Week 6: Clinical Case Study Part Two Discussion

Week 6: Clinical Case Study Part Two Discussion (Initial post due on Thursday; responses due on Sun.)

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Purpose

Problem-based learning is a methodology designed to help students develop the reasoning process used in clinical practice through problem solving actual patient problems in the same manner as they occur in practice.  The purpose of this activity is to develop students’ clinical reasoning skills using a case-based learning exercise. Through participation in an online discussion forum, students identify learning issues in a self-directed manner which facilitates learning for the entire group.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Synthesize clinical knowledge, didactic learning and research findings to provide appropriate primary care to patients with common acute and stable chronic conditions. (WO6.1) (CO 1, 2, 4 & 5)

Due Date: 

Student enters initial post to part one by 11:59 p.m. MT on THURSDAY;responds substantively to at least one topic-related post of a peer including evidence from appropriate sources AND all direct faculty questions in parts oneby Sunday, 11:59 p.m. MT.

A 10% late penalty will be imposed for discussions posted after the deadline on THURSDAY 11:59pm MT, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.

Total Points Possible:  50

Requirements:

1. What is your primary (one) diagnosis for this patient at this time? (support the decision for your diagnosis with pertinent positives and negatives from the case)
2. Identify the corresponding ICD-10 code.
3. Provide a treatment plan for this patient’s primary diagnosis which includes:
   • Medication*
   • Any additional testing necessary for this particular diagnosis*
   • Patient education
   • Referral
4. Provide an active problem list for this patient based on the information given in the case.
5. Are there any changes that you would also make to this patient’s overall treatment plan at this time? Must provide an EBM argument for each treatment or testing decision.
6. Provide an appropriate F/U plan.

*If part of the plan does not warrant an action, you must explain why. ALL medication and testing decisions (or decisions not to treat with medication or additional testing) MUST be supported with an evidence-based medicine (EBM) argument. Over-the-counter (OTC) and RXs must be written in full as if handing a script to the patient in the office.

 

Case Study

Now, assume that you sent your patient for labs and she returns the following day, as instructed, to review the results.

CBC with differential

WBC

8.6 x10E3/uL

RBC

4.44 x 10E6/uL

Hemoglobin

14.0 g/dL

Hematocrit

41.2%

MCV

93fL

MCH

31.5 pg

MCHC

34.0 g/dL

RDW

13%

Platelet

241 x 10E3/uL

Neutrophils %

67%

Lymphocytes %

22%

Monocytes %

8%

Eosinophils %

3%

Basophils %

0%

Absolute Neutrophils

5.7 x 10E3/uL

Absolute Lymphocytes

1.9 x 10E3/uL

Absolute Monocytes

0.7 x 10E3/uL

Eosinophils Absolute

0.3  x 10E3/uL

Basophile Absolute

0.0  x 10E3/uL

Immature Grans %

0%

Absolute Immature Grans

0.0 x 10E3/uL

TSH with Reflex to FT4

TSH

6.770 uIU/mL

FT4

0.62 ng/dL

PHQ-9 Depression Score=10 (previous was 5 at last visit 6 months ago)

 

**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.

DISCUSSION CONTENT

Category

Points

%

Description

Application of Course Knowledge

15

30%

1. Student chooses one appropriate diagnosis for the patient; AND
2. Diagnosis is supported with strong pertinent positive and negative subjective and objective data from parts 1 & 2; AND
3. The ICD code for the diagnosis is correct; AND
4. Treatment plan for primary diagnosis includes medication, additional testing, patient education, and referral; AND
5. Prescription and OTC medications are written appropriately as a RX and all components are correct; AND 
6. Treatment decisions (medication, additional testing, referrals) are supported with appropriate EBM arguments; AND 
7. An accurate problem list is presented based on case information; AND 
8. Student discusses changes (or not) to the overall treatment plan for the patient for pertinent issues; AND 
9. An appropriate F/U plan is provided

(9 critical elements)

Support from Evidence-Based Practice (EBP)

15

30%

1. Discussion post is supported with appropriate, scholarly sources AND
2. Sources are published within the last 5 years (unless the most current CPG is used) AND
3. A reference list is provided with in-text citations that match AND
4. All treatment and testing decisions are fully supported with an appropriate EBM argument

(4 critical elements)

Interactive Dialogue

10

20%

1. Student provides a substantive* response to at least one topic-related post of a peer AND
2. Includes evidence from appropriate scholarly sources AND
3. Provides a reference list which match in-text citations AND
4. Student responds to all direct faculty questions

(4 critical elements)

 

 

 

Total CONTENT Points= 40 pts

DISCUSSION FORMAT

Category

Points

%

Description

Organization

5

10%

1. Case study response is presented in a logical format, AND
2. Responses are in sequence with the numbered questions AND
3. The case study response is understandable and easy to follow AND
4. All responses are relevant to the case topic

(4 critical elements)

Grammar, Syntax, Spelling & Punctuation

5

10%

Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*

 

 

 

 

Total FORMAT Points= 10 pts

 

 

 

DISCUSSION TOTAL= 50 pts

 

**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.