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Session by Professor Omar Hasan
KasuleSr for Year 3 medical students Faculty of Medicine King Fahad Medical
City Riyadh Saudi Arabian on Monday 30 December 2013
Learning
Objectives:
·
To introduce students to critical issues and current models
for team management of Rheumatoid Arthritis
·
Keywords: Team management clinical models
Agenda
·
Background on team work
·
Presentation of the case
·
Role playing of consultants from various disciplines
involved in caring for patients with Rheumatoid Arthritis. The aim is to
develop a management strategy for the patient.
·
The panel will include Rheumatologists, Orthopedic Surgeons,
Physiotherapists, Occupational Therapists, Social Workers, General
Practitioners and patients.
·
The panel will be presented with the case of the PBL patient
of Rheumatoid Arthritis for discussion.
·
The panel is eventually required to develop a management
strategy.
References
Types of groups
·
A group is several interdependent and interacting persons.
·
A team is a group whose members work together for a long
time on specific objectives.
·
A task force is temporary (adhoc) group set up to solve a
specific problem.
Etiquette of teaching & learning in
the health care team
·
The hospital health care team consists of senior doctors,
junior doctors, allied health professionals, and students.
·
It is multi-disciplinary with complementary and
inter-dependent roles.
·
Members have dual functions of teaching and delivering
health care. Most teaching is passive learning of attitudes, skills, and facts
by observation.
Etiquette of care delivery in the health
care team
·
Each member of the team carries personal
responsibility with leaders carrying more responsibility.
·
Leaders must be obeyed except in illegal
acts, corruption, or oppression.
Principles of group work
·
Groups must be united, cooperative, open and trusting.
·
Group members must be similar, empathetic, supportive, and
sharing.
·
Group norms must be respected.
·
Breaking norms, secretive behavior, concealment of
information, and secret talks destroy groups.
Maturity of groups
·
Group identity,
·
Optimized feedback,
·
Decision-making procedures,
·
Cohesion,
·
Flexibility in organization,
·
Resource utilization,
·
Good communication,
·
Clear accepted goals,
·
Interdependence,
·
Participation by all
·
Acceptance of minority views.
Failure of groups
·
Constituted on the wrong basis,
·
When members cannot communicate,
·
There is no commonality (interests, attitudes, and goals),
·
Diseases of envy, hypocrisy, rumor mongering, backbiting,
lying, pride and arrogance, love of leadership, and negative feelings.
Effectiveness of groups
·
Members feel secure and not suppressed,
·
Members understand and practice sincere group dynamics,
·
Members are competent and are committed to the group and the
leadership.
Team positive behaviors:
·
Mutual love,
·
Empathy,
·
Caring for one another;
·
Leniency,
·
Generosity,
·
Patience,
·
Modesty,
·
A cheerful disposition,
·
Calling others by their favorite names,
·
Recognizing the rights of the older members,
·
And self control in anger.
Team negative behaviors
·
Harshness in speech,
·
rumor mongering,
·
Excessive praise,
·
Mutual jealousy,
·
Turning away from other for more than 3 days,
·
Spying on the privacy of others).
Case
summary
Mrs. Jean Norman is a forty-five-year-old house wife from Mildura where she helps her husband grow peaches. She’s had pain in her joints for the last eight months but put it down to “getting on a bit”. The symptoms started with occasional early morning stiffness and swelling in her right knee and ankle. Stiffness and swelling in her hands followed. She later experienced severe pain. She had difficulty walking. She failed to undertake activities of daily living (ADL) in her home. She always felt fatigue even when she did no work . Her muscled were weak. She became irritable quarreling with her husband, her neighbors, and children for no reason. She would also go into spells of depression. She went to see her primary care physician who referred her to a rheumatologist. After confirming the diagnosis the rheumatologist assembled an RA team to take care of her.
Members
of the RA team
·
Primary care
doctor: initial diagnosis and referaal to rheumatologist. Follow up after the
rheumtologiust
·
A rheumatologist:
specialist evaluation. Regular follow up by rheumatologist gives better results
because he can detect problems before they grow bigger. Rheumatologust refers
to other specialists
·
An orthopaedic
surgeon
·
A podiatrist
·
A physical and/or
occupational therapist
·
A massage therapist
·
A pharmacist
·
Alternative
medicine: chiropractor, an acupuncturist
·
An ophthalmologist
and/or optometrist
·
A psychiatrist or
psychologist
·
A social worker
EVALUATION
OF TEAM WORK DURING THE SESSION ON TEAM WORK IN ARTHRITIS
OBJECTIVE
- The objective of this exercise is to put into practice principles of effective team-work.
- Each team will have the task of developing a management strategy for the patient and present it to the whole class.
EVALUATION
- Each team will be given a score on each of 2 assessment areas (a) process evaluation (team or group dynamics) (b) outcome evaluation (successful completion of the task and presentation within the allocated time). Judges will stay with the team during planning and also during task execution. They will award scores to the team using score sheets.
- Scores of the teams will be totaled up and displayed at the end of the session. The criteria used will be distributed and will be discussed by all participants with Professor OHK moderating the discussions. An attempt will be made to summarize lessons on team work that will have been learned.
INSTRUCTIONS FOR TEAM
PARTICIPANTS
- You will be divided into several teams each consisting of 5-7 persons. Team allocations will be entirely random and you will have no say on the allocation process.
- Each team will have to carry out two tasks. The first task (discussing the management strategy) will be carried out simultaneously by all the teams. The second task (presenting the strategy) will be carried out by each team one at a time while the others listen and ask questions / make comments.
- Each team will be given a maximum of 30 minutes for task #1 to meet as a team and plan its strategy for each task. During the planning stage, the team members will not be allowed to talk to members of the other teams or even to eavesdrop on their discussions.
- Each team will be given a maximum of 20 minutes to accomplish task #2. One score point will be deducted for each minute of delay beyond this time limit.
INSTRUCTIONS FOR JUDGES
- Stay with the team continuously from the beginning of the planning to the end of task execution.
- Write notes continuously against each of the criteria that will be used to judge the process. Fill up the score sheet at the end of the process.
- Make note of additional criteria that you think should have been included on the score sheet. Write them in the additional slots at the bottom of the score sheet. You may if you wish use some or all of them in your evaluation.
- Make note of some criteria that you think may not be relevant to the task.
TABLE #1: SCORING GROUP MATURITY
Type of
Activity or Behavior
|
High
(2)
|
Medium
(1)
|
Low (0)
|
Observations
and Comments
|
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TOTAL
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TABLE 2: SCORING GROUP EFFECTIVENESS:
Type of
Activity or Behavior
|
High
(2)
|
Medium
(1)
|
Low (0)
|
Observations
and comments
|
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TOTAL
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TABLE #3 JUDGE’S
OBSERVATIONS ON INDIVIDUAL GROUP MEMBERS
ID
|
Comments
and observations
|