Altered Mental Status in an Older Adult: A Case-Based Exercise for Medical Students

Abstract

OPEN ACCESSJanuary 25, 2013Altered Mental Status in an Older Adult: A Case-Based Exercise for Medical Students Gary S. Winzelberg, MD, MPH, Amy C. Denham, MD Gary S. Winzelberg, MD, MPH University of North Carolina at Chapel Hill School of Medicine Google Scholar More articles by this author , Amy C. Denham, MD University of North Carolina at Chapel Hill School of Medicine Google Scholar More articles by this author https://doi.org/10.15766/mep_2374-8265.9319 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail Abstract Introduction: This case-based exercise, designed for second-year medical students, covers principles of diagnosis and management of delirium in older adults. It provides a structured team-based setting in which groups of medical students can practice clinical reasoning skills. It has been used as part of a series of clinical cases created to help students synthesize what they have learned in different organ system courses and apply their knowledge to geriatric practice. Methods: The case presents an 86-year-old man brought to an emergency room by his son because of lethargy. Learners should progress through the case and work towards a differential diagnosis for a geriatric patient with altered mental status. The facilitator guide includes the objectives for the case, a suggested schedule, ideas for effective implementation, and an answer guide for all of the assignments that students will be working on over the course of the exercise. A separate document contains all of the student materials that should be provided during the exercise. Results: A version of this case has been used in our institution for the last four years, with a total of approximately 640 second-year medical students. Although we haven't solicited formal feedback from faculty, our small group facilitators consistently comment that they are impressed by the level of student engagement and the clinical sophistication of students' small-group discussions. Student satisfaction with the exercise has steadily increased over the 4 years that we have run the case. Discussion: This case requires preclinical students to integrate and synthesize learning from many different courses and disciplines. In our experience, the modified team-based learning approach that this exercise generates lively and clinically sophisticated discussions among second-year medical students. Educational Objectives By the end of this exercise, learners will be able to: Construct a differential diagnosis for an older adult with altered mental status.Consider the clinical features that differentiate among patients with delirium, dementia, and depression.Understand the method used to diagnose delirium.Select appropriate diagnostic tests for an older adult with altered mental status.Discuss treatment approaches for an older adult with altered mental status. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: Altered Mental Status Case Facilitator Manual.doc Altered Mental Status Case Student Materials.doc To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor’s noteThis publication may contain technology or a display format that is no longer in use. CitationWinzelberg GS, Denham AC. Altered Mental Status in an Older Adult: A Case-Based Exercise for Medical Students. MedEdPORTAL. 2013;9:9319. https://doi.org/10.15766/mep_2374-8265.9319 Related Altered Mental Status in an Older Adult: A Case-Based Exercise for Medical Students Failure to Thrive in an Older Adult: A Case-Based Exercise for Medical Students A Fall in an Older Adult: A Case-Based Exercise for Medical Students Clinical Decision-Making for Older Patients With Multiple Chronic Conditions: A Case-Based Exercise for Medical Students Copyright & Permissions© 2013 Winzelberg and Denham. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsAltered Mental StatusDifferential DiagnosisDeliriumCommunity Acquired Pneumonia Disclosures None to report. Funding/Support None to report. Loading ...