Session by Professor Omar Hasan Kasule
Sr for Year 3 medical students Faculty of Medicine King Fahad Medical City
Riyadh Saudi Arabian on Monday 30 December 2014.
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 quarrelling 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 referral to rheumatologist. Follow up after the rheumatologist
·
A rheumatologist: specialist
evaluation. Regular follow up by rheumatologist gives better results because he
can detect problems before they grow bigger. Rheumatologist refers to other
specialists
·
An orthopedic 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
TABLE
#1: SCORING GROUP MATURITY
|
Type of Activity or Behavior
|
High
(2)
|
Medium
(1)
|
Low (0)
|
Observations and Comments
|
|
1.
Giving and accepting feedback
|
||||
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2.
Democratic decision making
|
||||
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3.
Group cohesion
|
||||
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4.
Flexibility of members
|
||||
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5.
Use of all member resources
|
||||
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6.
Members feel free to disagree
|
||||
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7.
Everyone is free to express an
opinion
|
||||
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8.
Humor is the norm
|
||||
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9.
Communication is effective
|
||||
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10.
Group sets clear strategies and
goals
|
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11.
Interdependence Among members
|
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12.
Shared participation and not
dictatorship
|
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13.
Listening to and considering
minority views
|
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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
|
|
1.
Productivity
|
||||
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2.
Positive handling of complaints
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3.
Positive conflict resolution
|
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4.
Commitment to goals
|
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5.
Action-orientation
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6.
Dealing with apathy of some
members
|
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7.
Encouraging creativity and
innovation
|
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8.
Competence of team
managers/leaders
|
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9.
Effectiveness of meetings and
discussions
|
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10.
Effective communication
|
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11.
Trust among team members
|
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12.
Making sure decisions are
understood by all
|
||||
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13.
Feeling good as a team member
|
||||
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14.
Principled behavior
|
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TOTAL
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TABLE #3 JUDGE’S OBSERVATIONS ON INDIVIDUAL GROUP
MEMBERS
|
ID
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Comments
and observations
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