I am a medical student who’s required to write a portfolio ( 1st point of view) about interprofessional education activity on diabetes that involved different students from other healthcare profession and that portfolio consists of 2 parts:
1- Description which should be detailed and focused on the event in an organized way
2- Reflection which should be a bit longer than the description reflecting on the activity and how it improved my knowledge in practice in addition to my strengths and limitations, and how to improve myself.
The theme of my portfolio is knowledge for practice which means that its related to applying knowledge of biomedical and clinical sciences through decision making.
I attached below the IPE activity details and the portfolio assessment scale in addition to some samples of portfolios, i hope you can please read it to have the whole concept.
Thank you in advance.
1
Interprofessional Education Activity on Diabetes
Monday October 16th, 2023
Ibn Khaldoon Qatar University
Welcome to this interprofessional activity in Qatar on diabetes. Interprofessional Education (IPE)
has been defined by the Centre for the Advancement of Interprofessional Education (CAIPE) as
two or more professions learn with, from and about each other at the same learning events, with
a view to improving collaboration and the quality of care. The Six professions involved in this
activity are:
Pharmacy
Medicine
Dentistry
Biomedical
Nutrition
Nursing
The learning objectives of this activity have been selected from the IPE shared competency
domains and competency statements shown overleaf.
The agenda for this activity will be as follows (all will be in small groups)
12:30 – 12:50 pm
Registration of attendance of group members + Activity 1
12:50 – 13:05 PM
Activity 2
13:05 – 13:40
Case State 1
13:45 – 2:30
Case State 2
We hope you will find this activity useful and beneficial.
2
IPE Shared Competency Domains & Competency Statements
Created by Johnson B; et al. Implementing Inter-Professional Undergraduate Health Care Education in Qatar Funded by Qatar
Foundation, NPRP # 4 – 693 – 3-197)
1. Role Clarification
Definition: Healthcare students/professionals understand and respect the role and responsibility
of all stakeholders.
Competencies:
1) Demonstrates through application an understanding of their own role
2) Understands scopes of professional practice and roles of each member of the healthcare
team
3) Demonstrates respect for other healthcare professionals roles and responsibilities
2. Interprofessional Communication
Definition: Healthcare students/professionals communicate in a collaborative, responsible and
culturally sensitive manner.
Competencies:
1) Demonstrates through application an understanding of the principles of team work
communication
2) Communicates to ensure common understanding of healthcare decisions
3. Shared Decision-Making
Definition: Healthcare students/professionals include all stakeholders in the decision making
process regarding patient healthcare outcomes.
Competencies:
1) Exchanges knowledge/skills with other members of healthcare teams at all times to
promote collaborative practice when assessing, developing, and planning during the
patient care process
2) Acknowledges each discipline’s perspective during team meetings and/or
interprofessional exchanges during the patient care process
3) Involves all members of the team as well as the patient and their family members in the
decision-making process related to planning and implementing care
4) Seeks to actively create and support a climate of shared decision-making and
collaborative practice
Activity 1:
3
Ice breaker: small group discussion
Introduce yourself and your discipline. As a group, decide on a name for your the group that represents
something you all have in common. You can utilize technology or flipchart to draw a picture that
represents your group.
Activity 2:
Small Group Discussion: Epidimiology of Diabetes
1. Why is diabetes considered a global public health problem?
2. How common is diabetes in Qatar?
3. What are the main strategies for reducing the risk of developing type two diabetes?
4. List healthcare professionals who will be involved in the care of a patient with diabetes and brief
description of their role?
4
Activity 3: Patient Case
Patient Profile
Patient Information
Patient initials:
M.A.
Gender
Male
Female
Age:
46
Weight
75 Kg
Allergies
Drugs: NKDA
Reaction: NA
Medical Information
Chief complaint/reason for admission:
A 46-year-old man, Mr. MA was admitted to the medical floor from the emergency department. His wife
found him confused and agitated in their apartment and brought him to the emergency department
where he was diagnosed with DKA and began his treatment.
History of present illness:
According to his wife, MA has with Type I (insulin-dependent) diabetes. He is adherent with his
medications. She states that he had “a throat and stomach flu” for four days with vomiting, pain in his
throat and stopped taking his insulin two days ago when he became sick. She also noted that he was
“smelling funny” and was going to the bathroom more than usual.
At the time of admission, MA also had a fever.
Past medical history:
Diagnosed with Type I (insulin-dependent) diabetes mellitus since childhood. Diagnosed with
hypertension one year ago. According to his wife, his blood pressure is generally well controlled.
Nutrition History:
History: Usual intake (for past several months)
AM: Toast jelly, coffe and scrambled eggs
Lunch: subway sandwich, chips, diet soda
Dinner: usually cooks pasta, rice, vegetables and some type of meat, eat out 3- 4 time per week
Social history
Tobacco use:
Yes
No
0-1 packs per day
>1 packs per day
Previous histoy of smoking
Alcohol use:
Yes
No
6 drinks per week, history of alcohol dependence
5
Caffenine use:
Yes
No
Other recreational drug use:
Yes
No
6 cups per week
Medication list
Current medication (including OTC and herbals)
Indication
12units of Humulin Regular plus 20units of Humulin NPH before breakfast; 8units of
Humulin Regular before dinner; and 8units of Humulin NPH at bedtime.
Diabetes Mellitus
Ramipril 2.5 mg PO OD
HTN
The paramedics started a saline lock in the right forearm and administered 250mL of 0.9% NS en route to
the hospital
The following were already completed in the Emergency department
Capillary glucose STAT
Urine dipstick for Ketones STAT
CBC, Electrolytes, BUN, Creatinine, Glucose, Phosphate, Magnesium, Calcium, STAT
ABG STAT
Urine culture and sensitivity, Urinalysis STAT
Blood Cultures x2
CRP
Portable Chest X-ray STAT
12-lead ECG STAT
Urinary catheter
Healthcare Provider’s Orders:
Continuous SpO2 monitoring
O2 per nasal cannula at 2LPM, maintain SpO2 greater than 92%
Continuous cardiac monitoring
Vital signs and level of consciousness every one hour
Intake and Output every one hour
Electrolytes, BUN, Creatinine, Glucose, and Anion Gap every one hour
IV 0.9% NS at rate of 1L/hour
Metoprolol 50 mg PO BID
Hold Ramipril
Insulin drip order: Mix 25 units of Humulin regular insulin in 250 ml of 0.9% NS. Infuse at 7.5
units/hour
Performs Capillary Glucose testing q 1 h the hospital.
