- Mary (Role-clarification and Patient-centred care): Mary was used in the 2010 winter term as an interprofessional exercise involving first year medical students, first year nursing students, advanced standing nursing students and second year occupational therapy students. Nursing and medical students met face-to-face on two occasions focusing on role clarification and patient centred care. Occupational therapy students (who were on placement) were already famliar with Mary's case, having encountered her in a previous course. They functioned as virtual consultants via email and discussion boards. Students were tasked with reviewing video of Mary and Debbie expressing their concerns related to her recent wrist fracture. Together, they worked to identify and respond to the patient issues, in the process discovering how their roles intersected and complemented those of their other professional colleagues. In addition to preparing a treatment plan for Mary, student were asked to reflect on what they had learned about roles during the exercise. [Way & Jones, 2000 - Collaboration: "an interprofessional process of communication and decision-making that enables the separate and shared knowledge and skills of health care providers to synergystically influence the client/patient care provided"] Lindsay Davidson, Catherine Donnelly
- Sophia (Role-clarification, patient-centred care, patient safety) was developed to highight the complex nature of patient non-adherence. She, like many patients, has many barriers to following directions pertaining to her health, and is not simply someone who does not wish to comply. The case focuses on her challenges and highlights how different health professionals might play a role in her care, to help her address her challenges. As I was planning on using Sophia's case for students about to start clerkship, the case focuses at this time on details that are most relevant to physicians, although there are significant nursing and OT issues, as well. Students reviewed the case prior to a session on medication safety. In a team-learning setting, they learned that Sophia is now to be admitted to hospital, and they need to write her medication orders. This allowed them to write orders as they would be doing in clerkship, to work through common issues pertaining to admitting patients (such as automatic substitutions) and to address diabetic control in a patient with an active infection. They used much of the information pertaining to the on-line module in making these decisions. Then, Sophia's case was advanced again, and they needed to plan for her discharge, taking into account all the factors that were clear from the on-line module (limited supports, fear of needles, etc.) To further complicate matters, they were told that they needed to discharge her home on insulin, so they had to have a plan as to how they would arrange this, making use of the different health care professionals they learned about during the module. What worked well was that they had a much richer background to a complex patient that can normally be presented in a classroom setting. It was far more "real world", and they were able to experience something much closer to the process of admitting and discharging from hospital. They appeared to have a better understanding of how other disciplines would work with a patient, since it was anchored in a particular clinical case. Dr. Michelle Gibson