6 The case

This simulation provides learners with an opportunity to practise the application of professional knowledge and skills to establishing a professional therapeutic relationships in home-based care, by immersing participants in a home visit as a health care practitioner, Flo Becaspin, in primary care who has recently started working in the multidisciplinary practice.

During this simulation learners take the role of Flo Becaspin, who plays an announced home visit to Mrs. Nelly Flament.  She is a 72-year-old client with diabetes type 2 on self-management. She has missed two previous appointments at the health care centre (‘no show’). To reach out to her, the health care practitioner in primary care called and suggested a home visit. Mr. Flament, her husband, answered the call and accepted the visit.

In preparation of the home visit, the learners are presented with the patient records, where they notice she had gestational diabetes. Since 2016 she was diagnosed with diabetes type 2 with an initial therapy on oral antidiabetic drugs (metformin). During the last visit, once-daily basal insulin was added because of persistent hyperglycaemia and high Hb1Ac-values. She was advised to monitor her glucose levels and referred to a walking club (move on prescription). She is otherwise healthy with few coexisting chronic diseases. Moreover, she found out that Mrs. Flament is married and has two adult children. Mr. and Mrs. Flament have Dutch origins, but English is their second language.

Learners will arrive at her house on a cold winter morning, sunny with cloudy intervals and will engage in the case by driving the situation as they answer different questions derived from the home visit and the interactions with the patient and her husband. Students will have to decide the best way to address the issues and will be provided with feedback for every decision, which will reinforce student learning.