ࡱ> edZ$( / 00DArialngsRomanll4ׯ0DTahomagsRomanll4ׯ0 DTimes New Romanll4ׯ00DWingdingsRomanll4ׯ0 A .  @n?" dd@  @@`` 8&B      !$ 0AA@83ʚ;ʚ;g4kdkdd ׯ0ppp@ <4dddd8vS0l3 80___PPT10 ?  %Alternative Teaching Models 0WFiscal Management Subgroup Mimi Arighi, DVM, MSc, DACVS Director, VTH Purdue UniversityXXIn the Exam Room:ZRounds occur first thing in AM, appts. don t start until 9:30am or later Client arrives, student goes out, greets client, and takes them into exam room Student takes history and does a P.E. on animal. Then student leaves client and patient, finds clinician and discusses case, including differentials and workup for patient. Clinician and student finally go into the exam room together to talk to the client and exam the patient.ZProblems with this systemLClient ends up waiting a long time before they see a doctor  could be more than 1 hour, complaints are generated Client many times has to repeat history when clinician comes into room after already having explained it to the student Appointments start late  usually 9:30-10:00am due to rounds$'/Potential new and more efficient ways to teach 00(G Student and clinician see client at same time. Introduce themselves to client, student still takes history and does P.E. on pet while clinician listens and watches. When student is done, clinician can ask more questions of client if still has questions on history. Clinician can do a physical exam on animal at this time too.HZH Clinician being in room while student is communicating with the client and carrying out the P.E. gives the clinician a lot of information on how that student is doing. Feedback on the student s interaction with client can then be given to student after client leaves. Differential diagnoses and plans for work-up must still be discussed. This could be done in exam room with client present or Clinician and student could excuse themselves and discuss those issues in another location away from client.2{Z!ZmZ Benefits  'This method of seeing clients at a teaching hospital could significantly decrease the time a client is left waiting which can only help public relations in that hospital This method also gives the clinician the opportunity to give critical feedback to the students on how they deal with clients(Z(  At Purdue, at least one of our faculty members has tried this method of receiving cases. They will go in with the student when the client arrives, and listen to the student as they deal with the client. Student feedback has been very positive. They like the feedback since with the old method, they never really knew if their method of communication was successful. They only assumed if no complaints from the client were heard that they were doing a good job.  Rounds:-At Purdue and other schools where I have taught, morning rounds are held, and many times, rounds again occur in the afternoon. Rounds are important for teaching purposes and also for the welfare of the patients in the hospital However, they also help make the hospital less efficient than it could be..Z.  RoundsSDue to rounds, appointments are normally not started until 9:30 or 10:00am in the morning. At Purdue, most specialty services also want their appointments to only be in the morning so that they can work up the hospitalized cases in the afternoon. This leads to a shortage of exam rooms in the morning and empty exam rooms in the afternoon.TZT   The late start of appointments and the lack of all day appointments also go to making the hospital less efficient by decreasing the number of cases that can be seen each day.  