Thank you for visiting this blog. Please don't hesitate to contact us if you find error/s. We would appreciate your comment to improve your experience in this blog.


131230L - TEAM APPROACH TO APPROACH TO ARTHRITIS

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
  1. The objective of this exercise is to put into practice principles of effective team-work.
  2. Each team will have the task of developing a management strategy for the patient and present it to the whole class.

EVALUATION
  1. 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.

  1. 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
  1. 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.

  1. 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.

  1. 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.

  1. 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
  1. Stay with the team continuously from the beginning of the planning to the end of task execution.

  1. 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.

  1. 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.

  1. 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
  1. Giving and accepting feedback





  1. Democratic decision making           





  1. Group cohesion                  





  1. Flexibility of members





  1. Use of all member resources           





  1. Members feel free to disagree





  1. Everyone is free to express an opinion





  1. Humor is the norm





  1. Communication is effective           





  1. Group sets clear strategies and goals  




  1. Interdependence Among members      




  1. Shared participation and not dictatorship




  1. Listening to and considering minority views        




TOTAL







TABLE 2: SCORING GROUP EFFECTIVENESS:

Type of Activity or Behavior
High
(2)
Medium
(1)
Low (0)
Observations and comments
  1. Productivity





  1. Positive handling of complaints
     




  1. Positive conflict resolution





  1. Commitment to goals





  1. Action-orientation





  1. Dealing with apathy of some members





  1. Encouraging creativity and innovation





  1. Competence of team managers/leaders





  1. Effectiveness of meetings and discussions





  1. Effective communication





  1. Trust among team members





  1. Making sure decisions are understood by all





  1. Feeling good as a team member





  1. Principled behavior





TOTAL







TABLE #3 JUDGE’S OBSERVATIONS ON INDIVIDUAL GROUP MEMBERS


ID
Comments and observations


































Video


Writings of Professor Omar Hasan Kasule, Sr








This section provides thoughts in Islamic Epistemology and Curriculum Reform.
This section covers motivation of a medical student and development of personal skills: social, intellectual, professional behavior etc. It also equips the medical student with leadership skills that will be required of him as a future physician.




New Items

This section contains monthly e-newsletter presents the most recent developments in the fields of Islamic epistemology and educational curriculum reform summarized from books, journals, websites, interviews, and academic proceedings (conferences, seminars, and workshops). We also accept original contributions of less than 500 words...










Recent Uploads


This section provides inter-disciplinary books authored by renowned scholars.

This section contains different e-journals.