Meal type: NPO then progress to clear liquid diet and then consistent carbohydrate- controlled
diet
State # 1
6
Patient spent day 1 in the emergency department. The next day, he was transferred to the
medical floor.
Upon admission to the medical floor, there is a slight improvement in the patient’s condition
(see the data below)
Healthcare Provider’s New Orders:
Continue previous orders.
D/C IV 0.9% NS
IV 0.45% NS with 10mEq KCL at rate of 1L/hour for 2 hours then decrease it to 500mL/h
for 4 hours reduce insulin infusion to 0.04/kg/hr so 3 unit/ hr
IV of Piperacillin/tazobactam was administered
Day1 (In Emergency)
Day 2 (medical floor)
39 oral
82/46
130
32 and deep
92% on room air
38 oral
118/79
94
24 and regular
96 % on 2L NC
Blood culture
Negative
Negative
Urine output
30 mL/hr dark yellow,
hazy
60 ml/hr yellow and
hazy
Neurological
Confused and
agitated
PERL
more alert, responds to
questions appropriately
PERL
Pulses intermittent
bilaterally, sinus
tachycardia
flushed and dry,
Acetone breath
Clear
equal bilaterally
26 mmol/L (X18=468
dmol/l)
18 mmol/L
CBC:WBC
15
14
(4-10)
Hgb (g/dl)
15
15.5
(13-18)g/dl
Hct
0.54
0.58
(0.40-0.54)%
Platelet
190
200
(130-400)
Glucose (mmol/L)
31.2
20.9
(3.5-6.0) mmol/L
Albumin
38
40
(35-55) g/L
BUN (mg/dl)
29.5
20
(1.7-8.3) mmol/L
Vital signs
Temp (C)
BP (mmHg)
HR (bpm)
RR (breaths/min)
O2 Sat
Normal values
Assessment
Pupils
CV
Skin
Breath
Breath sounds
Capillary Blood glucose
warm and dry
acetone smell very faint
Clear
Hematology
7
Serum Creat. (mmol/L)
160
150
(53-124) mmol/L
Electrolytes
Na (mmol/L)
day1 (In Emergency)
115
day 2 (medical floor)
132
(135-145) mmol/L
K (mmol/L)
4.5
3.6
(3.6-5.1) mmol/L
Cl (mmol/L)
93
98
(96-110) mmol/L
CO2 mmol/L
11
16
(22-29) mmol/L
PO4 mg/dl
1.03
(0.87-1.45) mmol/L
Mg mEq/L
0.62
(0.65-0.90) mmol/L
ABG
PH
7.20
7.30
7.35-7.45
PaCO2 (mmHg)
25
32
35-45 mmHg
PaO2 (mmHg)
106
100
80-100 mmHg
HCO3
11
13
22-26mEq/L
SaO2
96%
96%
95-100%
Urine analysis
PH
5
(4.6-8.0)
Specific gravity (g/cc)
1.030
(1.0-1.03)
Protein (mg/dl)
4
negative
Glucose
56
negative
Ketones
Large
Blood
Negative
negative
WBC
6-10
negative
ECG
Sinus tachycardia
Moderate
State one
negative
8
Small Group discussion questions
1. What physical assessment and lab findings indicate that that the patient is in DKA?
2. Which professionsl would be involved in this stage and what would be their role?
3. What will you monitor in this patient? Be specific.
How often will blood glucose levels be obtained in an acute DKA patient?
4. Why are ketones present in the urine?
5. Why is early potassium replacement essential?
6. Why would insulin administration continue if glucose values are nearly normalized? How would it
transition to SC insulin
7. List priorities of care for this patient
9
State # 2
Discharge planning
The multidisciplinary team meets to discuss the discharge needs of the patient
Healthcare Provider’s new Orders:
Upon dischsge the patient should be on
•
insulin NPH 20 Units qAM and 8 Units qHS
•
insulin regular 12 Units qAM and 8 Units at dinner
Ramipril 2.5 mg PO daily
Follow up in 4 weeks
day1 (In Emergency)
day 2 (medical floor)
day 5
Vital signs
Temp (C)
BP mmHg
HR (bpm)
RR (breaths/min)
39
82/46
130
32 and deep
38. C
112/72
104 – sinus tachycardia
24 and regular
37.2 C
120/80
92
20, regular
Blood Culrure
Negative
Negative
Not performed
Urine output
30 mL/hr dark
yellow, hazy
60 ml/hr yellow and
hazy
80-100 mL/hr, yellow and
clear
Neurological
confused and
agitated
92% on room air
more alert, responds to
questions appropriately
98% on 2 L nasal
Cannula
equal and reactive to
light
awake, alert, responds to
questions appropriately
98% on room air
O2Sat
Pupils
equal and reactive
to light
equal and reactive to light
CV
Pulses equal bilaterally
Pulses equal bilaterally
Skin
Pulses intermittent
bilaterally
flushed and dry
warm and dry
warm and dry
Breath
Acetone breath
acetone smell very faint
acetone in breath absent
Breath Sounds
crackles
Basal crackles
Clear
Capillary blood glucose
26 mmol/L (X18=468 18 mmol/L
dmol/l)
6.5 mmol/L
CBC:WBC
15
14
12
Hgb g/dl
15
15.5
16
0.54
0.58
0.59
190
200
220
Hematology
Hct
Platelet /mm
3
10
day1
day 2
day 5
Glucose mmol/L
31.2
20.9
12.0
BUN mg/dl
29.5
20
12
Serum Creat. Mmol/l
160
150
106
Na mmol/L
115
132
135
K mmol/L
4.5
3.5
3.7
Cl mmol/L
93
98
98
CO2 mmol/L
11
16
16
PO4 mg/dl
1.03
Mg mEq/L
0.62
ABG
PH
7.20
7.30
7.34
PaCO2 mmHg
25
32
35
PaO2 mmHg
106
100
100
HCO3
11
18
22
SaO2
96%
96%
96%
FiO2
2L/NC
2L/NC
Room air
Moderate
negative
Urine analysis
PH
5
Specific gravity (g/cc)
