Reviving the Narrative to Explore a Patient’s Suffering

1. Reviving the Narrative to Explore a Patient’s Suffering An Interprofessional Problem-Based Learning Module

2. Suffering Module: Goals • To bring together students from multiple health professions for: • 1. Interprofessional education • 2. Introduction to palliative care

3. The Narrative

5. Why use a narrative? • History • Simulates real patient encounter • Allows deeper exploration of the patient • Emotional power • Electronic delivery to allow non-linear exploration of the story • http://www.creatingthe21stcentury.org/Intro0-table.html • 4 business leaders discuss the importance of storytelling in the 21st century

6. Developing the Story • TW plus 3 students: • Medicine (Kate Strasburg) • Nursing (Christy Thompson) • English (Emily Martin) • Met with education experts from each health profession  learning objectives • From these, developed character sketch • EM used this to write 49 pieces of dialog

7. The Instructional Design

8. Face-to-Face #1 (30 min) • Introductions: Facilitator and Students • Instructions and Expectations • Pre-test • Resources distributed: • Overview of Total Pain • Introduction to Interprofessional Teams

9. Face-to-Face #1 (30 min) Meet the Patient • Using Patient Navigator • Non-linear navigation through the patient’s story • 60 minutes maximum

10. Story Map

11. Face-to-Face #1 (30 min) Meet the Patient • Using Patient Navigator • Non-linear navigation through the patient’s story • 60 minutes maximum

12. Face-to-Face #1 (30 min) Meet the Patient eHealth Record Private Notes Discussion Forum Progress Notes • Appears after 20 minutes • Mostly medical history • Personal • Private • Area for each profession • Students can post questions/ comments to any area • Each profession must post a preliminary assessment of the patient

13. Face-to-Face #1 (30 min) Meet the Patient eHealth Record Private Notes Discussion Forum Progress Notes • Appears after 20 minutes • Mostly medical history • Personal • Private • Area for each profession • Students can post questions/ comments to any area • Each profession must post a preliminary assessment of the patient

14. Meet the Patient eHealth Record Private Notes Discussion Forum Progress Notes Face-to-Face #2 (3 hours) • Compare progress notes to fully assess patient • Identify key contributors to patient’s suffering • Create learning objectives • Resources distributed: • Interprofessional articles • Profession-specific articles • Lists of internet and community resources

15. eHealth Record Private Notes Discussion Forum Progress Notes Face-to-Face #2 (3 hours) Self-Directed Learning • Read resources given • Access other online or paper resources • Gain knowledge of: • Their profession’s role • Assessment of suffering • Patient management

16. Face-to-Face #2 (3 hours) Self-Directed Learning Revisit Patient Private Notes Discussion Forum Progress Notes • Can re-enter the story at any previously seen point • 30 minutes maximum • Add more notes • Continue previous discussions or start new ones • Can update progress notes based on new knowledge/ assessment of patient

17. Face-to-Face #2 (3 hours) Self-Directed Learning Revisit Patient Private Notes Discussion Forum Progress Notes • Can re-enter the story at any previously seen point • 30 minutes maximum • Add more notes • Continue previous discussions or start new ones • Can update progress notes based on new knowledge/ assessment of patient

18. Self-Directed Learning Revisit Patient Private Notes Discussion Forum Progress Notes Face-to-Face #3 (3 hours) • Discussion about: • Each profession’s role • Information learned about management • Compare revised progress notes and finalize patient assessment • Assemble a final Interprofessional Care Plan • Evaluations of the module and the participants • Includes post-test

19. Revisit Patient Private Notes Discussion Forum Progress Notes Face-to-Face #3 (3 hours) Interprofessional Care Plan • Final deliverable • Synthesis of each profession’s contributions to patient management • Divided into domains of suffering • Will be saved for future spiralling of the case

20. The Product

22. Next Steps • Complete programming • Pilot the module: 2 facilitated groups of 8-10 students from multiple professions • Evaluation and revision • Enhance with media: Video, audio, photos

23. Demo http://137.122.239.228:8080/examples/totalpain02/ Disclaimer: We still have a lot of work to do!

24. Credits • Developers: • Emily Martin, Kate Strasburg, Christy Thomson, Tim Willett • EFPPEC: • Anne Bailliu, Peter Barnes, Leonard Bloom, Maryse Bouvette, Susan Brajtman, Alyson Brodeur, Mary Egan, Frances Fothergill-Bourbonnais, Pippa Hall, Frances Legault, Lynda Weaver • iMed: • Michael Clarke, Brad Genereaux, Nancy Hebert, Patti O’Brien, Rong Sun

25. Contacts • Pippa Hall, Department of Family Medicine, Division of Palliative Care, Faculty of Medicine, University of Ottawa, phall@scohs.on.ca • Michael Clarke, iMed, Faculty of Medicine, University of Ottawa, mclarke@uottawa.ca • Tim Willett, iMed, Faculty of Medicine, University of Ottawa, twillett@uottawa.ca