2. A Note to Facilitators
Dear Facilitator, Thank you for using Rural PREP’s materials to create an active learning experience for your site. Use this slide deck, along with the Facilitator Lesson Plan, to facilitate the Grand Rounds event at your site. Many of the slides contain additional information in the presenter notes area, so be sure to review the presentation and the notes prior to your Grand Rounds event.

3. Session Overview
10 minutes: Go over and discuss pre-assignment answers with the full group
20 minutes: Watch the Presentation
20 minutes: Facilitate the Team Activity
5 minutes: General Discussion and Social Charge
5 minutes: Evaluation of the Learning Materials as a group (5 minutes)
Facilitator,
Here are some time estimates to guide you as you move through each activity in this active learning session.

4. Alcohol Detox in a Rural Setting
Rural PREP Grand Rounds
Presenters: Kim Kardonsky, MD
Underserved Pathway Director and Targeted Rural and Underserved Scholars Track
and
Dave Evans, MD
MD Program Director for University of Washington Family Medicine Residency and Rosenblatt Family Endowed Professor in Rural Health at the University of Washington
This presentation was originally recorded on October 25th, 2018, in front of several
live, online sites connecting from different places across the country.
Facilitator,
Once you have gathered your teams in one place and confirmed that each person has brought with them a copy of their individual responses to the pre-assignment activities (from the web link you sent them), you can begin with this slide to introduce the active learning session.

5. Objectives After this presentation, participants will be able to:
Describe the prevalence of alcohol abuse and withdrawal in rural environments
Identify the unique considerations for alcohol abuse and treatment in rural settings
Discern which patients are appropriate for out-patient vs in-patient treatment, based on available options in a rural setting
Facilitator,
Please review these learning objectives with your teams. At the end of the session, we will ask you to evaluate how we our materials meet these objectives.

6. Team Readiness Quiz Facilitator,
You are about to begin the Team Readiness Quiz. The next few slides contain the questions and correct answers for the pre-assignment quiz. Everyone in the room should have their individual answers with them. When each question is presented, have teams discuss among themselves until they agree upon an answer. This may be very quick for easy questions or may take longer on tougher questions, where team members may disagree.
An added way to enhance this portion of the event is to give each team colored pieces of paper with Letters printed on them (each group gets a green “A” or a yellow “B” so that team answers can easily be viewed by the entire group.
The first question is on the next slide, and the correct answer is on the following slide.

7. Team Readiness Quiz
According to the RHI Hub, the prevalence of binge and heavy alcohol use among year olds is greater in completely rural areas compared to large urban areas.
a. True
b. False

8. Team Readiness Quiz
According to the RHI Hub, the prevalence of binge and heavy alcohol use among year olds is greater in completely rural areas compared to large urban areas.
a. True
b. False

9. Team Readiness Quiz
According to the RHI Hub, which of the following is NOT an organization that provides substance abuse information and prevention program resources for youth:
a. Truth Initiative
b. Keepin’ it REAL Rural
c. TEDS
d. Helping Kids PROSPER

10. Team Readiness Quiz
According to the RHI Hub, which of the following is NOT an organization that provides substance abuse information and prevention program resources for youth:
a. Truth Initiative
b. Keepin’ it REAL Rural
c. TEDS
d. Helping Kids PROSPER

11. Team Readiness Quiz
According to the RHI Hub, approximately 60% of drug overdose deaths across the country in 2015 were attributed to: a. Cannabis b. Alcohol c. Methamphetamine d. Opioids

12. Team Readiness Quiz
According to the RHI Hub, approximately 60% of drug overdose deaths across the country in 2015 were attributed to: a. Cannabis b. Alcohol c. Methamphetamine d. Opioids

13. Team Readiness Quiz
According to the TEDS report, substance abuse is more common in the rural population than in the urban population with (check all that apply): a. cocaine b. opiate pain relievers c. heroin d. alcohol e. stimulants

14. Team Readiness Quiz
According to the TEDS report, substance abuse is more common in the rural population than in the urban population with (check all that apply): a. cocaine b. opiate pain relievers c. heroin d. alcohol e. stimulants

15. Team Readiness Quiz
According to Muncie, Yasinian, and Oge’, this class of medications reduces psychomotor aggression and prevents progression of alcohol withdrawal symptoms: a. Benzodiazepines b. Phenothiazines c. Vitamins (Thiamine and Folic acid) d. Barbiturates

16. Team Readiness Quiz
According to Muncie, Yasinian, and Oge’, this class of medications reduces psychomotor aggression and prevents progression of alcohol withdrawal symptoms: a. Benzodiazepines b. Phenothiazines c. Vitamins (Thiamine and Folic acid) d. Barbiturates

17. Alcohol and Detox in a Rural Setting
Presented by:
Kim Kardonsky, MD
Underserved Pathway Director and Targeted Rural and Underserved Scholars Track
and
Dave Evans, MD
MD Program Director for University of Washington Family Medicine Residency and Rosenblatt Family Endowed Professor in Rural Health at the University of Washington
Facilitator,
It is now time to play the presentation by Kim Kardonsky and Dave Evans. Click on the “Launch the Presentation Now” link in the slide ( to play the video, which is 18:51 minutes long.
Launch the Presentation Now

18. Team Activity Facilitator,
Now that you’re finished playing the presentation, it is time to begin the team activity portion of the session. The next slide presents follow-up questions on the case presented in the video presentation. Have each team discuss the protocol they would follow to address the case. Teams are encouraged to use the AAFP navigator tool to find information about your community’s resources.

19. Team Activity
What if the person in the case we just presented came in to your rural community practice?
What do you do first?
Who do you call?
What community resources can you tap?
Would the care of this patient require inpatient treatment in your community?
Use the AAFP Neighborhood Navigator Tool and perhaps expand what you may already know about your community’s resources:

21. Discussion Facilitator,
Allow a member of each team to share their discussions and report on how they would respond to the case to the entire group. You may wish to ask questions about each case as it relates to your particular rural context.

22. Social Charge
What are you personally going to do with this information?
Facilitator,
As a group, consider how you might use this information to improve your rural practice.

23. Evaluation
Please evaluate these learning materials as a group:
Facilitator,
While you still have everyone together, please take a few minutes to provide us with some feedback so we can better serve you. Complete the following form:
You only need to submit one form for your entire group.