discussion inside the case website (like a chart)
Use any published resources you like
You may meet as a team, in person or in cyberspace
You may not discuss case content with people outside
your team (e.g. learners doing this before or after).
25. Goals of proctoring
Help team with team process
Guide team approaches to interaction
Provide feedback on process work and outcomes
Counseling, perhaps chasing down team members
who are not contributing satisfactorily
Trouble shoot technical issues, find help where
needed
Blackboard support: dmehling@kumc.edu
Grade each student’s teamwork after each unit
26. Proctor responsibilities
Supervise students of your discipline
Introduce yourself to the group if you have not yet met
Log in frequency
Ensure all of your students are participating
Your students will contribute to the wiki in one color
font but you should monitor if each student is
contributing (if more than one student in each group)
Be available to guide students regarding content
(eg, if there is a question about whether the student should know this
content)
Determine and follow through on the “grades” for
your students
Editor's Notes
Millions of dollars
Interdisciplinary team-coordinated medical care is recognized as a way to better identify, assess, manage and prevent older individuals’ overlapping acute and chronic medical and psychosocial problems.
In July 2007, the Association of American Medical Colleges (AAMC) and the John A. Hartford Foundation (JAHF) hosted a National Consensus Conference on Competencies in Geriatric Education. The charge was to attain consensus on a minimum set of graduating medical student competencies (learning outcomes) to assure competent care to older patients by new interns.
1. Cognitive and behavioral disorders
2. Medication management
3. Self-care capacity
4. Falls, balance, gait disorders
5. Atypical presentation of disease
6. Palliative care
7. Hospital care for elders
8. Health care planning and promotion
As it is web based, individual participation will be asynchronous
Not only is it critically important to have disciplines talk amongst themselves Transitions of care is important as when patient care is being handed off
You will have several students of some disciplines on your team and will not have other disciplines represented.
If you have several students in one discipline, please divide up responsibilities
If you have no students in a discipline, you will have access to the notes from that discipline and are expected to read those to help you answer questions.
Charting is for the purpose of documenting what knowledge you have (not graded on this but is good practice and helpful for sharing and having a record)
You only have some of the information. The rest of the team has had other interactions and likely additional information and baseline knowledge. You are encouraged to work as a team—ask your colleagues about what they know and try to solve the problems together!
Read questions—there will likely be many questions that you don’t know or you might think are out of your scope of practice. However, you should push yourself to read more, eg, from our resources and learn if this is something that may possibly apply to you.
Do your best to complete answers after reading and learning.
As emphasis is on the interaction,
Faculty proctors assigned for each discipline. These proctors will be responsible for assuring all team members are participating and are available for assistance. They can log on and see interactions. They will also be responsible for grading (passing grade necessary). Acceptable level of performance will be decided by proctors and they will be responsible for determination of passing grade.
You will be getting more details on feedback session.
If there are significant challenges, please tell us individually.
This is your “chart”
You are not being judged/graded on the details of the charting. The goal, as in real life, is that you can document information about the patient to share with other clinical staff. The goal of completing this is to optimize communication (and patient care) and help you answer questions.
You can add rows to the charts by clicking on “Edit Wiki content”
You will see some differentiations in this “chart” that do not occur in most charting but hopefully you will see how clinically helpful it can be to for instance recognize the patient’s function previously as compared to now.
Not more than one person can be editing this wiki at one time, therefore, it would be wise to decide ahead of time how to access this, who will be responsible, etc.
Will help team members understand who has got this info
It is quite likely that there will be questions that you do n
We have links to helpful educational resources.
This option is only to be used if your profession does not have the information or capacity to answer the question.
Encouraged to manage time well, work as a team and distribute the work.
For instance, decide how many days to do each task, when final answers will be submitted and who is responsible for entering AND how will interactions occur.
