In clinical practice, differentiating among the “three Ds” - Delirium, Dementia, and Depression - can be difficult because these disorders may co-exist in the same patient. Clinical pearls are needed in an educational session to assist learners with this clinical challenge. “Distinguishing Delirium, Dementia, and Depression” module, part of the GeriaFlix series, from the Carver College of Medicine at the University of Iowa, has been designed to address that and can be used “anytime, anywhere” by a wide spectrum of learners, from clinical students to practicing clinicians. The educational goals are to improve the learner’s ability to screen, diagnose, treat and increase their appreciation for the co-occurrence of the 3 D’s in the elderly patient.

The educational product is a streaming digital video format with synchronized PowerPoint presentation slides lasting approximately one hour. The lecture presentation, delivered by Dr. Gerald Jogerst, Professor of Family Medicine at the Carver College of Medicine at the University of Iowa, is divided up into three sections (one for each “D”). Each section includes a clinical case report as well as an image of a typical patient with the disorder. Dr. Jogerst is a skilled teacher and has a witty and engaging delivery. He does an excellent job of explaining concepts at a level appropriate to a broad spectrum of learners. He also makes it clear what is evidence-based and what is anecdotal in his recommendations. His presentation slides include a variety of figures, tables, and multiple-choice questions. Simple screening tools are also described that could be easily implemented immediately after watching the presentation. These screening tools are available for download on the University of Iowa website. In addition, the initial pharmacologic and non-pharmacologic therapeutic interventions of the delirious patient are reviewed.

Overall, the material is well-organized and easy to follow. Its ease of use and broad scope of information has allowed it to be embedded within curricula of multiple training programs at the University of Iowa Geriatric Education Center. Data provided by the authors at University of Iowa showed that, 96% of learners felt confident that they have achieved the four learning objectives. Many also commented that it provided materials and tools that they would use as teaching tools for their own professional/academic endeavors.

However, it would be helpful if a learner viewing the presentation could go directly to specific parts of the video presentation rather than an ordered approach. Another limitation is that the dementia section draws heavily on Alzheimer’s disease without distinguishing among other diagnostic possibilities such as vascular, frontal lobe or Lewy body. Some materials are also not adequately referenced so learners could not refer to the primary source for additional information. Most importantly, watching a digitized presentation can be a passive learning experience so the product should be an adjunct to a planned blended learning educational session.

This month’s Editor’s Choice, “Distinguishing Delirium, Dementia and Depression,” will help learners recognize and diagnose these conditions as they occur and co-exist in the geriatric patient population. Practical clinical tools for assessment are given and appear easy to employ. And this product is available here – for FREE - on POGOe.

Guest Reviewers: Andrew B. Rosenzweig, MD, Clinical Assistant Professor of Medicine and Margot I. Boigon, MD, Clinical Associate Professor of Medicine, Drexel University College of Medicine and Abington Memorial Hospital.