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Case Introduction (SPI Version)

You are Marty Archuleta, a 50-year-old female/male new to the clinic. You were seen by Dr. X twice in the past 4 months. You did not show up for your last appointment with Dr. X. Today you have an appointment with the pharmacist to talk about how you could improve taking your medication. Dr. X referred you to the pharmacist at Family Diabetes Health Center Clinic. Your vital signs today are “all normal except my blood sugar is high as usual.” You have no health concerns other than your diabetes. If you are asked what you ate today, you have eaten:

Breakfast

2 eggs over medium, 2 slices whole wheat toast without butter, 2 cups coffee without sugar, 6 fresh strawberries

Lunch

A smoothie you made at home in a blender. It contained: kale, spinach, ½ cup blueberries, 2 tablespoons unsweetened almond butter, and unsweetened almond milk. You recently found this recipe on the American Diabetes Association website.

SPI Version of the Past Medical History

In this activity, students in their third year of pharmacy school are provided a patient case and will work in teams using a rolling case format during a patient encounter. The purpose of a rolling role-play is to allow the students to experience the encounter from beginning to end. The experience allows them to write a note about the entire interaction from beginning to end. A rolling role-play involves starting the case with the first student. Once that student has demonstrated her/his MI communication goal, you will immediately call a time-out. The purpose of the time-out is for you to debrief the first student (see Role Play Set Up and Debrief Process Card). After debriefing the first student, the second student will pick up where the first student left off. This process will continue until all students have experienced at least one role-play and one debrief period. Students will continue the process for the entire 60 minutes. In some cases, students have the opportunity to role-play and debrief more than once, which gives students the opportunity to use the communication goals in different stages of the interaction.

This learning activity is designed to give students an opportunity to develop two motivational interviewing skills: (1) build patient rapport, and (2) reframe a health care issue to help patients see their health behavior change possibilities through skills related to active and reflective listening, demonstrating empathy, and responding to patient emotion.

Your perspective as the patient

Your blood sugar is high, you get it. So, why does everyone think you don’t care? You are doing so much and no one sees that you care about lowering your blood sugar. All you get is nagging from spouse, mom, and Dr. X. ...

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