PRAC 6675 Week 4 Discussion: Complex Case Study Presentation

PRAC 6675 Week 4 Discussion: Complex Case Study Presentation

PRAC 6675 Week 4 Discussion: Complex Case Study Presentation

In Weeks 4, 7, and 9 of the course, you will participate in clinical discussions called grand rounds. In one of these three weeks, you will be a presenter as well as help facilitate the online discussion; in the others you will be an active discussion participant. When it is your week to present, you will create a Focused SOAP note and a short didactic (teaching) video presenting a real (but de-identified) complex patient case from your practicum experience.

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You should have received an assignment from your Instructor letting you know which week of the course you are assigned to present.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

Learning Resources

Required Readings

Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.

Chapter 26, “Assessing Alcohol Use Disorder”

Meditrek

Links to an external site.

https://edu.meditrek.com/Default.html

Note:?Use this website to log into?Meditrek?to report your clinical hours and patient?encounters.to an external site.

Document: Focused SOAP Note Template (Word document)

Download Focused SOAP Note Template (Word document)

Document: Focused SOAP Note Exemplar (Word document)

Download Focused SOAP Note Exemplar (Word document)

Stahl, S. M. (2021a). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th ed.). Cambridge University Press.

Chapter 13, “Impulsivity, Compulsivity, and Addiction”

Office of Disease Prevention and Health Promotion. (n.d.). Social Determinates of Health.

Links to an external site. Healthy People 2030. U.S. Department of Health and Human Services. https://health.gov/healthypeople/priority-areas/social-determinants-health

Recommended Readings

American Psychiatric Association. (2018). Practice guideline for the pharmacological treatment of patients with alcohol use disorder

Links to an external site.. https://psychiatryonline.org/doi/book/10.1176/appi.books.9781615371969

Links to an external site.

American Society of Addiction Medicine. (2020). Clinical practice guidelines on alcohol withdrawal management

Links to an external site.. https://www.asam.org/docs/default-source/quality-science/the_asam_clinical_practice_guideline_on_alcohol-1.pdf?sfvrsn=ba255c2_2

Links to an external site.

American Society of Addiction Medicine. (2020). National practice guideline for the treatment of opioid use disorder: 2020 focused update

Links to an external site.. http://eguideline.guidelinecentral.com/i/1224390-national-practice-guideline-for-the-treatment-of-opioid-use-disorder-2020-update/0

Links to an external site.

Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.

To prepare:

Review this week’s Learning Resources and consider the insights they provide. Also review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.

Select a child/adolescent or adult patient from your clinical experience that presents with a significant concern. Create a focused SOAP note for this patient using the template in the Resources. All SOAP notes must be signed by your Preceptor. When you submit your SOAP note, you should include the complete SOAP note as a Word document and PDF/images of completed assignment signed by your Preceptor. You must submit your SOAP Note using Turnitin.

Please Note: Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Late Policies.

Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice what you will say beforehand, and ensure that you have the appropriate lighting and equipment to record the presentation.

Your presentation should include objectives for your audience, at least 3 possible discussion questions/prompts for your classmates to respond to, and at least 5 scholarly resources to support your diagnostic reasoning and treatment plan.

Video assignment for this week’s presenters:

Record yourself presenting the complex case study for your clinical patient. In your presentation:

Dress professionally and present yourself in a professional manner.

Display your photo ID at the start of the video when you introduce yourself.

Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information).

State 3–4 objectives for the presentation that are targeted, clear, use appropriate verbs from Bloom’s taxonomy, and address what the audience will know or be able to do after viewing.

Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management.

Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value.

Pose three questions or discussion prompts, based on your presentation, that your colleagues can respond to after viewing your video.

Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide.

Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?

Objective: What observations did you make during the psychiatric assessment?

Assessment: Discuss their mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5-TR diagnostic criteria and is supported by the patient’s symptoms.

Plan: What was your plan for psychotherapy (include one health promotion activity and patient education)? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Discuss an identified social determinate of health impacting this patient’s mental health status and provide your recommendation for a referral to assist this patient in meeting this identified need (students will need to conduct research on this topic both in the literature and for community resources).

Reflection notes: What would you do differently with this patient if you could conduct the session again? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow-up, discuss what your next intervention would be.

A note on grading:

Presenters: Review the Grand Rounds Presenter Rubric attached to this discussion to ensure you meet the scoring criteria.

Participants: Review the Grand Rounds Participant Rubric located on the following Week 4 Assignment 1 page to ensure you meet the scoring criteria. Note the Week 4 Assignment 1 page is for viewing the participant rubric only. Your response should be posted in the forum of this page.