1.030
Protein
4
Glucose
56
Ketones
large
Blood
Negative
WBC
6-10
Chest X-ray
Negative
ECG
Sinus tachycardia
11
State 2
Small group task
1. Write out a multidisciplinary discharge plan for this patient.
2. Design a pamphlet for this patient and his wife regarding ‘sick day management’. Explain
why insulin should not be stopped even if he is not eating
5. As an interprofessional team, describe the strengths of each of the following healthcare
professionals involved in today’s activity.
6. What is your team key takeaway message from today’s event? This can be written,
drawn (be creative)
Student Guide
Portfolio Project
Prepared by
Dr. Mubarak Bidmos & Dr Tanya Kane
College of Medicine
Qatar University
1
Acknowledgements
I wish to express my gratitude to Professors Salah Kassab and Marwan Abu-Hijleh for their
suggestions and comments, which have improved the quality of this work. Also, thanks to Dr.
Ayad Al-Mosleh for providing me with books and other resources on the portfolio, which were
used in the development of this document. I am also indebted to Prof Srikant Sarangi whose
critical review of the document is invaluable. Lastly, a big thank you to the members of the
portfolio committee: Prof Salah Kassab, Dr. Tanya Kane, Dr. Suhad Nashif and Dr. Hana Taha,
for their efforts in the review and finalization of the portfolio rubric.
MB
Doha, August 2020
I would like to add my appreciation to all the graders for the considerable amount of time and
effort they devote to this educational activity. A special mention goes to Dr. Mubarak for his
perseverance and support of the portfolio project. Thanks to the students as well for their
continual feedback and efforts to improve this valuable component of assessment.
TK
Doha, January 2021
2
Contents
1. Portfolio: Its value and purpose ………………………………………………………… 4
2. Learning outcomes ………………………………………………………………………….. 6
3. Organization and presentation of portfolio ……………………………………… 6
4. Assessment criteria and grading scale ………………………………………………. 8
5. General guidelines …………………………………………………………………………… 9
6. Submission details and deadline ………………………………………………………. 10
7. Feedback and Grade Appeal………..……………………………………………………. 10
8. Plagiarism ……………………………………………………………………………………….. 11
9. Samples of reflective writing ………………………………………………………….. 12
3
1. Portfolio: Its value and purpose
A Portfolio is a compilation of student work and educational evidence which show the
achievement of skills, knowledge, learning progress and professional growth through a
process of self-reflection over a period of time (Davis and Ponnamperuma, 2009).
In addition, a portfolio can be considered to be an interactive professional development tool
that is used for tracking progress and for monitoring of academic development throughout
learning through a process of self-reflection and feedback from mentors and peers
(Accreditation Council of Graduate Medical Education – ACGME)1.
The student portfolio aims to support competency objectives of the six themes of the medical
curriculum2 at the College of Medicine of Qatar University (CMED, QU).
a. Purpose
The portfolio shows evidence of your achievements and demonstrate a reflective record of
your academic and professional growth.
It serves to display samples of your best work, activities, and learning process during the course
of your medical school education. It will not only move you to a professional level of personal
responsibility but will assist you in examining your growth.
The portfolio provides you with a way to document your learning experience and reflect on
your intellectual and professional growth.
______________________________________________________________________________
1.
2.
http://www.acgme.org/
CMED Curriculum Map: A copy can be found in the Unit’s Study Guide
4
Benefits
Most reports have shown that the compilation, review and evaluation of the portfolio over a
period of time can provide a better understanding and a more accurate picture of what you (as
students) have progressively learned compared to the traditional measures like tests and
exams which only measure your ability only at a specific point in time.
Some other perceived benefits of portfolios include:
•
•
•
•
•
Assist students in improving their communication and decision making skills
Encourage students to take responsibility and ownership of their learning process
Provision of emotional support for students when they are dealing with difficult situations
Provide opportunities for self-assessment and learning through feedback from peers and
mentors
Assist mentors in understanding students’ needs and appropriate modification of teaching
strategies
Reflection3 + Documentation3 + Mentoring = Learning
___________________________________________________________________________
3.
See page 7 for details
5
2. Learning Outcomes
Through the practice of using portfolios, students are expected to achieve the following
learning outcomes:
#
1
2
3
4
5
6
Curriculum Theme Related students’ learning outcomes
Patient care and
1. Use patient history and physical examination as information to
clinical skills
achieve better clinical judgement
Population Health 2. Apply the principles of prevention and health improvement for
the community
Knowledge for
3. Apply knowledge of biomedical and clinical sciences through
Practice
decision-making
Communication
4. Demonstrate the ability to communicate with colleagues, tutors
and Collaboration
and patients in a way that is respectful, non-judgmental and
culturally sensitive
Personal and
5. Demonstrate evidence of ethical and professional behaviors
Professional
either of students or others in their professional activities.
Development
Research
6. Use scientific principles of research and scholarly inquiry to
solve population health problems
3. Organization and presentation of portfolio
The basic structure and organization of the student portfolio is based on the roles as defined by
the competency objectives of the six themes of the medical curriculum at CMED, QU. These
themes are:
1.
2.
3.
4.
5.
6.
Patient care and clinical skills
Population Health
Knowledge for Practice
Communication and Collaboration
Personal and Professional Development
Research
A description of each of these themes is well documented in the student guide.
The portfolio should include a series of activities that you participated in over a period of time.
