Ruta Marfatia MD Gretchen Shelesky MD Stephanie Ballard

Ruta Marfatia MD Gretchen Shelesky MD, Stephanie Ballard Pharm. D Rachelle Busby Pharm. D, Lisa Harinstein Pharm. D University of Pittsburgh- Department of Family Medicine Faculty Development Fellowship UPMC St. Margaret Pharmacy Residency Denver, CO 4/30/2009

After active participation in this seminar, participants will be able to: • • • Identify topics that can be used with Power. Point templates presented Identify at least three games/templates that can be used for teaching purposes Create a game using available Power. Point templates

Session Outline 1. Introduction 10 min 2. Large group discussion: topics for templates with examples 20 min 3. Activity: create presentations 30 min 4. Share activity experience creating presentation and discuss plans for use 25 min 5. Wrap-up and completion of evaluation forms 5 min

Educational Games “An instructional method requiring the learner to participate in a competitive activity with preset rules. ” 6

Why Use Games? • Work hour rule • Increasingly formal education • Half day didactic sessions • Need to keep residents engaged to enhance learning

Why Use Games? • Surveys show 3, 4, 5 – More enjoyable – Stimulating – Interactive • Risk-free active environment for – Decision Making – Problem Solving

Why Use Games? • Learning by – Own actions – Discussions – Interaction with others • Active Learning Experiences – Stimulate higher thinking-analysis, synthesis and evaluation – Fun and exciting – Reduce stress and anxiety

What We Have Used • Family Feud • $100, 000 Pyramid • Price is Right • Jeopardy • Are You Smarter Than a Fifth Grader? • Computerized board games

How Games Work • Games foster 1, 2 – Active Learning – Teamwork – Increased Motivation

How Games Work • Knowles’ Theory of Adult Learning – Autonomous and self-directed – Past experiences become resources for learning – Goal-oriented – Learning is problem-centered

Large Group Activity

Family Feud • Question Type: – Questions with multiple answers • Rules: – Each team is a family – Individuals face off – Each member of the winning team guesses individually – Three strikes and it passes to the other team • Attendance: Minimum 8 attendees • Examples: Future of Family Medicine/ IOM report

‹ Medicine New Health Care System

‹ Medicine 11 Characteristics of the new model of family medicine?

Personal Medical 1 Home Advanced information 7 systems Patient-centered 2 care Redesigned offices 8 Team Approach 3 Whole-person orientation 9 Elimination of Barriers 4 Care provided within a 10 community context Emphasis on quality and safety 5 Enhance practice finances 11 Committed to Family Medicine’s basket of 6 services XXX next Exit Game

‹ Medicine 8 Western Conference Teams that made it to the NBA Playoffs 2009?

Denver Nuggets 1 LA Lakers 2 Houston Rockets 3 Portland Trailblazers 4 San Antonio Spurs 5 New Orleans Hornets 6 7 Utah Jazz Dallas Mavericks 8 next XXX Exit Game

Are You Smarter Than a Fifth Grader? • Question Type: – – Multiple choice True/False Fill in the blank Matching • Rules: – Single contestant or group – “ 5 th grader” audience/another group – Cheats: copy, peek, save • Attendance: Minimum 5 attendees • Examples: Polypharmacy in the Elderly

Are You Smarter Than a 5 th Grader?

1, 000 500, 000 Are You Smarter Than a 5 th Grader? 300, 000 175, 000 100, 000 5 th Grade Topic 1 5 th Grade Topic 2 4 th Grade Topic 3 Beers 4 th Grade Topic 4 D-DI 3 rd Grade Topic 5 PK 3 rd Grade Topic 6 PK 2 nd Grade Topic 7 Beers 2 nd Grade Topic 8 Beers 1 st Grade Topic 9 Beers 1 st Grade Topic 10 Beers 50, 000 25, 000 10, 000 5, 000

5 th Grade Topic 1 Question /True or False: Warfarin is not on the Beers Criteria.

5 th Grade Topic 1 Answer /True Return

3 rd Grade Topic 6 Question /A 75 yo man has insomnia caused by stress and anxiety of caring for his wife. Which would be the safest pharmacologic therapy? /Alprazolam /Amitriptyline /Diphenhydramine /Temazepam

3 rd Grade Topic 6 Answer /Temazepam /Metabolized by phase 2 reactions, which are not affected by aging. Alprazolam is dependent on phase I. Decreased phase I metabolism is seen in elderly. Anticholinergic drugs such as amitriptyline and diphehydramine, can potentiate deficits in cholinergic neurons, causing memory loss or confusion and complicate urinary Return retention.

