This resource is a simulated patient case involving an elderly man with diabetes. The simulation may be run with a high-fidelity simulated patient or with an actor performing as a standardized patient. The first part of the simulation begins with nursing students who listen to a monologue from the patient, who has diabetes, was recently placed on insulin, and has developed a wound on his toe requiring assessment and treatment. In addition, he has trouble sleeping and does not follow a diabetic diet. Nursing students provide a home health visit in the simulated living room, where they perform assessments. In the second part of the simulation, pharmacy and medicine students join the nursing students for a simulated home health staffing meeting. The nursing students present their findings and answer questions from the other disciplines. The simulation moves forward 5 weeks, with the patient discovering that his wound has progressed as described in his second monologue. He arrives at the hospital emergency room accompanied by a family member. The students work as a team to complete an initial assessment and plan. Assessments include a history of the present illness, vital signs, directed physical examination, medication and medical history, and wound assessment. The team determines what laboratory tests are needed, and results are provided. After further assessment and consultation, initial orders for fluid and parenteral antibiotics are written, ending the simulation. The debriefing session begins with discussion of how students felt as they participated in the interprofessional activities. Processes that went well or that could be improved are discussed. Each student identifies a significant point of learning that he/she will take away from the activity. Finally, students are asked to complete an anonymous subjective survey of the simulation. In the evaluations, over 90% of our students reported that they received constructive feedback, were encouraged to explore possibilities, were supported in the learning process, and had an opportunity to work with their peers. Ninety-seven percent believed the teaching methods were effective. Over 85% actively participated in the debriefing session.
- Perform patient assessment appropriate for an independently living elderly man with a diabetic wound on his toe.
- Communicate with multiple disciplines (e.g., nursing, pharmacy, medicine) to identify and prioritize patient problems and potential interventions.
- Collaboratively create a plan of care for an elderly man with a diabetic foot ulcer at different stages of presentation.
- Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative.
- National League for Nursing. Faculty Programs and Resources: Advancing Care Excellence for Seniors (ACES). Case #2 Sherman “Red” Yoder. Accessed March 25, 2013. http://www.nln.org/facultyprograms/facultyresources/ACES/red.htm
- Agency for Healthcare Research and Quality. SBAR Technique for Communication: A Situational Briefing Model. Accessed March 25, 2013. http://www.ihi.org/knowledge/Pages/Tools/SBARTechniqueforCommunicationASituationalBriefingModel.aspx
- Hutchison LC, Ragsdale PS, Berryman SN, Bilbruck TJ. Simulation fosters interprofessional skills among nursing, pharmacy and medical students. American Geriatrics Society Annual Meeting, Seattle, WA, May 4, 2012.
- Berryman SN, Huff DC, Hutchison LC, Bilbruck TJ, Ragsdale PS, Jennings J, Lufton TM. Integrating interprofessional simulation into pre-licensure healthcare programs. Nursing Education Perspectives. Accepted for publication Dec 16, 2013.
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