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Medical Consultation Role Play

Gail Wortmann



Type of Entry:

  • Lesson/Class Activity

Type of Activity:

  • Authentic Assessment
  • Group/Cooperative learning

Target Audience:

  • Anatomy/Physiology
  • Biology


Abstract:

This activity is designed to function as an authentic assessment after the study of the human muscular system. With an emphasis on problem solving, students are given a patient with some background information and symptoms. It is up to a pair of students to diagnose their patient (having a well known muscle disorder) and then inform the relatives of the patient about the condition. One of the most interesting aspects of this assessment is that the students have a defined audience (the patient's relatives) and that audience may ask probing questions and respond appropriately to good or bad news about the diagnosis. Real life skills are practiced as the scenario unfolds.


Background:

Notes for the teacher:
Depending on how much time you want to give this assessment, various components may be used or deleted. The performance criteria includes:

1) a Patient Chart fashioned after the one used at your local hospital to include patient information, vital signs, symptoms, tests ordered, test results, diagnosis with a description of the condition, and treatment.

2) a Work Log where daily notes, references, and team dynamics are recorded.

3) a Presentation Format which may be notes, an outline, a script, etc. (whatever the team has decided to use during their presentation is acceptable).

4) a Consultation Presentation which is given to 2 students acting as the relatives of the patient; it must include an audio-visual to help the relative understand the condition.

Materials needed:

  • patient cards (enough so that each pair of students has one with a different muscle disorder)
  • a "consultation corner" in your classroom (An area of your room can be set up like a clinic office with a small table, chairs, a plant, and audio-visual aids like a laser disc, overhead, chart holder, etc.)

Class time needed:
One day is given for library research, a second day can be used in the library or classroom as needed. Presentations are on the third day. To insure that all students are making progress, if they are having trouble with their diagnosis, they may purchase help from a professional consultant (the teacher) for the cost of a few points from their score.

Preparation time needed:
Time will be needed to write the patient cards. Examples are given below. School staff can be used for the names of the doctors. Information for the patient cards can be gleaned from medical texts, home medical guides, encyclopedias, health CD-ROMS, etc. The following disorders affecting muscles can be used with success: myasthenia gravis, sprain, tetanus, Duchenne's muscular dystrophy, gas gangrene, trichinosis, steroid abuse, angina pectoris, carpal tunnel syndrome, writer's cramp, myotonic muscular dystrophy, and rotator cuff problems. Information on these disorders are not discussed in class first - the students must use their knowledge of the muscle system and research tools to figure them out!

JASON KRAMER (teacher note: trichinosis)
Jason Kramer, a science student at Learnall High School, was participating in a dissection lab in an anatomy and physiology class when he consumed some raw pork from the outside of a bone specimen. His parents were duly notified and asked to watch for any problems. Diarrhea and vomiting started 36 hours later. In a week, fever appeared along with swelling around the eyelids and severe muscle pains in his extremities. An allergic rash was also noted on his trunk and limbs.

Dr. Wortmann, his local physician, ran some blood tests which indicated the presence of larval antibodies and a high eosinophil count. He then requested a muscle biopsy which showed larval cysts in microscopic slides of Jason's muscle tissue.

Dr. Wortmann then prescribed an antihelmintic drug (thiabendazole) and corticosteroid drugs to reduce inflammation. Jason had to take these drugs for several weeks because his severe muscle pains only gradually disappeared.

GAIL HENRY (teacher note: carpal tunnel syndrome)
Gail Henry is a 50-year-old secretary in a legal office. When she first started working, she did a lot of typing on an "old-fashioned" carriage-type typewriter. As the years have progressed, she has adapted to electric typewriters, and finally, to the world of computers and word processing.

Some time ago, she began to notice a tingling on the radial side of her hand. It also seemed as if her hand was weakening and it occasionally caused her pain. This resulted in restricted motion in her hand, and she began to notice that she was making more and more typing errors. Lately, it seems as if the tingling and pain can be felt all the way to her shoulder.

Since this problem is beginning to affect her job, she has taken time off to go and see Dr. Wortmann. The doctor noted that all her vital signs were normal, but after examining Mrs. Henry, Dr. Wortmann suggested that there might be a need for surgery near her median nerve.


Lesson: PERFORMANCE TASK / TEST GRADE

Muscle Disorder Assessment and Presentation

Valued Outcome: Students will investigate symptoms and determine what muscle disorder is described in their case study. They will then present their findings and prognosis to relatives of the patient.

Mode of Presentation: Patient report, Consultation presentation

Description of Task:

You and your partner are a team of a medical pathologist and a public relations person at a large hospital. Your job is to research diseases and disorders in order to inform families of patients about specific diseases, their conditions and their prognosis. Assume that the family has very little knowledge of the condition. Your presentation to them must be compassionate, interesting, informative, and as personable as possible.