Jeopardy • Question Type: – Questions with one answer • Rules: – Answer in the form of question – Time after buzzing in – Passing (e. g. passing to audience) • Attendance: Minimum 3 attendees • Examples: Basic research topics

Research Design Review Definitions Statistics Name the Name Mixed Bag Study the Bias 100 100 100 200 200 200 300 300 300 400 400 400 500 500 Final Jeopardy

Answer: The sample population chosen is not representative of the population at risk Question: What is ‘Sampling Bias’?

Answer: Patients with the disease are more likely to carefully consider whether or not an exposure occurred. Question What is ‘Recall Bias’?

Answer: Survey of the entire population for presence of absence of a disease and the potential risk factors at a particular point in time Question: What is a ‘Cross Sectional Study’?

Price is Right • Question Type: – Questions that can be answered with numbers • Rules: – Picking teams to “come on down” – Random question followed by educational question • Attendance: Minimum 4 attendees • Examples: Inhaler therapy

Question 1 How much does Pro. Air HFA cost? http: //www. walgreens. com/

$41. 84 www. drugstore. com

For the prize… How many actuations in a single Pro. Air HFA inhaler? 200 • One of 3 branded albuterol products – Most-covered product (? ) • Red canister reminder of rescue

Albuterol 0. 083% for nebulizer 1 box of 25 vials = $18. 99 $$$$$$$$$$$$$$$$$$$ http: //www. walgreens. com/

Question 2 How much for Xopenex (levalbuterol) 0. 63 mg/3 m. L vials 1 box of 24 vials? http: //www. walgreens. com/

$102. 78 www. drugstore. com

$100, 000 Pyramid • Question Type: – Questions with multiple answers • Rules: – 1 st round: Guess the words in the category – Lightening Round: Guess the category – What you are allowed and not allowed to say • Attendance: Minimum 8 attendees • Examples: $100, 000 Psychiatric Pyramid

The $100, 000 Psychiatric Pyramid

6 Crazy Things 4 1 2 3

Crazy Things Describe for your partner in 30 seconds or less the symptoms of schizophrenia

Crazy Things 1. Delusions 2. Hallucinations 3. Alogia 4. Disorganized Speech 5. Catatonic Behavior 6. Echolalia 7. Flat affect

Lightning Round Name for your partner things that fit each category OR what a patient would say if they have that disease. You may not describe the category OR the disease, only list items within it OR say what your patient would say. You have one minute.

Schizoaffective $$100, 000 d/o Thought $50, 000 content Major Depressive $10, 000 d/o Anorexia $75, 000 Nervosa Alzheimer’s $20, 000 Dementia Generalized Anxiety $35, 000 d/o

Small Group Activity • • • Break into your groups Each group works with one game Each individual will have paper templates Small group facilitators have e-templates Begin a presentation with a topic chosen by group consensus

Evaluations • Strengths – Interactive – Engaging – Fun and effective way to review – Format captured audience interest and participation – Repetition of terms-lecture, game

Evaluations • Suggestions for improvement – More questions – Include more data – Repeat answers given by audience can be hard to hear – Shorten lectures

Summary • We discussed why and how Power. Point games enhance learning • We showed you how we have used Power. Point games in our teaching • You partially created a Power. Point game that you can use in the future • We discussed the small group activity experiences and shared our creations

Resources • Free templates – http: //www. murray. k 12. ga. us/teacher/kara%20 le onard/Mini%20 T's/Games. htm • Inexpensive website to buy templates – FTC publishing: http: //www. ftcpublishing. com/index. php? option=c om_content&view=article&id=57&Itemid=58 – Teachers pay teachers: http: //www. teacherspayteachers. com/

References 1. Patel J. Using Game Format in Small Group Classes for Pharmacotherapeutics Case Studies. Am J Pharm Educ. 2008; 1(72): 1 -5. 2. Persky AM S-ZJ, Dupuis RE. Students' perceptions of the incorporation of games into classroom instruction for basic and clinical pharmacokinetics. Am J Pharm Educ. 2007: 71. 3. Howard MG, Collins HL, Di. Carlo SE. "Survivor" torches "Who Wants to Be a Physician? " in the educational games ratings war. Adv Physiol Educ. 2002 Dec; 26(1 -4): 30 -6. 4. Mann BD, Eidelson BM, Fukuchi SG, Nissman SA, Robertson S, Jardines L. The development of an interactive game-based tool for learning surgical management algorithms via computer. Am J Surg. 2002 Mar; 183(3): 305 -8. 5. O'Leary S, Diepenhorst L, Churley-Strom R, Magrane D. Educational games in an obstetrics and gynecology core curriculum. Am J Obstet Gynecol. 2005 Nov; 193(5): 1848 -51. 6. Akl EA, Sackett K, Pretorius R, Erdley S, Bhoopathi PS, Mustafa R, Schunemann HJ. Educational games for health professionals. The Cochrane Database of Systematic Reviews 2008, Issue 1 Art No. : CD 006411. DOI: 10. 2002/14651858. CD 006411. pub 2