All materials
1. NEW! Powerpoint to use with detailed script in slide notes: Kavita’s Detailed Powerpoint with audio
2. Full Video (edited 9/1): https://youtu.be/x61zs1aKUEg or play directly below
3. Other Documents to print:
- Detailed Script for use with video: Facilitator Agenda (Detailed)
- (Updated) 2 Page Hour 2 Facilitator Map (13 min. rounds): v5 Updated PIVOT Facilitator Map for Hot Seats (print for each facilitator)
4. All Student Handouts: All in One Student Packet.pdf (36 pages, print 2-sided color)
- Contains Hour 1 student didactic materials (please print .pdf pages 1-10 if you want to staple hour 1 and hour 2 separately):
- Optional pre-/post evaluation (for tearing out and submitting)
- EPA 9 Schematic (p.2)
- Teaching Handout: From Conflict to Connection (p.3-4)
- Blank practice PIVOT worksheet for MRI scenario: From Conflict to Connection (p.5-6)
- Written Script of “MRI Request” Kim and Dr. Lovell scenario with the lines delineating each component of PIVOT (p.7-8)
- End Hour 1 handouts
- Same all-in-one file also contains all Hour 2 Hot Seat Handouts (Please print .pdf pages 11-36 2-sided, in color if stapling Hour 2 separately)
- Hour 2 Volunteer Participant Pre-Hot Seat and Post-Hot Seat Form (go to footer label Hour 2-pages 1-2, or .pdf pages 11-12)
- All cases in the packet can also be viewed at the tabs above for facilitator ease while presenting.
- Case Vignette #1: “Does she need the ICU? (go to footer label Hour 2-p.4 or .pdf page 14)
- Case Vignette #2: “Should the Dialysis Catheter be placed today?” (go to footer label Hour 2-p.6, or .pdf page 16)
- Case Vignette #3: “Whose job is it? (go to footer label Hour 2-p.8, or .pdf page 18)
- Case Vignette #4: “Is this patient safe for overnight cross-cover?” (go to footer label Hour 2-p.10, or .pdf page 20)
- Not for instructional use – Solo practice case: (go to footer label Hour 2- p. 11, or .pdf page 21)
- Blank page for student notes (go to footer label Hour 2-p. 12, or .pdf page 22)
- Seven removable Hot Seat Observer forms (remainder of packet, or .pdf pages 23-36) to be turned in to classmates
- End of all-in-one packet)3
What learners see:
Case Vignette: “Does She Need the ICU?”
You are the OB/GYN intern covering the postpartum floor overnight. You are called by the bedside nurse about Mrs. Thompson, a 29-year-old woman who underwent a cesarean delivery earlier today for preeclampsia with severe features. She is currently receiving a magnesium sulfate infusion for seizure prophylaxis.
The nurse reports that over the past several hours, Mrs. Thompson’s blood pressure has decreased to 88/54 mmHg, her heart rate is 105 beats per minute, her urine output has been borderline, and she appears more drowsy than earlier in the evening, although she is still easily arousable. The nurse is concerned that Mrs. Thompson’s condition is worsening and believes she may require transfer to the ICU. You feel that there may be opportunities to stabilize and further evaluate the patient on the postpartum unit before escalating her level of care.
Your task is to discuss the situation with the nurse and determine the next steps for Mrs. Thompson’s care.
SP Instructions HERE: SP handout ob intern
What learners see:
Case Vignette: Should the Dialysis Catheter Be Placed Today?
You are a pediatric intern rotating on the nephrology service. Your patient, Sarah, is a 10-year-old girl with acute kidney injury who is becoming increasingly volume overloaded. The nephrology team believes she should begin dialysis as soon as possible and has requested placement of a dialysis catheter today.
You are concerned about delaying dialysis and want to advocate for your patient. Your task is to discuss the situation with the anesthesiology attending and work to determine the safest plan for Sarah’s care. You will start with introducing yourself to the anesthesia attending and telling them about Sarah and why she needs a dialysis catheter.
SP instructions here: SP Script anes attg_nephrology intern
What learners see:
Case Vignette: “Whose Job Is It?”
You are the cross-covering intern on the general medicine ward during the evening shift. Mr. Rodriguez is a 67-year-old patient with advanced heart failure who has been hospitalized for 10 days. Today, his condition has worsened, and his family is anxious and has many questions about the current plan of care.
The bedside nurse, who has developed a strong relationship with the patient and family during the hospitalization, asks you to speak with the family. However, you have never met Mr. Rodriguez before and are unfamiliar with the details of the discussions and decisions made by the primary team.
You are concerned about providing inaccurate information but also recognize that the family is distressed and needs support. Your task is to discuss the situation with the nurse and work to determine the best way to address the family’s needs.
SP instructions here: SP Script crosscover intern_floorRN
What learners see:
Case Vignette: Is This Patient Safe for Overnight Cross-Cover?
You are the night intern covering the internal medicine floor. During evening sign-out, you receive handoff on Ms. Green, a 72-year-old patient with pneumonia and sepsis who is on hospital day two.
The day intern reports that Ms. Green remains febrile (38.8°C) with a heart rate of 115 beats per minute, blood pressure of 88/54 mmHg despite receiving 2 liters of IV fluids, and an oxygen saturation of 91% on 3 L nasal cannula. Her lactate has improved from 4.1 to 3.2, but remains elevated. She is receiving broad-spectrum antibiotics and repeat lactate testing and blood cultures are still pending.
During sign-out, you learn that no ICU consultation has occurred and that the patient does not yet have a central line. The day intern believes the patient can be safely monitored overnight and asks you to continue to observe her and provide additional fluids if needed.
You are concerned that Ms. Green may still be unstable and worry that accepting the handoff without a clearer plan could put the patient at risk. Your task is to discuss your concerns with the day intern and work to develop a safe overnight plan.
SP instructions here: SP Script intern_intern