Performance Criteria: Grade:

Patient Chart including: Individual

Analysis of the case study

Diagnosis and treatment of the patient's condition

Work log (notes, sources, comments, answers to questions) Individual

Consultation which includes: Group

appropriate dress
audio-visual aid
presentation outline: description of disease (symptoms, causes, treatments)

Timeline: Library work day ______________________
Library/classroom work day ______________________
Consultation Presentations ______________________
Paperwork due: ______________________
Patient Chart (I), Work log (I), Consultation outline (G)
(NO class time will be given this day, so be ready!)


REQUIREMENT DETAILS:

PATIENT CHART (30 points)
The Patient Chart must be filled out with the appropriate information. If specifics on the patient are not given in the case study, you need to create them to fit the parameters of the given information. Example: If the patient is 41, the birth date needs to be somewhere in the year that happened 41 years ago! If the blood pressure is normal, you need to look up the range for normal blood pressure, and create a blood pressure that is within those norms.

WORK LOG (30 points)
You will be required to keep a daily log of your work on this project. This is the place where you will take notes, jot down references, record your progress, and comment on how your team is functioning. Follow the format below:



DATE:                  TOTAL TIME SPENT:                   WORK COMPLETED:

Keep your log on notebook paper. Write on both sides of the page. The research information recorded in the log will need to be specific. It will not be enough to just enter: "did research in library" or "worked on presentation." You need to record what you worked on specifically and what progress you made. Comments on how you and your partner are getting along are appropriate here.

A specially marked section (*) must include the answers to the following questions:

1. What function of the muscle system does this disorder affect?

2. What type of muscle is affected by the disorder and how is it affected?

3. What relationship does this disorder have to the sarcomere?

4. What alternative ways could the body perform the functions lost by this disorder?


CONSULTATION PRESENTATION:

Outline: Research/Writing Component (20 points)
1. Two students (a team) will work together to diagnose the muscle disorder in their case study. Once a diagnosis has been agreed upon, the research can begin. If you need help in diagnosing, your instructor will show you a list of the disorders used in these case studies, but hiring that outside help will cost you 3 points. If you still cannot determine a diagnosis, your instructor will tell you what disorder you have in your case study, but it will cost you 3 more points.

2. The team will work together to research the muscle disorder indicated in their case study. Each student is responsible for checking at least two different sources and writing notes on them in their work log. Sources must be recorded. While researching, be sure to answer the four questions (*) required in your work log.

3. The two students write the format for their Consultation Presentation together; each is responsible for seeing that his/her researched information is included. The Consultation format will include a description of the disorder, symptoms, causes, and treatments and can be used during the consultation.

Oral Presentation Component:

1. The Consultation Presentation (50 points) will be four minutes long (maximum). During the consultation, you may rfer to your outline and medical charts, BUT NOT SIMPLY READ THEM ALOUD!! Two other students will be chosen to act as the relatives, so you will be sharing the information with them. The relatives will be allowed to ask questions, which you will answer as professionally as possible. Keep in mind that you need to be compassionate, interested, informative, and personable. Both partners need to participate equally. Credit will be given for "looking the part," i.e. dressing appropriately for your consultation. Dressing for the jobs described does not necessarily require hospital attire (lab coats, etc.), but it does require looking professional.

2. An audio/visual aid must be used in your presentation to help the relatives understand the condition. Posters, laser disc, overhead transparencies, charts, etc. may be used. The A/V aid needs to carry important information about the disorder, to be well integrated into the consultation, to be appropriate for the relatives, and to show creativity in its use. (10 points will be given for the quality of the A/V aid.)

3. Your peers will be helping to grade you during your presentation, as well as your instructor. Criteria may be found on the Peer Review grading page. (35 points)


Evaluation:

This authentic assessment is the main evaluation instrument for this unit. The only other assessments are short content quizzes earlier in the unit.

A) A scoring rubric for the instructor's review is given to the students at the beginning of the assignment for the consultation presentation. The "excellent" category on the rubric could include categories and descriptors such as: "The student is dressed in a professional manner for this consultation and shows professionalism when consulting with the relatives. The student clearly describes the disorder studied; specific information is given to the consultees. The delivery is engaging and sentence structure is consistently correct. Eye contact is made and sustained throughout the presentation. There is strong evidence of preparation, organization, and interest in the topic. The visual aid is used to make the presentation more informative. Questions are clearly answered with specific information."

B) A peer review can also be used as the rest of the students in the class listen to the consultation presentations:

Please rate the entire consultation presentation -not just the individuals- using the following:

SCALE: 5 = excellent 4 = very good 3 = good 2 = adequate 1 = poor

Consultation Team: Period:

1.    _____        Presented relevant information clearly.
2.    _____        Presented in mature, professional manner.
3.    _____        All members provided worthwhile contributions.
4.    _____        Audio/visual aids helped in understanding the materials.
5.    _____       Questions were answered clearly.  (If no questions are asked, score as a 5.)
6.    _____       Members were compassionate and personable.
7.    _____       My understanding of this disorder has improved.

C) And finally, a group assessment evaluation may be added.


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