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Caring Across the Continuum: Mrs. Porter Age 81


Caring Across the Continuum: Mrs. Porter Age 81

University of Texas Medical School at Houston
Jennifer Larson, MD, Kathleen Pace Murphy, MD, Sharon Ostwald, MD, Nasiya Ahmed, MD
Donald W. Reynolds Foundation
POGOe Id: 
Date Posted: 
Date Reviewed/Updated for Clinical Accuracy: 

Caring Across the Continuum: An Aging Virtual Patient Series. Case Three: Mrs. Porter Age 81- Introduction to Common Geriatric Syndromes. This case, the third in a four-part series about the virtual patient, Mrs. Porter, introduces the learner to in-patient care, delirium and the interprofessional team (IPT) roles. The case is set in an Acute Care of the Elderly (ACE) Unit. Mrs. Porter is admitted to the ACE Unit with Dr. Pat and members of the IPT because she has had an unwitnessed fall and is delirious. Concepts included in this case are common etiologies and risk factors for falls; benefits of an IPT assessment in the ACE Unit; the effect of medication on falling; fall-induced delirium; types of delirium; the Confusion Assessment Method (CAM); obtaining a complete History of Present Illness; pain assessment; abnormal review of symptoms; and pre-operative testing.  After thorough evaluation, it is determined that Mrs. Porter has a fractured hip and will undergo surgery. The case concludes with a request of the learner to provide a complete pre-operative review of Mrs. Porter's assessment and exam.

Educational objectives: 

On completion of Case Three: Mrs. Porter Age 81, students will be able to:

  1. Define and describe select components of diagnosing an unwitnessed fall
  2. Describe multiple risk factors of falls
  3. Assess delirium using the Confusion Assessment Method (CAM) tool
  4. Provide a comprehensive abnormal review of symptoms for patient diagnosis
  5. Prepare a comprehensive pre-operative patient review
Additional information/Special implementation requirements or guidelines: 

This product is one part of a short series consisting of the following products:

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.)

Intended learner audience: 
Estimated time to complete: 
1 hour
Conflict of Interest Disclosure: 
No, I (we) have nothing to disclose.
Already Expired Email Date: 
Wednesday, February 28, 2018 - 10:57am
Already Expired Email 1 month date: 
Thursday, March 15, 2018 - 9:35pm
Expired Email Date: 
Saturday, March 31, 2018 - 12:23am
Contact Person/Corresponding Author:
Suggested Citation:
Dr. Kathleen Pace Murphy, Dr. Sharon Ostwald, Jennifer Larson and Dr. Nasiya Ahmed. Caring Across the Continuum: Mrs. Porter Age 81. POGOe - Portal of Geriatrics Online Education; 2013 Available from:
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