1. Interdisciplinary Case Discussion n Rural Health School n Don Uden, PharmD, College of Pharmacy

2. Objectives n Students n Understand the case format and your responsibilities so as to effectively participate in the case discussions in the RHS sessions.

3. Interdisciplinary case studies n Are designed to n have many issues n have aspects that all disciplines can relate to

4. Interdisciplinary case studies n Are used to n stimulate discussion n familiarize students to other disciplines n give a personalized, clinical or community oriented view of a topic n Broaden horizons for ALL disciplines

5. Interdisciplinary case studies n Are NOT n puzzles to solve n tests of technical knowledge n There is no correct answer!!

6. The big question n How do we merge the strengths of each discipline to achieve the best overall care for a patient/client/family? n Especially important in rural or under- served areas

7. Models of care n Medical model --> n in search of the correct diagnosis n Nursing model --> n in search of the best health

8. Models of care n Pharmacy model--> n in search of the best drug therapy n Social work model --> n in search of the best overall person- environment fit

9. Models of care n When assessing an individual or family all disciplines have: n an assessment n care planning n follow-up or evaluation component.

10. Case example n John is a 35 year old married farmer. He has 3 children ages 7, 10, and 12. His wife Mary works with him on their 200 acre farm. They milk 50 dairy cattle with the help of his brother who owns the next farm.

11. Case example n John has not felt well for the past 2 months. He did not feel he could take off time to go to the physician because it was during the haying season. The nearest physician is an hour drive away. When he finally went, he heard the diagnosis leukemia.

12. Case example n He will need to be treated with chemotherapy, on an outpatient basis, for the next 6 weeks. The family canceled its insurance last year because of an inability to pay the premiums. The nearest town (pop 1,200) is 25 minutes away and it has a pharmacy.

13. OSCE (objective structured clinical examination) n A way to assess the “state of interdisciplinariness” of a team n Goal is to work as a team and, in a set time, assess a standardized patient and develop a comprehensive interdisciplinary health-care plan.

14. OSCE - What do you have to do? n Near end of session n Assessment of stdized patient - 45 minutes n Care plan discussion - 45 minutes

15. OSCE - Assessment n Comprehensive and focused providers n Social aspects n Community resources n Traditional assessment n History n Review of systems n Physical examination n Diagnostic testing n Diagnosis/impression

16. OSCE - Discussion n Goal determination n Diagnostic/ psychosocial issues n Disease treatment/interventions and drug therapy n Education/Disease prevention/Health promotion n Consults or referrals n Follow-up