const pptxgen = require("pptxgenjs");
const fs = require("fs");
const path = require("path");

// ─────────────────────────────────────────────────────────────────────────────
// COLOUR PALETTE  (inspired by the 1st PDF warm amber/tan but shifted to a 
// fresh teal-green + cream palette to look "a little different" while staying
// humanised and professional)
// ─────────────────────────────────────────────────────────────────────────────
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  red:        "C0392B",   // conflict / negative
  green:      "1E8449",   // positive / resolution
  blue:       "1A5276",   // info / questions
};

// ─────────────────────────────────────────────────────────────────────────────
// HELPERS
// ─────────────────────────────────────────────────────────────────────────────
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// ─────────────────────────────────────────────────────────────────────────────
// BUILD PRESENTATION
// ─────────────────────────────────────────────────────────────────────────────
let pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Multidisciplinary Approaches – Case Scenario 3 Liam";
pres.author = "Vinisha";

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 1 – TITLE SLIDE
// ═══════════════════════════════════════════════════════════════════════════
{
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  s.addText("Case Scenario 3 – Liam: Newly Diagnosed Type 1 Diabetes", {
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  s.addText("Undergraduate Certificate in Nursing Studies", {
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  s.addText("Lecturer: Ms Dorianne Cachia | June 2026", {
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  });
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 2 – CASE SCENARIO: WHO IS LIAM?
// ═══════════════════════════════════════════════════════════════════════════
{
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    ["Age", "10 years old"],
    ["Diagnosis", "Newly diagnosed with Type 1 Diabetes Mellitus"],
    ["Symptoms", "Very thirsty, losing weight, tired; going to the toilet a lot"],
    ["Concerns", "Very scared of needles; got upset when insulin was first mentioned"],
    ["Parents", "Both parents are anxious – they don't feel ready to manage this at home"],
    ["School", "School is worried about him having a hypo during the day"],
    ["Activity", "Plays football regularly and really doesn't want to give it up"],
  ];

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  citationLine(s, "Patient-centred MDT approach | ISPAD Guidelines 2022; WHO 2024");
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 3 – TASK 1 BANNER
// ═══════════════════════════════════════════════════════════════════════════
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  s.addText("Working in a Multidisciplinary Approach", { x: 1, y: 2.2, w: 8, h: 0.5, fontSize: 20, color: C.white, fontFace: "Calibri", align: "center" });
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  });
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 4 – Q A: PATIENT-CENTRED APPROACH
// ═══════════════════════════════════════════════════════════════════════════
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    { text: "  – World Health Organisation, 2024", options: { bold: true } }
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  // 5 role boxes
  const roles = [
    ["Medical", "Insulin therapy &\nglycaemic control"],
    ["Nutritional", "Carb counting &\nmeal planning"],
    ["Psychological", "Needle fear &\nadjustment"],
    ["Family", "Parent training\n& support"],
    ["Educational", "Keeping school safe\n& reintegration"],
  ];
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  citationLine(s, "WHO (2024); Suarez et al. (2022); ISPAD (2022)");
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 5 – Q A: HCPs INVOLVED (1 of 2)
// ═══════════════════════════════════════════════════════════════════════════
{
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    ["1", "Paediatric Endocrinologist", "Responsible for the overall medical plan – sets the insulin doses, checks HbA1c and decides if a pump might help down the line (Danne et al., 2006)"],
    ["2", "Diabetes Specialist Nurse (DSN)", "Often the family's main point of contact. Teaches parents how to do injections, check blood glucose, and spot a hypo. Also talks to the school (ISPAD, 2022)"],
    ["3", "Paediatric Dietitian", "Works with Liam on carb counting and building a meal plan that fits around football and school – not the other way round (Davis, 2017)"],
    ["4", "Paediatric Psychologist", "Uses CBT to tackle the needle fear. Also helps the whole family come to terms with a lifelong diagnosis – that's not a small thing (Fengsil et al., 2006)"],
    ["5", "Ward Nurse (Paediatric)", "Provides day-to-day care on the ward, gives the insulin, notices when something isn't right and speaks up. The ward nurse is really Liam's advocate (Jennings & Evans, 2020)"],
  ];

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}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 6 – Q A: HCPs INVOLVED (2 of 2)
// ═══════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape("rect", { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.cream } });
  headerBand(s, "Question A – Healthcare Professionals Involved (2 of 2)", "👩‍⚕️");
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    ["6", "GP / General Paediatrician", "Takes over once Liam goes home – deals with everyday illness, coordinates any follow-up referrals (ISPAD, 2022)"],
    ["7", "Pharmacist", "Makes sure the right insulin and supplies are dispensed, provides glucagon kits and explains how each medicine works (CDC, 2024)"],
    ["8", "Social Worker", "Supports the family emotionally and practically – including help with costs and linking them to the right community services (ISPAD, 2022)"],
    ["9", "School Health Nurse", "Goes into the school, trains staff to spot a hypo and steps in if Liam needs support during the school day (ISPAD, 2022)"],
    ["10", "Exercise Physiologist", "Works out a safe plan for Liam to keep playing football – adjusting carbs and insulin around training and matches (ISPAD, 2022)"],
  ];

