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Case Name & Day Restriction of Use: The School of Medicine considers all PBL cases and supporting materials to be secure and intended solely for the educational purposes of the students and faculty of the University of Texas Medical Branch. Students should not access the PBL cases prior to release on the course website. At no time should the PBL cases and supporting materials be copied or distributed. Individuals violating these policies are subject to disciplinary action. Slide 1 of 28 Background This slide includes: • An introduction of the patient from his/her background story up to the reason for the visit (possibly including a history of present illness). Go through the PBL Process before moving to the next slide. Start Problem and Hypotheses Lists on the whiteboard. Slide 2 of 28 Past Medical History Go through PBL Process before moving to next slide. Continue Problem and Hypotheses Lists. What additional information Slide 3 of 28 would you like to know and how would you obtain it? Family History Go through PBL Process before moving to next slide. Continue Problem and Hypotheses Lists. What additional information would Slide 4 of 28 you like to know and how would you obtain it? Social History Go through PBL Process before moving to next slide. Continue Problem and Hypotheses Lists. What would you want to learn Slide 5 of 28 from the physical exam? Physical Exam • Review of Systems • Physical Findings Go through PBL Process before moving to next slide. Continue Problem List as needed and revise and prioritize the Hypotheses List Slide 6 of 28 Tasks This slide might include: • Can you form hypotheses regarding pathogenesis based on the problem list? List them on whiteboard. • Consider VITAMIN ABCDE. • What other information would you like to have about the patient to confirm or disconfirm hypotheses? • How could you get the information you need? Discuss the above tasks (if not already discussed) before proceeding to next slide. Slide 7 of 28 Additional Information This slide might include: • Information from questions asked of the patient • Lab values • Exhibits Revise the problem list as needed. Revise and prioritize Hypotheses List based on new information. Slide 8 of 28 Exhibit 1 This slides will include: • Exhibits that are embedded within the case (rather than hyperlinked at the end of the case). Slide 9 of 28 Tasks This slide might include: • Pharmacology • Possible treatment choices • Additional information needed about this patient • Diagrams Discuss the above tasks (if not already discussed) before proceeding to next slide. Slide 10 of 28 End Day 1 Please turn off projector using the wall-mounted key pad. Thank you. Slide 11 of 28 Begin Day 2 Case Name & Day Restriction of Use: The School of Medicine considers all PBL cases and supporting materials to be secure and intended solely for the educational purposes of the students and faculty of the University of Texas Medical Branch. Students should not access the PBL cases prior to release on the course website. At no time should the PBL cases and supporting materials be copied or distributed. Individuals violating these policies are subject to disciplinary action. Slide 12 of 28 Student Presents Patient Subjective • • • • • Patient Demographics PMH FH SH ROS Objective • PE • Labs Slide 13 of 28 Student Presents Patient Assessment • • • • Primary problem Possible etiologies Relation among problems Rationale for interventions and diagnostic tests Plan • Current medications • Management steps Slide 14 of 28 Learning Issues • Discuss the learning issues and apply them to the case. • Revise or reprioritize the Hypotheses List (if necessary) based on information ascertained from the discussion. Slide 15 of 28 Diagnosis This slide includes: • A diagnosis given to the patient and the patient’s reaction/questions. • Tasks that should prompt the students to answer any patient questions and to justify the diagnosis given by providing the confirming evidence for the diagnosis or the disconfirming evidence for competing diagnoses. STOP and discuss before advancing slide. Slide 16 of 28 Treatment • Depending on the case, this may take the form of a description of treatment undertaken or a description of treatment options presented to the patient. • This may take multiple slides and include patient questions about treatment. STOP and discuss before advancing slide. Slide 17 of 28 Tasks Tasks at this point should include the impact of treatment medically, psychologically and socially. Such as: • Describe the effect of treatment(s) on problems. • Describe other effects (possibly unintended) of treatment. • Compare cost associated with treatment options. • Discuss adherence issues for treatment regimen or recovery time if treatment is surgical. Discuss the above tasks (if not already discussed) before proceeding to next slide. Slide 18 of 28 End Day 2 Please turn off projector using the wall-mounted key pad. Thank you. Slide 19 of 28 Begin Day 3 Case Name & Day Restriction of Use: The School of Medicine considers all PBL cases and supporting materials to be secure and intended solely for the educational purposes of the students and faculty of the University of Texas Medical Branch. Students should not access the PBL cases prior to release on the course website. At no time should the PBL cases and supporting materials be copied or distributed. Individuals violating these policies are subject to disciplinary action. Slide 20 of 28 Student Presents Patient Subjective • • • • • Patient Demographics PMH FH SH ROS Objective • PE • Labs Slide 21 of 28 Student Presents Patient Assessment • • • • Primary problem Possible etiologies Relation among problems Rationale for interventions and diagnostic tests Plan • Current medications • Management steps Slide 22 of 28 Learning Issues • Discuss the learning issues and apply them to the case. • Revise or reprioritize the Hypotheses List (if necessary) based on information ascertained from the discussion. Slide 23 of 28 Patient Follow-Up This slide includes: • Follow-up visit including unresolved problems • Follow-up lab values where appropriate Discuss before advancing slide. If new or unresolved problems are present, you may want to go back through the PBL Process. Slide 24 of 28 Synthesizing Tasks This slide may include: Learning activities, e.g., quizzes, concept maps, etc • Are there tasks such as diagrams etc that would help students synthesize the information in this case? • Also consider alternate ending scenarios of how might this outcome be different : • if the patient were older or younger? • had chosen a different treatment option • had a concurrent diagnosis of . . ., etc. Slide 25 of 28 Theme Issues / Tasks This slide may include: • Tasks focused on issues about health care delivery, preventive health, or professionalism that students should consider in reflecting on the case. Slide 26 of 28 Credits • Case author(s): • Image attribution: Slide 27 of 28 End Day 3 Please turn off projector using the wall-mounted key pad. Thank you. Slide 28 of 28