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Training Residents in a Best-Practice Approach to the Diagnosis and Management of Alzheimer's Disease
Assignment/exercise   Peer reviewed

Training Residents in a Best-Practice Approach to the Diagnosis and Management of Alzheimer's Disease

Michael Rosenbloom, Rachel Ziegler, Michelle Barclay, Jane Miller and Anne Woll
MedEdPORTAL, Vol.12, 10377
04/06/2016
DOI: 10.15766/mep_2374-8265.10377
url
https://doi.org/10.15766/mep_2374-8265.10377View
Published (Version of record)Zip file with 8 docx, pptx, pdf and mp4 files

Abstract

Introduction: Alzheimer's disease (AD) is the most common cause of dementia, affecting 5.4 million Americans, yet the diagnosis is frequently missed by physicians. Potential challenges in evaluating AD include both cultural and medical origins. As a result, the approach to delivering an AD diagnosis is variable in the medical community and has the potential to emotionally impact the patient and caregiver. To address this an observed structured clinical examination (OSCE) was developed to provide neurology residents with a foundation for the diagnosis and management of AD. Methods: An introductory instructional video, dementia curriculum, and case study were circulated 1 week prior to the exercise to establish expectations for the OSCE. For the exercise, neurology residents within their postgraduate training years one to four (PGY1-PGY4) were asked to communicate the news of an AD diagnosis to a standardized patient–caregiver dyad. Neurology faculty remotely evaluated residents on their ability to provide an accurate diagnosis and prognosis, respond to family's questions, and formulate a treatment plan that included both pharmacological and nonpharmacological interventions. In addition, learners were scored based on their communication skills. Results: Seventeen neurology residents completed the OSCE with a mean performance score of 70.5%. In anticipation of the simulation, 82% (14/17) of residents reviewed the preparatory educational materials. In postfeedback surveys the majority of faculty (N = 6) agreed that they received useful information about trainees' skills from the session. Discussion: We conclude that the assessment of a resident's ability to deliver an AD diagnosis in a simulated environment is an effective method to assess and enhance a learner's ability to effectively communicate bad news to patients and families. *************************************** Educational Objectives By the end of this session, the learner will be able to: 1. Understand the clinical rationale for diagnosing Alzheimer's disease. 2. Distinguish Alzheimer's disease from dementia. 3. Understand the prognosis of Alzheimer's disease. 4. Deliver the bad news of a new Alzheimer's diagnosis in a compassionate and effective manner. 5. Respond to questions of patient and caregiver. 6. Recognize the importance of caregiver and family support.

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