A Repaired Cleft Is Not a Cured Cleft
Disease domain · Lesson 18 of 20 · Shared clinical backbone (the cleft team)
Today's goal: Students will identify the major long-term complications after cleft repair (oronasal fistula, velopharyngeal insufficiency, midface hypoplasia, otitis media with hearing loss, and obstructive sleep apnea) and explain which team member catches each and how.
What a finished product looks like
This is a model of the work you should turn in. Use it to check your own: match the structure and the level of detail, do not copy it. Your wording should be your own.
Mateo's watch list:
- Oronasal fistula | surgeon | nasal leak of food or liquid, found on exam.
- Velopharyngeal insufficiency (VPI) | speech-language pathologist | hypernasal speech and nasal air escape.
- Midface hypoplasia | orthodontist and surgeon | bite problems and a flat midface in adolescence.
- Otitis media with hearing loss | audiologist and ENT | failed hearing checks and ear pain.
- Obstructive sleep apnea | sleep medicine (history and sleep study) | snoring and pauses in breathing.
For the parents: 'His cleft being repaired is great news, but some problems only show up later, each one watched by a different specialist, so his appointments continue for years to catch anything early.'
Also due today: Note that Mateo has no Robin sequence and no micrognathia, so his OSA risk is lower; OSA is taught here as a general cleft complication, most relevant in Robin or syndromic airways. No diagnosis is named.
How this was built, step by step
The finished product above did not appear all at once. Here is the path from the question to the turned-in work, so you can follow the same steps.
- 1Start from today's question: What can still go wrong for Mateo after his is repaired, and which team member is positioned to catch each problem?
- 2Work the Model and the Explore questions to reason it out before writing anything.
- 3Pull the specific evidence the product needs from the reading and any database you used.
- 4Write it up in the required format: Write Mateo's ten-year 'watch list' as a five-row table: complication, the specialist who owns it, and the one check or symptom that would catch it. Then add one sentence to his parents explaining, in plain language, why his being 'fixed' does not mean his appointments are over.
- 5Check it against the rubric, then submit.
| Criterion | Proficient | Developing | Beginning |
|---|---|---|---|
| Complete | Every required part of the artifact is present and filled in. | Most parts are present, but one is missing or left blank. | Several parts are missing. |
| Accurate | The science and data are correct and match the evidence. | Mostly correct, with a small factual slip. | Key science or data is wrong. |
| Scientific reasoning (CER) | States a claim, backs it with specific evidence, and explains the reasoning. | Has a claim and evidence, but the reasoning is thin or missing. | Gives an answer with no evidence or reasoning. |
| Professional communication | Clear, organized, and labeled the way a clinician or scientist would write it. | Readable but disorganized or missing labels. | Hard to follow. |
| Submitted | Turned in the right way (Schoology for routine work) and confirmed. | Turned in, but in the wrong place or unconfirmed. | Not turned in. |
- CompleteProficient: Nothing is left blank: the model fills every part of "Write Mateo's ten-year 'watch list' as a five-row table: complication, the specialist who owns it, and the one check or symptom that would catch it. Then add one sentence to his parents explaining, in plain language, why his cleft being 'fixed' does not mean his appointments are over.".
- AccurateProficient: Every number and claim matches the case evidence.
- Scientific reasoning (CER)Proficient: It names a claim, cites the specific evidence, and explains the reasoning, not just the answer.
- Professional communicationProficient: It is organized and labeled like a real chart note.
- SubmittedProficient: It would be turned in on Schoology and confirmed.
WebXam problem for today's skill
One exam-style question that uses exactly what you practiced today. Try it before you reveal the answer, then read why each choice is right or wrong.
Tap an answer to see the full explanation. Nothing is recorded or graded.