Week 4 Presenters:

By Day 3

Post your video and your focused SOAP note to the Grand Rounds Discussion forum. You must submit two files for the SOAP note, including a Word document and scanned PDF/images of completed assignment signed by your Preceptor. Then, actively respond to and guide the conversation as your colleagues post responses to your video.

Week 4 Participants:

By multiple days between Days 4 and 7

Respond at least 2 times each to all colleagues who presented this week (should be 2-3 presenters each week). The goal is for the discussion forum to function as robust clinical conferences on the patients. Provide a response to 1 of the 3 discussion prompts that your colleagues provided in their video presentations. You may also provide additional information, alternative points of view, research to support treatment, or patient education strategies you might use with the relevant patient.

PRAC_6675_Week4_Discussion_Presenter_Rubric

PRAC_6675_Week4_Discussion_Presenter_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome Photo ID Display and Professional Attire
5 to >0.0 pts

Excellent

Photo ID is displayed. The student is dressed professionally.

0 pts

Fair

0 pts

Good

0 pts

Poor

Photo ID is not displayed. Student must remedy this before grade is posted. The student is not dressed professionally.

5 pts

This criterion is linked to a Learning Outcome Time
5 to >0.0 pts

Excellent

The video does not exceed the 8-minute time limit.

0 pts

Fair

0 pts

Good

0 pts

Poor

The video exceeds the 8-minute time limit. (Note: Information presented after the 8 minutes will not be evaluated for grade inclusion.)
5 pts

This criterion is linked to a Learning Outcome Objectives for the Presentation

5 to >4.0 pts

Excellent

3–4 objectives provided and written in terms of what the audience will know or be able to do after viewing. Appropriate Bloom’s verbs are used. Objectives are targeted and clear.

4 to >3.5 pts

Good

3–4 objectives provided and written in terms of what the audience will know or be able to do after viewing. Appropriate Bloom’s verbs are used.

3.5 to >3.0 pts

Fair

At least 3 objectives provided and written in terms of what the audience will know or be able to do after viewing, but are somewhat vague or unclear. Appropriate Bloom’s verbs may be missing.

3 to >0 pts

Poor

Fewer than 3 objectives provided. Objectives for the presentation are vague, unclear, or missing.
5 pts

This criterion is linked to a Learning Outcome Discuss subjective data:• Chief complaint• History of present illness (HPI)• Medications• Psychotherapy or previous psychiatric diagnosis• Pertinent histories and/or ROS
5 to >4.0 pts

Excellent

The video is a Kaltura video and accurately and concisely presents the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis.

4 to >3.5 pts

Good

The video is not a Kaltura video but easily opened and accurately presents the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis.

3.5 to >3.0 pts

Fair

The video is not a Kaltura video and did not open without needing to reach the student. The 2nd attempt video presents the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis but is somewhat vague or contains minor inaccuracies.

3 to >0 pts

Poor

There is no video submission or video presents an incomplete, inaccurate, or unnecessarily detailed/verbose description of the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis. Or subjective documentation is missing.
5 pts

This criterion is linked to a Learning Outcome Discuss objective data:• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses

10 to >8.0 pts

Excellent

The video accurately and concisely documents the patient’s physical exam for pertinent systems. Pertinent diagnostic tests and their results are documented, as applicable.

8 to >7.0 pts

Good

The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are documented, as applicable.

7 to >6.0 pts

Fair

Documentation of the patient’s physical exam is somewhat vague or contains minor inaccuracies. Diagnostic tests and their results are documented but contain inaccuracies.

6 to >0 pts

Poor

The response provides incomplete, inaccurate, or unnecessarily detailed/verbose documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or objective documentation is missing.
10 pts

This criterion is linked to a Learning Outcome Discuss results of assessment:• Results of the mental status examination• Provide a minimum of three possible diagnoses in order of highest to lowest priority and explain why you chose them. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and is supported by the patient’s symptoms.
20 to >17.0 pts

Excellent

The video accurately documents the results of the mental status exam. Video presents at least 3 differentials in order of priority for a differential diagnosis of the patient, and a rationale for their selection…. Response justifies the primary diagnosis and how it aligns with DSM-5-TR criteria.

17 to >15.0 pts

Good

The video adequately documents the results of the mental status exam…. Video presents 3 differentials for the patient and a rationale for their selection. Response adequately justifies the primary diagnosis and how it aligns with DSM-5-TR criteria.

