Burrell College of Osteopathic Medicine – Chapman University School of Pharmacy

IPE Simulation
Team Plan Worksheet

Instructions
Your group has successfully interviewed a standardized patient (SP).

Student teams will have a total of 30 minutes to develop a plan to deliver to the SP. The worksheet is
intended to help guide the team’s development with their plan and delivery to the SP. Teams will
simulate the delivery of the plan to the SP when the host notifies the patients to return back to the virtual
rooms. If needed, you may ask the SP additional questions. Facilitators will “visit” breakout rooms to
provide guidance at different times.

If you have developed your plan before the 30 minutes ends, you may inform your SP to return to the
room to deliver the plan. They will turn on their mic/video.

Student teams should select a scribe to note the reponses and two spokespeople (one from each
profession) to share the team’s responses during the debrief.
Please do not distribute this document.

S – Subjective
 What are the patient’s concerns?

O – Objective
 List pertinent findings (labs, physical exam findings, diagnostic results)
 How do you interpret the vital signs?

A – Assessment
 Diagnosis/diagnoses
 Most likely etiology/Risk factors:
 Other medical or non-medical issues?

P – Plan
 Specifics on your plan for the patient, including medications, tests, other therapies
o What is the worst thing that could be missed in this case?
o For medications, please include all details (i.e. name, frequency, route, dose)
o Are there any medicicines that are either inappropriate or mid-dosed?
o Formulate the talking points to educate the patient on the next steps and what should
happen next. You will deliver these to the patient.

Delivery of Plan
 Prioritize 3 – 5 takeaways you want to share with the patient
 Who will deliver which piece of information?
 What information will this person(s) share with the patient?

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2021 March BCOM CUSP Simulation – Team Plan Worksheet