Each activity should involve two components:
6
A. Description of the activity or event
In addition to stating when the activity or event took place, the following questions should be
answered while describing the event: What happened? Where did it happen? In what
circumstances did it happen? Think of this description as setting the scene, informing the
reader of the details surrounding the event.
B. Self-reflection
Self-reflection is the key to any portfolio. The value of a student portfolio in improving student
learning depends on not just a collection of your work (evidence) for assessment. It should
address vital reflective questions as part of the self-reflection process. You may consider and
answer the following questions fully as part of this process:
1. How did this experience improve my basic intellectual and professional development?
2. How could I have improved the value of what I have learned?
3. What is my future plan of action that will enhance learning?
This reflection is evidence of your learning so there is not necessary to include photos or screen
shots of attendance etc.
For more information on reflective writing, you are requested to (i) watch the video with the
following link: https://www.youtube.com/watch?v=QoI67VeE3ds and (ii) refer to the attached
document “Reflective writing: a basic Introduction” for more information.
In addition, sample activity reports and reflections from selected submissions of students from
Fall 2020 are provided as a guide at the end of this document.
7
4. Assessment criteria and grading scale
Each of these activity reports will be graded at the end of the semester using the rubric that has
been adopted by the CMED Assessment Committee as shown below:
Category
Organization
and quality
of
presentation
(Max 2)
Criteria
Organized (title page, table of contents, use of headings and
subheadings) & well presented (clear, appropriate tone, free of
spelling/grammatical errors)
Partially organized and/or poor quality of presentation
Disorganized & not well presented (lacks clarity, adopts inappropriate
tone, lacks structure, contains spelling/grammatical errors )
Description
of an event
(Max 2)
Reflection
(Max 6)
The selected events are explicitly and appropriately linked with the
curricular themes.
Descriptions of events are coherent (detailed and focused) and flow
smoothly; rich in contextual details; and draw upon vivid and specific
examples
The selected events are implicitly and partially linked with the curricular
themes.
Descriptions of events show a degree of coherence, but inconsistent in
flow; contain some contextual details but without elaboration; and
minimal use of examples
The selected events are not explicitly or appropriately linked with the
curricular themes.
Descriptions of events are incoherent (not detailed and not focused)
and do not flow smoothly; do not provide adequate contextual details
and/or specific examples
Reflection demonstrates and provides evidence of the following 3
main characteristics:
Critical awareness of self and others
• Demonstrates understanding of the interrelation between self
and others
• Demonstrates an ability to recognize own and others’ strengths
and weaknesses as a basis for learning and improving practice
• Demonstrates an understanding that situations can be viewed
and interpreted differently depending on the perspective of the
person involved
• Demonstrates partial awareness of the interrelation between
self and others
• Absence of awareness of the interrelation between self and
others
Points
2
1
0
2
1
0
2
1
0
8
Experiential knowledge
• Communicates how experiencing (feelings, thoughts, fears,
internal dialogue) or witnessing an event has changed or
reinforced one’s perspectives
• Transforms new knowledge to inform future action and
provides specific details of goals and plans
• Explores alternative ways of solving problems/decision-making
based on a combination of knowledge and experience
• Demonstrates partial experiential knowledge
• Absence of experiential knowledge
Ability to identify and manage uncertainty and indecisions
• Takes initiative and discusses implications of risk-taking
• Identifies and reports mistakes and errors of judgement (own or
others’) and discusses potential causes and consequences
• Identifies and navigates multifaceted problems for which there
is no ideal solution
• Ability to partially identify and manage uncertainty and
indecisions
• Absence of the ability to identify and manage uncertainty and
indecisions
TOTAL
2
1
0
2
1
0
/10
5. General guidelines
•
Two reflective entries per semester are required.
•
Please note as per QU Health Cluster Policy, the biannual IPE events are now mandatory
curricular components which require a reflective assessment. As such, mandatory
portfolio entries comprise the portfolio assessment in year 2 and 3* (see below).
•
*Year 2 one of the two entries submitted must be related to the IPE event in both Fall
and Spring semester (can be an entry under any of the following themes: II Population
Health; III Knowledge for Practice; IV Communication & Collaboration or V Person &
Professional Development).
•
*Year 3 one of your two Fall semester entries must be a reflection on your IPE event.
•
When submitting reflections on the IPE event, please ensure that it is Entry 1 (i.e. the
first reflective entry).
•
Failure to reflect on the IPE event during the requisite semester/s will be penalized with
a 5/10 point grade deduction from your final grade, unless a medical certificate is
provided to Student Affairs (i.e. the highest mark you can receive on your portfolio is
5/10%). Please note that if you do not attend the IPE event for any reason, you should
not write about it.
9
•
Each curricular theme must be addressed at least once over the course of your preclerkship years. This is to demonstrate evidence of learning across the six curricular
themes. You have 10 entries during pre-clerkship so 4 curricular themes will be repeated
a maximum of two times.
•
You cannot reuse a reflection from a previous year (even if you are repeating a year).
•
Please refer to the FAQ (frequently asked questions) discussion board on the
Community group. If you have a question, please check to see if it has already been
asked prior to posting it on the discussion board. This will enable your peers to also
share the information. Queries will only be responded to on the Blackboard, so please
do not send individual emails to the Portfolio Chair. Any concerns of the group should
be channeled to the Portfolio Chair through the class representatives.
6. Submission details and deadline
•
•
•
•
•
•
Please use your student number on the title page (no names) on your submission to
ensure anonymity. Portfolios are confidential documents.
File must be submitted in PDF format and using this specific filename format:
S2021-YEAR-STUD_ID-CMED-OR-CDEN
e.g., S2021-Y2-200112345-CMED.pdf; F2021-Y3-20012345-CMED.pdf (S=Spring; F=Fall)
Failure to comply with this directive will result in a mark of ZERO.
Avoid leaving your submissions to the last minute! Students are required to submit their
portfolio prior to or by the submission deadline that will be announced on the
Blackboard at the beginning of each semester. This date is non-negotiable and requests
to change the date are considered unprofessional and will be dealt with as such
(professional violation).
