Learning Objectives

Broad Goals

• Describe the diagnostic features and pathophysiology of sickle cell disease (SCD).
• Discuss both pharmacologic and non-pharmacologic treatment strategies for SCD in an adolescent, using an integrative medicine approach.
• Discuss psychosocial, environmental, and lifestyle factors that may trigger an SCD crisis or complicate treatment.
• Engage with members of the interdisciplinary team to provide patients with multiple approaches to pain management, in keeping with the patient's preferences, particularly when pain is chronic and severe.
• Demonstrate how to encourage active self-management by adolescents, in concert with ongoing provider care, as they transition to adulthood and the adult healthcare system.

Discipline-Specific Learning Objectives

Hematology

1. Review acute pain assessment and management in SCD patients.
2. Discuss ways to teach and support self-management of adolescents and young adults with SCD as they transition to adulthood.
3. Transfer essential information about the SCD patient at times of transition between providers.

School Nurse

1. Given that good pain control reduces absences from school, discuss the complex role of the school nurse in managing and advocating for adolescents with SCD.
2. Describe the nurse's role in helping students with pain control, including development of a 504 plan that enables a student to obtain accommodation appropriate to their medical condition in required academic and physical activities.
3. Discuss why some students with SCD refuse to disclose their illness to schools and classmates, and how school nurses can help to protect their confidentiality.

Population Health

1. Identify barriers to care for adolescents with SCD, including implicit bias among care providers.
2. Discuss the specific challenges that adolescents with SCD face as they transition to self-management in the adult health care system.
3. Discuss resources available to SCD patients, including support groups, and how they might access these, locally and nationally.

Pharmacy

1. Educate adolescents with SCD on realistic pain management expectations, and help transition to self-management of their care.
2. Design an appropriate pharmacologic and non-pharmacologic pain management regimen for patients with SCD that reflects specific patient and environmental factors.
3. Counsel patients with SCD on safe and appropriate use of hydroxyurea and analgesics.

Pharmacology

1. Describe the process of hematopoiesis
2. Describe the pathophysiology of sickle cell disorder
3. Describe the pain pathways associated with sickle cell disorder

Psychology

1. Describe how clinical psychology can foster patient understanding of the biopsychosocial model and cognitive-behavioral framework, and how such understanding can promote enhanced health and wellness.
2. Identify behavioral and other non-pharmacological strategies for stress and pain management.
3. Discuss the medical team's role in helping the SCD patient to transition from pediatric care to adult care.

Physical Therapy

1. Describe the role of the physical therapist in treating the cardiothoracic, musculoskeletal, and nervous system effects of SCD.
2. Describe the role of the physical therapist in educating an individual with SCD about the potential benefits and risks of various forms of exercise.
3. Discuss how physical activity may help an individual with SCD to maintain good health.

Acupuncture

1. Discuss the relevance of acupuncture to the management of acute and chronic pain.
2. Describe how a licensed acupuncturist examines and diagnoses a patient with SCD.
3. Discuss the current evidence base relating to acupuncture and SCD.