Possible solutionsStart rounds at 7:30 or 8:00am, finish in one hour. Have first appointments starting at 9:00am, drop-offs can occur between 7:00am-7:30am or 8:00am. Have some services take appointments in the afternoon and work up cases in the morning that were hospitalized the day before. Might only work for some sections. Or outpatients could be seen in the morning and cases that need to be hospitalized seen in the afternoon.Z  Another option would be for a service to have two appointment tracks  one with and one without students. The non-student track appointments would normally go faster and could be limited to types of cases that are not as good teaching cases: radiation therapy cases, recheck appointments, the multiple appointments needed for chemotherapy patients, etc.cZc The non-student track would probably need a dedicated technician to help the DVM move the cases through and would normally be for outpatient cases only. The DVM assigned to that track could be a senior resident or a senior clinician. Benefits  VMore cases would flow through the hospital so revenue would increase More efficient use of exam rooms should benefit case numbers If a non-student track was used, it would benefit the owners since the cases would go through the system faster. All the above would benefit the students since there would be more cases and better cases to see. WZW 'QUESTIONS, COMMENTS, OR OTHER IDEAS????1  0` r3y`f` S?'gN/زt̙_/` TTTdddIt}` .\:tyf` ur3mo` ` ^^ttfff̙` 333` f33>?" dd@,?nPd@  d @ ` n?" dd@   @@``PR    @ ` `6p>> rj x(  xT  x "V x  BCDEF" @ ++@`"H   G x  BCDEF"@ @`" x <t " `}  T Click to edit Master title style! !$ x 0` " `  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S x 6, #" `` `  \*  x 6d #" ``   ^*   x 6D #" `` `  ^* B x s *޽h ? 333___PPT10i.b @j+D=' = @B + Slit 0   |(  |T  | "J | s B#C DEF" @ " ##"@`"H   # | c BCiDEFd@  i  @`#"  i | 0P " `    W#Click to edit Master subtitle style$ $ | 6T #" `` `  \*  | 6X #" ``   ^*  | 6 ] #" `` `  ^*   | <b "Z  T Click to edit Master title style! !B | s *޽h ? 333___PPT10i.b @j+D=' = @B +0  *(  x  c $j |Z  r  S Hl| `    H  0޽h ? 33___PPT10i.+D=' = @B +} 0 @$(  r  S 8|x `}   r  S dx `   H  0޽h ? 333___PPT10i.ƃjt+D=' = @B + 0 P0(  x  c $@x `}   x  c $x `  H  0޽h ? f___PPT10i.+D=' = @B + 0 `0(  x  c $x `}   x  c $x `  H  0޽h ? f___PPT10i.,+D=' = @B + 0 p0(  x  c $x `}   x  c $x0 `  H  0޽h ? f___PPT10i.pr +D=' = @B + 0  0(   x  c $x `}   x  c $x` `  H  0޽h ? f___PPT10i._b+D=' = @B + 0 $0(  $x $ c $Ax `}   x $ c $Bx `  H $ 0޽h ? f___PPT10i.Pz=+D=' = @B + 0 (0(  (x ( c $x `}   x ( c $X4x `  H ( 0޽h ? f___PPT10i.q+D=' = @B + 0 00(  0x 0 c $$[x `}   x 0 c $[x `  H 0 0޽h ? f___PPT10i.qD-+D=' = @B + 0 40(  4x 4 c $ix `}   x 4 c $|jx `  H 4 0޽h ? f___PPT10i.0+D=' = @B + 0 80(  8x 8 c $vx `}   x 8 c $wx0 `  H 8 0޽h ? f___PPT10i.wd+D=' = @B + 0 <0(  <x < c ${x `}   x < c $|x` `   H < 0޽h ? f___PPT10i.o+D=' = @B + 0 D0(  Dx D c $x `}   x D c $Ȏx` `  H D 0޽h ? f___PPT10i.S +D=' = @B + 0  H0(  Hx H c $Кx `}   x H c $x` `  H H 0޽h ? f___PPT10i.f+D=' = @B +} 0 $(  r  S 졅x `}   r  S x `  H  0޽h ? 333___PPT10i.ăйA|+D=' = @B + 0 0L0(  Lx L c $ x `}   x L c $x `  H L 0޽h ? f___PPT10i.#S+D=' = @B +rd:?