Printable Versions of Materials needed to create station:
Guide for Preceptors:
NOTE: the information posted just below is identical to that in the printable version of the preceptor guide above.
Preparing for this station: Print off the three sheets that follow below, laminate them, and cut them up into individual cards by cutting on the lines around each item. Notice that some cards provide a classic clinical symptom vignette that should trigger the students to think of a particular type of incontinence. Some provide the therapeutic class that is typically used (if a drug is used at all), and others give the chemical names of individual drug treatments. Each group has a card for behavioral or other treatments. Others are just miscellaneous “fun-facts” related to a particular type of incontinence.
Purchase a set of five small trays or baskets for sorting. Although the students will only be using Stress, Urge, Overflow, and Functional Incontinence categories, go ahead and label a basket with “Mixed Incontinence” but block it off so it is not used. Note: We make a special point of emphasizing that mixed incontinence is extremely common, but that we are trying to keep this task focused on a clear-cut set of separate conditions, for learning purposes. We comment that in ‘real life,’ many people will have mixed disorders such as urge/stress, or urge/functional, etc.
Running this station: Set up the labeled baskets or trays. Shuffle all individual cards from all types of items, mixing clinical vignettes, treatments, and all other types of items together into a random order. Spread them out face down on the table, like playing “Go Fish.” See photo below. In our setting, about 3 or 4 students at a time work with one faculty member who is seated right with the students & facilitating.
To start, each student will take turns turning over a card, deciding where they think it belongs, and then dropping it into the correct basket for Stress, Urge, Overflow, or Functional incontinence. They may be unsure and discuss with other students. The faculty member watches, listens to the student discussion, and assures that in the end, all cards are sorted properly. Faculty members will clarify any areas where the students have been confused. Students may correctly point out some areas of overlap, particularly in behavioral treatments, but try to redirect them to the most classic ‘pearls’ for each type of incontinence. When all cards are off the table and sorted correctly, the task is done. (Do not expect an equal number in each basket because some groups have additional items.)
Clarifications:
Stress: Although treatment is generally non-pharmacologic, we include sympathomimetic Rx here, mainly to make the pharmacologic contrast between stress/sympathomimetic and urge/anticholinergic treatments.
Urge: You may wish to point out the active direct-to-consumer marketing of various competing pharmacologic products for urge incontinence.
Overflow: We include two vignettes: one for neurologic impairment (diabetes and stroke) in which the bladder does not empty, and a second one in which a symptomatic BPH patient is finally obstructed by a dose of anticholinergic medication, and then leaks.
Functional: We include two vignettes: one for cognitive/ functional problems in voiding due to Parkinson’s disease, and a second one with mobility impairment after a hip fracture, both of which lead to difficulties getting to the bathroom and voiding before incontinence occurs.
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The University of Kansas Medical Center