15 to >13.0 pts

Fair

The video presents the results of the mental status exam, with some vagueness or inaccuracy…. Video presents 3 differentials for the patient and a rationale for their selection. Response somewhat vaguely justifies the primary diagnosis and how it aligns with DSM-5-TR criteria.

13 to >0 pts

Poor

The response provides an incomplete, inaccurate, or unnecessarily detailed/verbose description of the results of the mental status exam and explanation of the differential diagnoses. Or assessment documentation is missing.
20 pts

This criterion is linked to a Learning Outcome Discuss treatment plan: • A treatment plan for the patient that addresses psychotherapy; one health promotion activity and one patient education strategy; plan for treatment and management, including alternative therapies; pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters; and a rationale for the approaches selected. Discusses an identified social determinate of health impacting this patient’s mental health status and provide your recommendation for a referral to assist this patient in meeting this identified need

20 to >17.0 pts

Excellent

The video clearly and concisely outlines an evidence-based treatment plan for the patient that addresses psychotherapy, health promotion and patient education, treatment and management, pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. A clear and concise rationale for the treatment approaches recommended is provided. Discussion includes a social determinate of health need impacting mental health status with referral recommendation and evidence of researching literature and incorporating local community resources

17 to >15.0 pts

Good

The video clearly outlines an appropriate treatment plan for the patient that addresses psychotherapy, health promotion and patient education, treatment and management, pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters. A clear rationale for the treatment approaches recommended is provided. Discussion includes a social determinate of health need impacting mental health status with referral recommendation but no evidence of researching literature and incorporating local community resources

15 to >13.0 pts

Fair

The response somewhat vaguely or inaccurately outlines a treatment plan for the patient and provides a rationale for the treatment approaches recommended. Discussion includes a social determinate of health need impacting mental health status with no referral recommendation or evidence of researching literature and incorporating local community resources

13 to >0 pts

Poor

The response does not address the diagnosis or is missing several elements of the treatment plan.

20 pts

This criterion is linked to a Learning Outcome Reflect on this case. Discuss what you learned and what you might do differently. Pose 3 questions or discussion prompts, based on your presentation, that your colleagues can respond to after viewing your video.
5 to >4.0 pts

Excellent

Reflections are thorough, thoughtful, and demonstrate critical thinking…. Questions or prompts for colleagues are thought-provoking and will require substantive responses and critical thinking.

4 to >3.5 pts

Good

Reflections demonstrate critical thinking. Questions or prompts for colleagues are appropriate and will require substantive responses.

3.5 to >3.0 pts

Fair

Reflections are somewhat general or do not demonstrate critical thinking. Questions or prompts for colleagues are somewhat general and may not require substantive responses.

3 to >0 pts

Poor

Reflections are incomplete, inaccurate, or missing. Questions or prompts for colleagues are general, inappropriate, or missing.

5 pts

This criterion is linked to a Learning Outcome Focused SOAP Note

10 to >8.0 pts

Excellent

The response clearly, accurately, and thoroughly follows the SOAP format to document the selected patient case. Preceptor signature and date pdf/image is uploaded on the completed assignment (not an electronic signature).

8 to >7.0 pts

Good

The response accurately follows the SOAP format to document the selected patient case. Preceptor signature and date pdf/image is uploaded on the completed assignment but is an electronic signature.

7 to >6.0 pts

Fair

The response follows the SOAP format to document the selected patient case, with some vagueness and inaccuracy. Preceptor signature and date pdf/image is uploaded on the completed assignment but is an electronic signature.

6 to >0 pts

Poor

The response incompletely and inaccurately follows the SOAP format to document the selected patient case. No preceptor signature submitted.
10 pts

This criterion is linked to a Learning Outcome Presentation Style
5 to >4.0 pts

Excellent

Presentation style is exceptionally clear, professional, and focused.

4 to >3.5 pts

Good

Presentation syle is clear, professional, and focused.

3.5 to >3.0 pts

Fair

3 to >0 pts

Poor

Presentation style is unclear, unprofessional, and/or unfocused.
5 pts

This criterion is linked to a Learning Outcome Discussion Facilitation

10 to >8.0 pts

Excellent

Presenters effectively lead, sustain, and engage the discussion from Day 4 through Day 7.

8 to >7.0 pts

Good

Presenters lead, sustain, and engage the discussion from Day 4 through Day 7.

7 to >6.0 pts

Fair

Presenters lead, sustain, and engage the discussion at least three out of four days between Days 4 and 7.

6 to >0 pts

Poor

Presenters did not sustain and engage the discussion through Day 7.

10 pts

Total Points: 100