>BD`GILOQ5TV WY[@`b$1y^(=c1Oh+'0T@ hp    (00Alternative Teaching Model - In The Exam Room Mimi Arighi 9Microsoft Office PowerPoint@P.i)@0`D@AiG?g  &" WMFC  (lx EMF(o@F(GDICx!b $$=='% % V0xx x % % $$AA" FGDICF(GDIChF(GDIC(h!b !; $$==V4xx$$AA<C  % '% % V0(g'hh''% % ( '% % V0(g'hh''% % ( '% % V0("g'h"h"''% % ( '% % V0"('g"'"h'h''"'% % ( '% % V0'(+g'''h+h+'''% % ( '% % V0+(0g+'+h0h0'+'% % ( '% % V00(4g0'0h4h4'0'% % ( '% % V04(9g4'4h9h9'4'% % ( '% % V09(=g9'9h=h='9'% % ( '% % V0=(Bg='=hBhB'='% % ( '% % V0B(FgB'BhFhF'B'% % ( '% % V0F(JgF'FhJhJ'F'% % ( '% % V0J(OgJ'JhOhO'J'% % ( '% % V0O(SgO'OhShS'O'% % ( '% % V0S(XgS'ShXhX'S'% % ( '% % V0X(_gX'Xh_h_'X'% % ( '% % V0_(eg_'_hehe'_'% % ( '% % V0e(nge'ehnhn'e'% % ( '% % V0n(|gn'nh|h|'n'% % ( '% % V0|(g|'|hh'|'% % ( % " " FGDICF(GDICg!b !; $$==V01 `8 1 $$AA<C  % '% % V0ehh% % ( '% % V0#eh#h#% % ( '% % V0#-e##h-h-#% % ( '% % V0-6e--h6h6-% % ( '% % V06=e66h=h=6% % ( '% % V0=De==hDhD=% % ( '% % V0DKeDDhKhKD% % ( '% % V0KTeKKhThTK% % ( '% % V0T[eTTh[h[T% % ( '% % V0[de[[hdhd[% % ( '% % V0dpeddhphpd% % ( '% % V0p{epph{h{p% % ( '% % V0{e{{hh{% % ( '% % V0ehh% % ( % " " FGDICFGDICF(GDICl.vFGDICF(GDIC6ljvFGDICF(GDIC >FGDICRp@Tahoma,XĐ90,\8OdXĐdOb08OQÐOl͐,PQ%0\U䩐  4 0s xPxPE0\PlP \dv%    T$0AA/LAlternative Teaching Models    T#/AA.LAlternative Teaching Models % ( F(GDICCdFGDICRp@TahomaS,DSTahomapN\U1 :@Tahoma 0 ʐSxO0O0x%0\U䩐ܔXĐl͐P0ැ,Py0 \dv%    T)FxLAA)LLFiscal Management Subgroup    T(EwKAA(KLFiscal Management Subgroup % ( Rp@TahomaW,DSTahomapN\U1 :@Tahoma 0 ʐSxO0O0x%0\U䩐ܔXĐl͐P0ැ,Py0 \dv%    T'O{UAr&WMFC(A'ULMimi Arighi, DVM, MSc, DACVS    T&NzTAA&TLMimi Arighi, DVM, MSc, DACVS % ( Rp@Tahoma',DSTahomapN\U1 :@Tahoma 0 ʐ SxO0O0x%0\U䩐ܔXĐl͐P0ැ,Py0 \dv%    T?Xc^AA?^ LhDirector, VTH    T>Wb]AA>] LhDirector, VTH % ( Rp@Tahoma2,DSTahomapN\U1 :@Tahoma 0 ʐSxO0O0x%0\U䩐ܔXĐl͐P0ැ,Py0 \dv%    T:ahgAA:gLpPurdue University    T9`gfAA9fLpPurdue University % (   x--$xx--',h()(*)+*,+-},.y-/u.0p/1l02h13d24`35\46X57T68O79K8:G9;C:<?;=;<>7=?3>@/?A*@B&AC"BDCEDFEGFHGI HJIKJZY[Z\[y]\o^]e_^\`_Ra`Hba?cb5dc+ed"fegfhg---$'hh''----$'hh''----$'h"h"''----$"'"h'h''"'----$'''h+h+'''----$+'+h0h0'+'----$0'0h4h4'0'----$4'4h9h9'4'----$9'9h=h='9'----$='=hBhB'='----$B'BhFhF'B'----$F'FhJhJ'F'----$J'JhOhO'J'----$O'OhShS'O'----$S'ShXhX'S'----$X'Xh_h_'X'----$_'_hehe'_'----$e'ehnhn'e'----$n'nh|h|'n'----$|'|hh'|'---'',fZY[Z\[z]\o^]d_^Y`_Na`Cba7cb,dc!edfe ---$hh----$h#h#----$##h-h-#----$--h6h6-----$66h=h=6----$==hDhD=----$DDhKhKD----$KKhThTK----$TTh[h[T----$[[hdhd[----$ddhphpd----$pph{h{p----${{hh{----$hh---''@Tahoma??-. 02 /Alternative Teaching ModelsS.. 02 .Alternative Teaching ModelsS."System-@TahomaS?-. .2 L)Fiscal Management Subgroup.. .2 K(Fiscal Management Subgroup.-@TahomaW?-. 12 U'Mimi Arighi, DVM, MSc, DACVS.. 12 T&Mimi Arighi, DVM, MSc, DACVS.-@Tahoma'?-. 2 ^? Director, VTH.. 2 ]> Director, VTH.-@Tahoma2?-. !2 g:Purdue University.. !2 f9Purdue University.-՜.+,0     (0 8 On-screen Show0Purdue University, Veterinary Teaching Hospitald6' ArialTahomaTimes New Roman WingdingsSlitAlternative Teaching Models In the Exam Room:Problems with this system0Potential new and more efficient ways to teach Slide 5Slide 6 BenefitsSlide 8Rounds:Rounds Slide 11Possible solutions Slide 13 Slide 14 Benefits Slide 16  Fonts UsedDesign Template Slide Titles_c    !"#$%&'()*+,-./012456789:;<=>?@ABCDEFGHIJKLMNOPQRSUVWXYZ[]^_`abcfRoot EntrydO)Current User\SummaryInformation(3@PowerPoint Document(dDocumentSummaryInformation8T