Case Presentations of Psoriasis

Signature Assignment

Case Presentations of Psoriasis

Summary:  Each Student will prepare and present 2 pathophysiology case presentations.  The following week students will work in small groups and discuss the presentations posted by the members in their small group.  Presentations are due in week 3 and 6, while the discussions will be held during weeks 4 and 7.

Students will be assigned a diagnostic topic and patient scenario to present as a case presentation. Presentations will be completed as a narrated Power Point Presentation and posted in the Discussion Board for the corresponding week. Please see the presentation content tab for instructions on how to post in DB as well as a table of student topic assignments.

Directions:

1. Give an overview of the patient with the presumptive diagnosis*.   You can “create” a patient case based on your knowledge of the diagnosis, based on a patient you have seen in your work or personal experience, or use a case study from the following recommended text:

Harold J. Bruyere (2009) 100 Case Studies in Pathophysiology. Login Bros. ISBN 978-0-7817-6145-1

1. Give an overview of the diagnosis including risk factors and how they cause or contribute to adaptation or pathogenesis.
2. Give an in-depth discussion of the pathophysiology of your diagnosis as it occurs over time; include signs, symptoms, diagnostic studies and the underlying pathophysiologic process causing these signs and symptoms.   Support this pathophysiology with high level evidence.
3. Summarize treatments and outcomes in terms of pathophysiologic alterations.
4. Once you have had an in-depth discussion of your diagnosis overall,  be sure to connect your case discussion back to the patient you have presented.  Example, If your patient has HTN and DM, be sure to include a discussion of the symptoms that your patient is exhibiting and discuss treatments specifically aimed for your patient.
5. Support your case discussion with current (in the past 5 years) high level evidence.  Patient information portals, disease association websites  and other resources such as Uptodate, Epocrates, Medscape, Mayo Clinic are not considered high levels of evidence and should be avoided for your presentations.  While use of the course textbooks is permitted, a minimum of 3 high level citations outside of the course texts is required.  If you are unclear about what is considered high level evidence, please review content from your Evidence Based Nursing Practice Course
6. Include some graphics to support your presentation and to make it more visually engaging
7. Be sure that you are using your slides to support the verbal presentation.  Do not simply read the slides to your audience.  Presentations that are read to the audience without expansion of the content will be graded as if no narration were included.
8. Presentation Length: The Patient Presentation component is typically 5 min or less, and a maximum of 3 slides.  Be sure to include just the pertinent positive and pertinent negatives.  The discussion of the case progression and pathophysiology is typically 10 -15 slides, and 15-20 minutes in length.  The entire presentation is a maximum  of 25 minutes and maximum of 18 slides which includes your title and reference slides.  
9. APA formatting for your presentation is required.

Power Point Post Requirements:  

1. You will post 2 files.
   1. The first is a copy of your presentation with a transcript of your planned narration in the notes section of the ppt file.  This file should not have the narration included.
   2. The second file is of your narrated presentation.
2. It is acceptable to post a link to a youtube video of your ppt presentation**.  If you do so, you must also post the non-narrated ppt with transcription of your planned narration.
3. Please do not post your presentation as any other type of document or movie file.  This include MPV4 files etc.

**View these instructions for recording your presentation using Screencast-o-matic https://drive.google.com/open?id=10IgEjiJCp5s2WIxposCGNLJNqO3WxAnJaeqAMiVxvjs

*Patient Presentation Guidelines

Summary:

Advance Practice Registered Nurses frequently need to present a patient to another health care provider in a concise manner. Your case presentation is an excellent opportunity to practice patient presentations to a colleague.

Overview:

• Patient presentations are concise, and brief.
• Presentation should be completed in 2- 3 minutes unless it is a new patient which may extend up to 5-6 minutes.
• Delivery should be smooth and succinct. Avoid the inclusion any superfluous information.
• Format should be made so that the collaborating provider can anticipate your assessment and plan: each piece of information should provide the listener clues regarding your thinking process and differential diagnosis.
• Notes should be made regarding some pertinent information which may be difficult to remember. The presenter should refer to these notes if necessary, but should not read these notes to the listener.

TYPES OF PATIENT PRESENTATIONS

New Patients: 

• Includes: Pt name, age, then proceed to Chief complaint. Give brief and pertinent HPI, important and related PMH, PSH, and FH. (you will not include an entire PMH, PSH, and FH as the other provider can read about this at another time)
• ROS is not included as anything important would have been included in the HPI.
• PE positive and pertinent negatives,
• Assessment and plan if you know it, including what diagnostic tests done, and tx that you have previously implemented.
• Finally, State what your question, or indicate what you are asking for help with. (this should match the chief complaint)

Follow Up

• The presentation on a follow up may be updating the collaborating provider regarding results of tx plan previously implemented, or results of diagnostic tests ordered previously ordered.
• You will need to give some information to remind the collaborating provider of what tests or tx were implemented, why these were ordered, and what the results were or response was to the treatment.

Problem Focused:

• Includes: Pt name, age, chief complaint or problem. Give brief HPI for this problem, with related PMH and medications. (will not be as detailed as for new patients).
• Next give PE including pertinent positive and negatives. Include any pertinent diagnostic information here
• Assessment and Plan: presentation is concluded with the assessment and plan, or with the request for tx recommendations from the collaborating provider.

PREPARATION

• Information Search: have information prepared regarding pathophysiology of the problem and usual tx of the problem
• Know what questions you have about this particular patient.

PROCESS:

• Be prepared for this presentation, have information ready, including medications, lab and procedure results.
• Be concise and complete: expect to have the attention of the listener for less than 3 minutes.
• Know your question: usually the presentation is formatted so that the listener can anticipate the possible diagnoses. You are guiding them through the case presentation and essentially telling a story. This may be very different from a case presentation done with your preceptor, where you are anticipating your preceptor to have questions about the patient and to discuss/determine the diagnosis and treatment plan with you.
• Anticipate and Expect questions from the listener. Often it will appear as if the listener is trying to trick you and is only out to identify that you missed some bit of information. In reality it is that this information was missing in the first place or was not completely clear, or that the listener has an idea of the diagnosis and treatment plan and needs more information to confirm this.

TIPS

• Include only the most essential facts: but be ready to answer ANY questions about all aspects of your patient.
• Keep your presentation lively.
• Do not read the presentation
• Expect your listeners to ask questions
• Follow the order of the written case report
• Keep in mind the limitation of your listeners.
• Beware of jumping back and forth between descriptions of separate problems
• Use the presentation to build your case.
• Your reasoning process should help the listener consider a differential diagnosis