Discussion: Treatment Goals for Margaret Today

Purpose
Problem-based learning is a methodology designed to help students develop the reasoning process used in clinical practice through problem solving actual patient problems in the same manner as they occur in practice. The purpose of this activity is to develop students’ clinical reasoning skills using a case-based learning exercise. Through participation in an online discussion forum, students identify learning issues in a self-directed manner which facilitates learning for the entire group.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
Synthesize clinical knowledge, didactic learning and research findings to provide appropriate pharmacological care to primary care patients. (CO 1, 2, 3, 4 & 5)
Due Date:
The student must provide an initial response to the discussion topic by Wednesday, 11:59pm MT. Subsequent posts, including substantive responses to peer(s) and faculty questions must occur by Sunday, 11:59pm MT. A total of 3 substantive posts are required on 3 different days. (Week 8 only- Subsequent posts, including substantive responses to peer(s) and faculty must occur by Saturday, 11:59pm MT).

A 10% late penalty will be imposed for initial discussions posted after the deadline on Wednesday 11:59pm MT, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.

A 10% penalty will be imposed for not entering the minimum number of interactive dialogue posts (3) OR not posting on the minimum required number of days (3). NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0)
Total Points Possible: 100
Case Study & Discussion Questions
Margaret is a 59-year-old Caucasian female who presents to the clinic for follow-up of her hypertension. She reports that she has a worsening of a tremor in her hand over the last few months. She was seen by a neurologist previously and was diagnosed with an essential tremor but opted to not take medication because it wasn’t particularly bothersome. She reports now that she has difficulty pouring a drink, drinking from a cup, using utensils to eat, and writing or drawing. Margaret also reports that since you started her on Clonidine last month for her blood pressure, she has been having some difficulties with headaches, dizziness, dry mouth and difficulty urinating. You plan to discontinue the clonidine.
Past Medical History: Hypertension, essential tremor and seasonal allergies.
Surgical History: Tonsillectomy.
Family History: Mother HTN & essential tremor, Father Diabetes, Sister Diabetes all deceased.
Social History: Denies tobacco use, wine one to two glasses a week, denies recreational drugs, exercises twice a week.
Allergies: NKA
Current medications: Multivitamin with Iron 1 tab PO daily, Claritin 10mg daily PO prn for allergies, Clonidine 0.1mg PO BID
All vaccines up to date.
Vitals: Height 57 inches, Weight 145 pounds, BP 156/85, P 70, R 16.
Physical exam is normal.
What are your treatment goals for Margaret today?
What is your pharmacological plan and rationale? (cite with appropriate clinical practice guidelines or scholarly peer-reviewed articles and always include medication name, strength, dosage form, route, frequency and duration when making recommendations)
Pick one medication from your response above and list five patient-centered teaching points for the medication.
Discussion Guiding Principles
The ideas and beliefs underpinning the discussions guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of discussions provides students with opportunities to contribute level appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the discussion generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. Discussions foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
Direct Quotes
Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category.
**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric. 
DISCUSSION CONTENT
Category
Points
%
Description
Application of Course Knowledge
35
35%
Decisions are well supported with EBM arguments that are in-line with the scenario; AND
Proper rationale and reasoning skills are demonstrated; AND
Information is taken from source(s) with appropriate interpretation/evaluation to develop a comprehensive analysis or synthesis of the topic at hand; AND
Applies concepts to personal experience in the professional setting and/or information has relevant application to real life; AND
All of the post makes direct reference to concepts discussed in the lesson; AND
Posts are on topic and answer all presented questions which demonstrates a solid understanding of the topic.
(6 critical elements)
Support from Evidence-Based Practice (EBP)
35
35%
Discussion post is supported with appropriate, scholarly sources; uses valid, relevant, and reliable outside sources to contribute to the threaded discussion; AND
Sources are published within the last 5 years (unless it is the most current CPG); AND
Reference list is provided and in-text citations match; AND
Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
(4 critical elements)
Interactive Dialogue
15
15%
Student provides a substantive* response to at least one topic-related post of a peer; AND
Evidence from appropriate scholarly sources are included; AND
Reference list is provided and in-text citations match; AND
Student responds to all direct faculty questions OR if student was not asked a direct question student responds to either a 2nd peer post or a faculty question directed towards another student
(*) A substantive post adds new content or insights to the discussion thread and information from student’s original post is not reused in peer or faculty response
(4 critical elements)



Total CONTENT Points= 85 pts
DISCUSSION FORMAT
Category
Points
%
Description
Grammar, Syntax, Spelling & Punctuation
15
15%
Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*
(*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.




Total FORMAT Points= 15 pts



DISCUSSION TOTAL= 100 pts