Instructions: The attending faculty for this session needs to have the power point slides ready and distributes the nurse's notes as roles are assigned. Generally, the orientation works best if you assign a case, then distribute the nurse notes for that case, show the power point slide telling the nurse’s first words to the doctor, and then have the fellows act out the rest.

The attending faculty asks for two fellows to volunteer for each scenario:

• One fellow acts as the “fellow” answering the phone at night while on call for the teaching nursing home service of a Geriatric Medicine Fellowship program. This fellow does not have a “script” but must rely on their clinical judgment to determine what questions to ask the “nurse”. If the “fellow” is stumped, he or she must ask his or her colleagues (the other fellows at the orientation) to help with the case or management.

• The other fellow acts as the “nurse” at the teaching nursing home who is calling the “fellow” about a patient. The “nurse” must try not to volunteer information, but instead offer information that is asked. If the “fellow” is stumped and the colleagues are not able to help, the “nurse” can offer the rest of the information on the “nurse’s notes”.

• The attending faculty acts as a facilitator during this orientation, generally not jumping into the question/ answer period until the fellows feel the phone call has been resolved. At the end of the case, the faculty highlights key teaching points noted at the bottom of the case’s nurse’s notes and offers gentle, constructive feedback on the interpersonal communication skills of the fellows. Continue the cases until all fellows have had an opportunity to act as both “fellow” and “nurse”. At the end of the session, the faculty debriefs the fellows to ensure that everyone is comfortable with the learning session and the process of covering nursing home phone calls.