Before writing your portfolio, you are strongly encouraged to brainstorm the incident
with your mentor to explore various angles that you might wish to explore as you
reflect. Your mentor will not grade your portfolio.
You are strongly advised to check the spelling, grammar and clarity of your document
prior to submission
The penalty for late submission on the first day will be an automatic 2-point reduction
(20%) (i.e. 8/10 is the highest mark you can earn); an additional 1 point will be
deducted from your score every day thereafter (i.e. received a day after the deadline
7/10; two days after the deadline 6/10).
For each activity report, kindly consider the following:
•
•
•
•
•
Maximum word count for each reflection event is: 1200 words
Font size: 12
Font and line spacing: Arial, 1.5
Paragraph form
References are only necessary if you cite a source and should be used sparingly. If
included, please use APA citation style.
10
7. Feedback and Grade Appeal
You will receive a detailed portfolio feedback form when you receive your grade.
Requests to appeal your portfolio grade should be sent to the Portfolio Chair via email
(tkane@qu.edu.qa) by the predetermined date that will be announced on Blackboard.
You MUST adhere to the deadline date otherwise your request for feedback will NOT be
considered. This is to ensure adequate time to regrade. If you submit a grade appeal request,
the final grade will be an average of your original score and the appealed score awarded by
the independent grader.
Should you wish to appeal your final grade, kindly follow the University appeal process. Please
do not send an email to Dr. Tanya Kane or Dr. M Bidmos for a grade change.
8. Plagiarism
Your attention is drawn to the University’s policy on Plagiarism (see the link:
http://libguides.qu.edu.qa/c.php?g=281524&p=1875380). Kindly ensure that your submitted
document is available online with the similarity report.
An automatic one-point deduction will be applied to any submission that surpasses the 20%
Turnitin Similarity Report.
Kindly ensure that your submitted document is available online with the similarity report.
Failure to comply with this directive will result in you receiving a ZERO mark. Similarity score of
more than 25% will attract deduction of marks as follows: 1 (26 – 29); 3 (30 – 39); 5 (40-49).
However, a student will receive ZERO for a similarity score of 50% and above. It is the student’s
responsibility to make sure that the similarity of the assignment is less than 25 % after the
submissions of all students are done. In order to achieve this, the similarity at time of
submission should be kept to a minimum (e.g. 5% or less).
11
9. Samples of Reflective Writing
12
Table of contents
Patient care and clinical skills
“Clinical Elective”
Description:
Starting from the Fall semester, I enrolled myself in a clinical elective in the emergency
department at Hamad Medical Corporation (HMC) to refine the clinical skills that I learned
throughout my second year of medical school.
On the 16th of September, midway through my elective, I witnessed a remarkable case. I
was assigned in the high acuity department with Doctor T. Around 09:00 PM, the paramedics
brought a 31-year-old male patient with an oxygen mask on his face, he looked pale and in
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apparent distress. After stabilizing him, Dr. T asked me to take history and perform a general
physical examination.
I started asking the patient what had happened, but I couldn’t understand his replies.
Fortunately, I found his brother in the hallway, and he told me that he has a congenital heart
defect, since his birth. He added that his brother suffers from developmental delays and
communication barriers. Nevertheless, he mentioned that his brother could understand conveyed
questions.
Therefore, I returned to the patient and started asking him if he felt pain in specific regions
by pointing to them and observing if he nodded or shrugged. After that, I examined his heart,
breathing, abdomen, and neural reflexes. He pointed that he is feeling severe chest pain for a
long time which was consistent with the physical exam findings of a systolic murmur and coarse
breathing sounds.
I tried to ask him why he didn’t convey that to his family, but he got frightened and did not
answer. Doctor T inspected his medical history and found that he has a condition called Tetralogy
of Fallot. He added that his family refused an emergent surgical intervention to close the
congenital defect when he was younger. The doctor mentioned that this might be a case of
medical neglect and domestic violence. Therefore, he called for the social worker.
Reflection:
To begin with, having finished my clinical elective in HMC and reflecting on the whole
experience, I can clearly say that it was helpful. Not only did this experience improve my historytaking and clinical reasoning skills, but it also helped me find an answer to a question inside me.
Throughout the second year of medical school, I started questioning if medicine was what I
wanted to pursue in the future. Interacting with patients, nurses, and doctors, I understood why
we have to put all of these efforts as students since making an impact in someone’s life is indeed
an extraordinary feeling.
Through the many shifts I had in the emergency department, I saw many cases with
different diseases, personalities, motives, and interactions. I stumbled upon many challenges and
obstacles that helped me achieve better personal and clinical judgments. For example, when
doctor T asked me to take the history from the patient in high acuity, I was hesitant to do so. I was
afraid of not being able to elicit the needed information from a patient in such a critical condition.
What made it more challenging for me was the fact that I couldn’t understand what the patient
was trying to say. Nonetheless, I took the initiative and started looking for one of his family
members rather than returning to doctor T empty-handed. Fortunately, I found the patient’s
brother and he gave me valuable information about the patient’s medical condition. Upon returning
to the patient’s room, I started asking myself how I can approach him and develop a mutual
14
understanding and immediately, an idea came to my mind. I started pointing to specific regions
and asked the patient to nod if has pain there.
This particular encounter changed a lot in me. To elaborate, I became aware of some of
my weaknesses such as not being able to elicit information from patients with developmental
delay and communication barriers. Moreover, I mistakenly presumed that the patient’s history was
of little importance since nothing was documented on the system. However, I soon came to realize
that this was because the patient did not follow up with the hospital. As a consequence of this
mistake, my clinical decision regarding the case, when I presented to doctor T, was inappropriate.
On the other hand, provided I had checked if the patient had followed up with external clinics, it
would have alerted me to a different clinical decision. Moreover, revisiting everything that
happened that day, this case improved my clinical knowledge and skills. For example, I learned
how to take history and helpful pieces of information from a relative when I am not able to take it
from the patient himself. Additionally, having just finished the CVS unit last year, I got the
opportunity to practice what I learned in a real clinical scenario. Tetralogy of Fallot is a rare,
uncommon congenital condition that we studied during the CVS unit and the patient had a typical
presentation. Moreover, I was able to perform a physical examination on the patient, further
consolidating what I had studied.
