University of Texas Medical School at Houston
Caring Across the Continuum: An Aging Virtual Patient Series. Case Two: Mrs. Porter Age 74 - Introduction to Geriatric Differential Diagnosis. This case, the second in a four-part series about the virtual patient, Mrs. Porter, introduces the learner to the complexities associated with diagnosing a common geriatric condition, and occurs in an outpatient ambulatory setting. Mrs. Porter visits Dr. Pat after missing her last three appointments, but visits mainly to refill a prescription. Concepts included in this case focus on an in-depth geriatric history-taking; conducting a comprehensive medication review; and, screening for depression. The importance of evaluating differential diagnoses for an older adult patient is also included. The Geriatric Gems in the case provide in-depth information and resources about a variety of geriatric health topics. The Gems in Case Two include Caregiver Stress; Depression; Hypothyroidism; and, Medication Review. The case concludes with a critical thinking activity inviting the learner to use the SOAP (subjective and objective observations, recommendations for further assessment, and a plan for treatment) format to complete their own assessment of Mrs. Porter.
On completion of Case Two: Mrs. Porter Age 74, students will be able to:
- Complete components of a comprehensive geriatric assessment
Address the following Association of American Medical Colleges (AAMC) geriatric competencies:
- Identify and document a geriatric patient's medication review
- Assess falls, balance, and gait of the virtual patient
- Assess functional abilities
- Generate a differential diagnosis of a unique presentation of a common older adult condition
- Develop a SOAP note based on Mrs. Porter's Outpatient visit
- Generate a medical management plan for the virtual geriatric patient
This product is one part of a short series consisting of the following products:
- Caring Across the Continuum: Case One: Mrs. Porter Age 67 - Introduction to Comprehensive Geriatric Assessment
- Caring Across the Continuum: Case Two: Mrs. Porter Age 74 - Introduction to Geriatric Differential Diagnosis
- Caring Across the Continuum: Case Three: Mrs. Porter Age 81- Introduction to Common Geriatric Syndromes
- Caring Across the Continuum: Case Four: Mrs. Porter Age 88 - Introduction to Palliative Care
As an innovative, virtual learning series, this web-based series of cases spans the 21-year relationship of care between geriatrician Dr. Patricia Thompson and her patient, Mrs. Alice Porter. This virtual learning experience for medical students, based on the Association of American Medical Colleges (AAMC) competencies, is designed to pique interest and enhance knowledge and skills in the care of older adults. The web-based learning environment provides students the unique opportunity to observe and interact with Mrs. Porter, in an ongoing doctor-patient relationship, outside of the traditional classroom setting. The series exposes students to the importance of continuity of patient care, since each case correlates to a different year of medical school education. As the medical student advances in their curriculum, Mrs. Porter continues to age, requiring more complex care and further application of critical thinking skills from the student. Each case has a unique focus that targets key geriatric and/or palliative concepts appropriate to the level of the student that can easily be embedded into existing medical school courses.
The virtual cases allow students to explore approaches to the patient; observe model clinician-patient interactions; choose practice techniques; offer health promotion, palliative counseling, and patient counseling; and contemplate complex ethical decisions regarding the care of the patient in an innocuous, self-paced, virtual environment. The embedded natural language system in each case offers an opportunity to pose real-world questions and problems to the learner, with the goal of eliciting critical thinking skills and reflective learning.
The series offers a readily available complementary assignment to the classroom and clinical experience. The self-paced case studies contain video animation, an interactive electronic medical record, Geriatric Gems and Palliative Pearls, natural language style critical thinking, clinical reasoning and clinical judgment learning activities, and evidence-based expert explanations. Evaluative tools include a pre and post quiz and rubric-scored natural language short answer and essay questions. The natural language system provides hints to the students and evaluates their responses based on the information they provide. Student actions and choices are captured for formative evaluation, as well as to provide student feedback.
The virtual patient system is a web-based application that runs on Windows Server, running IIS with ASP enabled within IIS. The project database is Microsoft Access.
The first time you explore a case, you will need to register. There is a "Register" button at the bottom of the login form. Click this button to register or to have your password sent to the email address you entered when you registered.
On the popup registration form, you will need to enter an ID and a password. Your ID can be anything you wish. You can use the same User ID and password for any of the four cases. All of the other fields are optional. (The email field is optional. If you don't enter an email address when you register, the system can't send you your password and/or ID if you forget them.)