Posted: May 1st, 2022

Select an older adult patient from your clinical experience

Grand Rounds Discussion: Complex Case Study Presentation

Photo Credit: [RGtimeline]/[iStock / Getty Images Plus]/Getty Images
This week you participate in the final of three clinical discussions called grand rounds. When it is your week to present, you will create a focused SOAP note and a short didactic (teaching) video presenting a real (but de-identified) complex patient case from your practicum experience.

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You should have received an assignment from your Instructor letting you know which week of the course you are assigned to present. Any student who has not yet presented should present this week.

TO PREPARE:
Select an older adult patient from your clinical experience that presents with significant concern. Create a focused SOAP note for this patient using the template in the Resources.
Then, based on your SOAP note of this patient, develop a video case study presentation. Set aside time to practice what you will say beforehand and ensure that you have the appropriate lighting and equipment to record the presentation.
Your presentation should include objectives for your audience, at least 3 possible discussion questions/prompts for your classmates to respond to, and at least 5 scholarly resources to support your diagnostic reasoning and treatment plan. Choose an older adult patient from your clinical experience who is presenting with substantial concern and write about him or her. Create a focused SOAP note for this patient using the template provided in the Resources section of this page.
Then, using the SOAP note you took of this patient, create a video case study presentation for him or her. Prepare for the presentation by scheduling time to practice what you will say and making sure you have the proper lighting and equipment to record the presentation before it begins.
At least three possible discussion questions/prompts for your classmates to reply to, as well as at least five academic references to support your diagnostic rationale and treatment plan, should be included in your presentation for your audience.
Video assignment for this week’s presenters:

Record yourself presenting the complex case study for your clinical patient. In your presentation:

Dress professionally and present yourself in a professional manner.
Display your photo ID at the start of the video when you introduce yourself.
Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information).
State 3–4 objectives for the presentation that are targeted, clear, use appropriate verbs from Bloom’s taxonomy, and address what the audience will know or be able to do after viewing.
Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management.
Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value.
Pose 3 questions or discussion prompts, based on your presentation, that your colleagues can respond to after viewing your video.
Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss their mental status examination results. What were your differential diagnoses? Provide a minimum of 3 possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and is supported by the patient’s symptoms.
Plan: What was your plan for psychotherapy (include one health promotion activity and patient education)? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
Reflection notes: What would you do differently with this patient if you could conduct the session again? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow-up, discuss what your next intervention would be.