On a personal level, having to communicate with the patient by means other than speaking
allowed me to appreciate the role of empathy and understanding in clinical care and history taking.
On a professional level, I reinforced the principles that I learned during my studies such as being
beneficent, non-maleficent, and always putting patient care over other factors. To elaborate, the
case I faced had an intricate problem that had no ideal solution. The patient was in severe pain,
but he was afraid of telling his family. Moreover, the family refused a surgical operation to manage
his congenital defect when he was young and did not bring him for follow-up in the hospital.
Going through this, experience my views and perspectives changed significantly.
Witnessing how the family hindered medical care for their child and reading more about domestic
violence and neglect, I became aware of our society’s flaws and inequalities. Nonetheless, when
I looked at the scenario from a different angle, I came to the conclusion that some external factors
such as the financial status of the patient family and their life circumstances might have hindered
their ability to look after the patient and follow up with hospital. Therefore, as future doctors, we
have to always be on the patient’s side and help him and his family in every way possible.
My plan for the future is to consolidate my communication skills by learning new
languages, including sign language, which I believe is essential to be able to deal with those with
difficulties. Additionally, to improve the value of what I learned, I will read more about medical
neglect and domestic violence and how to act in such situations.
Word Count: 1094
15
Personal and Professional Development
“IPE Group Leader”
Description:
On the 4th of October 2021, I had the opportunity to represent my college and
profession in my second consecutive interprofessional education activity. Similar to the previous
academic year and under the circumstances of COVID-19 restrictions, the event took place
virtually in Microsoft Teams. Health cluster students from five different professions were invited
to share their competencies and knowledge in a multidisciplinary case study on Diabetes Mellitus.
The five professions involved were Biomedicine, Nutrition, Pharmacy, Dentistry, and Medicine.
Doctor M facilitated a session that included three activities, with the first activity being an icebreaking small group discussion. We started by introducing ourselves and disciplines, then we
chose a name for our group by suggesting names on the JamBoard platform and voting for the
best name. In the second activity, we started discussing the global burden of diabetes and how it
affects the healthcare system. Moreover, we looked at the statistics showing diabetes incidence
in Qatar and the fact that it is rising even among adolescents. Next, we discussed different
prevention levels and measures that can be implemented to control the incidence of diabetes.
Activity two ended with rule clarification, in which the group members demonstrated their roles
and responsibilities in the management of diabetes. The third activity was a clinical case study on
Mr. MA, a 46-years-old man with Type 1 Diabetes Mellitus who developed DKA and was brought
to the emergency department. As a group, we discussed the case holistically and communicated
to reach a collective understanding of the case including the rationale behind diagnostic
parameters and the roles of each member in the healthcare team involved in the management
and monitoring of Mr. MA. After discussing the case and clarifying the roles, we exchanged our
expertise and planned a discharge plan for Mr. MA.
Reflection:
Following last year’s IPE event portfolio reflection and observing its beneficial influence
on my character and professional development, I was enthusiastically waiting for this year’s IPE
event. Nonetheless, this time the experience was different and brought with it more lessons and
benefits. Early in the session, I had no idea what a huge challenge awaited me, one that would
have a significant impact on my views and mindset.
Following icebreaking, Doctor M asked us to nominate a leader amid us to keep track of
time and mediate the discussion. Silence dominated the scene for a while and no one expressed
his wish of being the leader. We were all hesitant to nominate ourselves as we had just known
each other. Nevertheless, I took the initiative to lead the group and broke the inexplicable silence.
While leading the group discussion through the clinical case and on the experience, I was able to
recognize my strengths and weaknesses as a group leader.
16
Regarding the strengths, I was able to get all of the team members to engage and
contribute to the discussion. Moreover, I kept track of time and we were able to finish all the tasks
on a timely basis. However, I reckoned that I had some areas of weakness that I had to work on.
To elaborate, I felt that I was overbearing and dominating the discussion rather than mediating it.
I talked a lot and minimized my colleagues’ contributions and I felt that some of the group
members stopped contributing to the discussion because of what I did. Furthermore, after the
event, one of my colleagues commented that I had spoken a lot, which could have been the
reason some of the team members stopped contributing to the discussion.
Having said that, retrospectively looking this experience helped me appreciate the
important of good leadership skills and changed my views regarding my demeanors. Looking
back at what happened with a focusing eye, this event stimulated me to develop my leadership
and time management skills, both personally and professionally as a future contributor in a
multidisciplinary healthcare team. On a personal level, these skills will help me interconnect better
with my friends and colleagues without imposing my opinions and thoughts on them when we
discuss a particular topic.
Moreover, I came to appreciate one of my errors of judgment in my daily interactions. I
used to engage in discussions for the sake of winning the arguments rather than gaining
knowledge and benefiting and that is when I started to notice my unconscious biases.
Consequently, that led to many non-constructive arguments with my colleagues. Additionally, on
the professional level, as a future healthcare worker, strengthening my leadership skills will help
me provide better care for patients when I become part of a multidisciplinary team.
Going back to the IPE event, I should have dealt with the situation differently. For example,
I should have mediated the discussion by asking questions and listening to my colleagues’
answers rather than imposing my answers. All of this brought to my attention an intricate problem
that I couldn’t find an answer to. How to be a good leader without imposing my opinions? Looking
for an answer to this question, my views and perspectives regarding leadership changed and I
began to appreciate the importance of teamwork and effectiveness in the decision-making
process .
As a future plan, I aim to utilize the knowledge and skills that I learned from this event to
improve my personal and professional leadership skills. Taking the initiative to be the leader,
doing some mistakes, and learning from them will surely help me become a better team member
and leader. Furthermore, I’ve learned to listen more and speak less, and that initiating a
discussion does not imply excluding others from it. Furthermore, mutual respect and shared
decision-making are critical in healthcare practice and lead to better outcomes.
Finally, to improve the value of what I learned, I plan to take the lead more often in my
PBL sessions and ask my colleagues for constructive feedback to further consolidate what I learn.
Finally, our role as medical students is not only tied to grasping scientific knowledge and
17
mastering clinical skills. In fact, the core and essence of medical care lie within our roles as
effective players in the multidisciplinary healthcare team.
Word Count: 1011
Reflect!
Year 3
Fall 2021
F20XXXXXXXXX.CMED.pdf
November 8, 2021
Word count: 2300
18
Page
Number
THEME 1: PERSONAL AND PROFESSIONAL DEVELOPMENT
3
IPE: A Patient with Diabetes
DESCRIPTION
4
REFLECTION
5
EVIDENCE
7
THEME 2: COMMUNICATION AND COLLABORATION
8
IT IS OKAY NOT TO BE OKAY
DESCRIPTION
9
REFLECTION
10
REFERENCE AND EVIDENCE
13
19
Description:
On October 4, 2021, throughout the second week of urinary system, I was part of
this year’s Interprofessional Education event (IPE), which allows students from different
20
professions to learn from, and about each other’s professions. This year’s theme focuses
on ‘Diabetes’ to ensure collaboration and shared decision-making among healthcare
providers to deliver a higher quality of care for patients with diabetes. Due to the ongoing
circumstances of the COVID-19 pandemic, it was inevitable to conduct this event through
one of the virtual platforms (Microsoft teams). This event involves students from different
health professions such as dentistry, pharmacy, biomedicine, nutrition, and medicine
represented by us. Students from all the involved disciplines were divided into small
groups beforehand, which were led by a faculty member to ensure a common
understanding of the collaborative activity.
The session began at 12:00 p.m. with a welcoming address and an ice breaker.
Then, we had an introductory group discussion to know the burden of diabetes as a health
problem locally and globally.
In the next activity, the instructor asked us if anyone wants to be a leader to have
a real experience of professional practice. Without hesitance, I stepped up for the lead. I
ensured to promote collaborative practice by saying, ‘’ before we start reading the case,
I need you all to know that this is a shared-decision making process.’’ In a nutshell, the
case was about a patient who had diabetic ketoacidosis as a consequence of his noncompliance with his diabetic medications. The first part was about the patient’s admission
to the emergency. We saw the history of the patient, his laboratory results, and initial
emergency management. This opened the floor for an in-depth discussion about the
patient’s clinical manifestations, pharmaceutical, and nutritional management.
We reached the last part of the case which was mainly demonstrating a follow-up
of the patient till he got discharged. In this station, the pharmacy students were dominating
the session by their knowledge despite that I was the actual leader. By the end of the
case, we had an insightful discussion about the discharge plan and dose adjustment.
Finally, we all summarized what we learned in terms of clinical and interprofessional
knowledge. The facilitator was delighted to say that we now know the true meaning of
collaborative practice.
Reflection:
I would like to begin my reflection by stating this year’s IPE was the most
informative and educating event of all. In such a unique opportunity, I had to make the
best out of it. For that, I stepped up for an additional commitment to lead the team which
was a bit challenging. I had to call them by name to overcome the embarrassing moments
of silence to initiate any sort of engagement. Although calling them by their professions
21
would have been a better respectful alternative, it was pleasing to see all the team
members contributing equally to the discussion which helped me to further explore their
potentials. Personally, as a learner, I learned that to be a good leader, I have to involve
everyone, so I can be part of the team, not ‘the’ team. Having said that, I realized that
being able to bridge the gap between self and others is a critical leadership trait. Putting
this in a future perspective, I am pleased to say that without such an initiative behavior, I
would not be aware of what I might face as a physician when being stumbled in real
clinical practice.
Having been through this experience, I appreciated the importance of
collaborative practice to provide optimal care for the patient. Despite the individual
differences in terms of competencies and knowledge, a collaborative practice will be
stronger than any individual effort. Throughout the case discussion, I was able to clearly
see that a strength of a pharmacy student is, indeed, a weakness of mine, which supports
the fact that all healthcare professions are of an equal importance. Additionally, I believe
it is important to know that similar situations can be viewed differently according to the
person involved. For instance, upon seeing our patient who presented with diabetic
ketoacidosis, a pharmacy student said that the patient’s non-compliance to medication
was the cause. While I thought of it as a pathological progression of type 1 diabetes. This
made me appreciate the fact that our professions shape our perception of things.
Personally, I believe that tackling mistakes is the first step towards professional
and ethical improvement. For that, I would like to highlight one of the misjudgments that I
was previously not aware of. Throughout the discussion, the instructor was very cautious
about saying ‘Patient with diabetes’ instead of ‘diabetic patient’. To be honest, I was
curious to know why he did not use them interchangeably as they mean the same thing!
After thinking of it profoundly, I realized that despite the fact that diabetes is a disease
that may be life-changing, this disease should never be life-defining. In other words, when
I say, ‘diabetic patient’, it means that I tend to see the disease before the patient which
makes it the main identifier of the patient. As a result, this would not motivate the patient
to take extra steps to manage his condition as he lacks those first seeds of confidence
that come from others seeing him as a person first, not a disease. Therefore, I realized
that it is crucial to respect the patient’s integrity by being cautious in describing the
associated conditions of what a normal individual might have. Nevertheless, one can
notice that the word ‘diabetic’ is still commonly used by some of healthcare providers
when referring to individuals with diabetes. Thinking of a young child with diabetes who
22
is barely tolerating the burden of the disease, I was uncertain whether there would be an
ideal solution to ensure that such patients are being normalized across different health
care systems.
With this experience embedded in mind, my next step is to enhance my leadership
skills by reading a book ‘The Art of Medical Leadership’ to further empower my potentials
as a future doctor. Additionally, I will try to be more involved in similar experiences with
students from different professions to be more of a ‘team worker’ person. To transform
what was learnt into tangible outcomes, I plan to raise awareness about the essentiality
of a proper clinical description of the patient’s condition and its impact on the patient’s
wellbeing
Word count: 1100
23
Theme2: Communication and
Collabration
Title: It is okay not to be okay
Description:
. My first clinical placement as a third-year medical student took place on the 12th
of October 2021. It was during the third week of the renal system. I was assigned to
Mesaimeer health center to learn and explore the role of a general practitioner at the
PHCC. This time, I was excited because the focal person assigned me to a physician who
24
treats patients in person despite the ongoing circumstances of the COVID-19 pandemic.
“First floor, room 3, on your left hand,” said the focal person. At first, I was a bit lost
because I could not find the doctor’s room on the male side ‘as expected’. Surprisingly,
the doctor’s room appeared to be on the female’s side which was a bit of an added
challenge to me. I stepped into the doctor’s office with a big smile. However, the doctor
seemed to have a tough day and my attendance made it even worse.
Just in a few minutes, the first patient was knocking on the door. It was a 42-yearold Asian female who works for a private company. The patient seemed to be a bit anxious
and uncomfortable. Yet, the doctor did not assure her. Although I was not fully confident
whether I would be able to take a proper history from a female patient, I stepped up for
this encounter. I listened attentively to the patient’s history. Luckily, she did not have any
alarming symptoms and she was mainly concerned about her diabetic medications. I
thought this was an ‘easy catch’ and my role is over, till the doctor asked me to further
investigate her previous admissions and laboratory results. Interestingly, or shall I say,
unfortunately, she had some electrolytes disturbances, her bicarbonate levels were below
normal, and she had increased levels of serum creatinine. Nevertheless, she did not have
any history of renal disease. ‘Now, this is Alarming!’ I said in my mind. With the doctor’s
assistance, I was able to calculate the patient’s eGFR using different parameters. Based
on the patient’s eGFR, she was diagnosed with stage 4 chronic kidney disease (CKD).
I was glad that I picked up such an advanced diagnosis. However, the patient did
not share the same feelings. She collapsed emotionally and said, ‘‘I knew I was not okay!
I knew I was not okay!’’ I was trying to show her some empathy and normalize her
situation. Not so long and the doctor unexpectedly said, ‘‘Madam, please go and cry
outside, other patients are waiting.’’ She grabbed her bag, took the prescription, and went
away with tears on her eyes.
Reflection:
I would like to start my reflection by stating that this is one of the most meaningful
PHCC visits, as it helped me to view the clinical practice differently. To begin with, one of
the most challenging elements I faced during this placement arose from the need of
communicating deliberately in a culturally sensitive manner. The reason being is that I
was involved more than ever in addressing the needs of a female patient. To be honest,
it was quite challenging for me to show the patient some empathy despite the fact the
physician did not have any attempts to validate her discomfort and emotions. Yet, I am
25
very pleased that I took the initiative and stepped up for this encounter. To me as a
learner, I knew that there was a risk of not handling the patient’s emotions properly which
might have some consequences. However, I had to show the patient that I care about
her. It is worth mentioning that it would have been better to explore alternative ways of
addressing the patient’s concern to ensure that she is ‘healthy’. This is because the health
of the patient is not necessarily confined to the treatment of the disease, there are other
factors that the patient is already overwhelmed with outside the clinic which need to be
addressed as well. Thinking of my patient, maybe she was concerned whether her
condition would affect her employment, so assuring her about that would have helped
her.
After thinking profoundly, I can confidently say that this visit helped me to recognize
my own strengths and weaknesses to set the basis for better self-improvement.
Furthermore, my self-esteem went sky-high when I diagnosed the patient with stage 4
CKD based on her manually calculated eGFR. Perhaps, it was my first time to apply
medical knowledge in real practice which made me more confident about my potentials.
However, the joy did not last for long as I noticed the patient face. Indeed, it seemed that
I was happy for the same reason that makes the patient suffer. This made me question
the ethical acceptance of such joy! Having been through that, I can clearly see how the
same situation could be viewed differently based on which side I am on. Additionally, I
used to think that the patient’s chief complaint reflects all her needs. However, I can
highlight this thought as one of the main mistakes I had while addressing the patient’s
needs. The reason is that being able to think beyond the patient’s chief complaint helps
in revealing other issues which will aid in providing better care for the patient. For
instance, if we did not check her previous laboratory results, we would have missed an
alarming disease that requires immediate management. This sheds the light on the
importance of analytical thinking in medicine. Although I am not fully confident about
having such skill, this shall be improved by experience in years to come.
Having analyzed this experience, it is essential to tackle one of the main
misjudgments I had prior to this visit. I used to think that doctors can always deliver the
optimal care for their patients despite the monotonous routine and stress. However, I
realized that the nature of the work is the most pervasive threat faced by healthcare
professionals. Furthermore, a doctor might unintentionally lose his ethical and
professional attitudes towards the patient because of the stressful work environment. In
fact, a study found that stress in the workplace can affect both technical and nontechnical
26
performance of a health worker, potentially leading to malpractice (Williams & Lewis,
2020). This might explain why the doctor did not acknowledge and validate the patient’s
emotions. Having said that, I questioned myself whether my ethical, professional, and
patient caring attitudes would diminish with time? This made me realize that idealizing
my personality into reaching the ideal solution which is to abide to core humanitarian
values is not always achievable in real life, which explains the fact that I had this daunting
question in my thoughts.
I am glad to say that I passed this experience with exceptionally satisfactory
changes on the personal and the professional level. Nevertheless, it is essential to have
a clear set of plans to improve my competencies. Firstly, I still need to get out of my
comfort zone and get more involved in similar experiences. Relatively, I will try to practice
more with female patients during our clinical sessions to enhance my communication
skills so I can easily create an alliance between me and my patients. Most importantly,
acknowledging my responsibilities as a doctor will help me to interrelate between myself
and the patient’s expectations from me as a doctor to become more professional and
trustworthy.
Word count: 1186
Reference
Williams, I., & Lewis, W. (2020). Stress in the workplace for healthcare
professionals. Physiological Reports, 8(13). doi: 10.14814/phy2.14496
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