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  citationLine(s, "CDC (2024); ISPAD (2022); Guare et al. (2022)");
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 7 – Q B: ATTRIBUTES, SKILLS & BEHAVIOURS
// ═══════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
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  headerBand(s, "Question B – Attributes, Skills & Behaviours for MDT Success (S&E 2.5)", "🤝");
  s.addText("What actually makes an MDT work well together?", { x: 0.2, y: 0.76, w: 9.6, h: 0.26, fontSize: 11, color: C.midTeal, bold: true, fontFace: "Calibri" });

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    ["Communication", "Clear, timely and jargon-free – using shared records and regular team meetings. Less jargon means fewer mistakes (Pelp et al., 2022)"],
    ["Role Clarity", "Everyone knows their own job and respects what others bring (Jennings & Evans, 2020)"],
    ["Person-Centred Care", "Liam and his parents aren't just recipients of care – they're part of the team (Nursing Standard, 2021)"],
    ["Shared Decision-Making", "When patients have a say, they're more likely to follow the plan (Nursing Standard, 2021; Cachia 2021)"],
    ["Tuckman's 5 Stages", "Forming → Storming → Norming → Performing → Adjourning – all teams go through this (Tuckman, 1965; Kivunja et al., 2019)"],
    ["Continuous Learning", "Staying current with ISPAD guidelines and new tech like closed-loop systems (Jennings & Evans, 2020)"],
    ["Professional Accountability", "Following CNM & WHO codes, staying within your scope, documenting accurately and speaking up when something isn't right"],
  ];

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  citationLine(s, "Pelp et al. (2022); Jennings & Evans (2020); Tuckman (1965); Kivunja et al. (2019); Nursing Standard (2021)");
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 8 – Q C: BENEFITS
// ═══════════════════════════════════════════════════════════════════════════
{
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    ["Holistic Care", "Rather than treating just the diabetes, the whole child is looked after"],
    ["Fewer Errors", "When multiple people check the same thing, errors are caught before they reach the patient (He et al., 2022)"],
    ["Better Glycaemic Control", "Children whose families get proper MDT education tend to have better blood glucose control (Danne, 2006)"],
    ["Family Confidence", "Parents feel less alone when professionals meet with them together – it visibly reduces anxiety"],
    ["Continuity of Care", "Good MDT communication means Liam's move from hospital to home to school doesn't fall apart"],
    ["Efficient Resources", "Nobody repeats the same assessment twice, which makes better use of limited NHS resources (He et al., 2022)"],
  ];

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  citationLine(s, "Proessl et al. (2021); Suarez et al. (2022); Danne/man (2006); He et al. (2022)");
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 9 – Q D: BARRIERS
// ═══════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape("rect", { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.cream } });
  headerBand(s, "Question D – Barriers to Working in a Team (A&A 1.2)", "⚠️");
  s.addText("The things that get in the way", { x: 0.2, y: 0.76, w: 9.6, h: 0.26, fontSize: 11, color: C.midTeal, bold: true, fontFace: "Calibri" });

  const barriers = [
    ["Communication Breakdown", "Rushed handovers, too much jargon, or not sharing key info – still one of the biggest MDT problems (Elberzhagen et al., 2019)"],
    ["Professional Hierarchy", "When consultants dominate, nurses and allied professionals stop raising concerns – which is dangerous (Suarez et al., 2022)"],
    ["Professional Tribalism", "Professionals sticking to 'their lane' and not trusting others to contribute (Guare et al., 2022)"],
    ["Role Ambiguity", "When nobody's sure who owns a task, it either gets done twice or not at all"],
    ["Time & Workload", "On a busy ward, finding time for everyone to meet regularly is genuinely hard (British Journal of Nursing, 2022)"],
    ["Resistance to Change", "Not everyone embraces change – particularly around new tech or updated guidelines"],
  ];

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    const col = i < 3 ? 0 : 1;
    const row = i % 3;
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  citationLine(s, "Elberzhagen et al. (2019); Suarez et al. (2022); Guare et al. (2022); British Journal of Nursing (2022)");
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 10 – TASK 2 BANNER  ★ NEW TOPIC ★
// ═══════════════════════════════════════════════════════════════════════════
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  s.addText("Conflict in the Multidisciplinary Team", { x: 1, y: 2.1, w: 8, h: 0.5, fontSize: 20, color: C.white, fontFace: "Calibri", align: "center" });
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 11 – Q1: DEFINING CONFLICT
// ═══════════════════════════════════════════════════════════════════════════
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  const reasons = [
    "Each profession has different training and priorities – those differences can clash",
    "No one's sure who's meant to do what (role ambiguity)",
    "Things get lost in handovers, or people use different terminology",
    "Competing for the same beds, equipment or funding creates tension",
    "Seniority differences and personality clashes between individuals",
    "When families are unhappy, that pressure often lands on the team",
  ];

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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 12 – Q2: CASE SCENARIO – MEDICATION ERROR DISAGREEMENT
// ═══════════════════════════════════════════════════════════════════════════
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      "• The elderly patient was at risk of a medication adverse event\n• The nurse was left feeling unheard and professionally unsafe\n• The wider team noticed the tension, which affected communication",
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  citationLine(s, "RNAO (2012); NMC (2018); WHO Medication Safety 2022");
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 13 – Q3: EFFECTS OF CONFLICT
// ═══════════════════════════════════════════════════════════════════════════
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    "Once trust breaks down between nurse and doctor, it takes time to rebuild",
    "Ongoing conflict is exhausting – staff burn out and call in sick (Cerqueira et al., 2024)",
    "When people stop talking properly, critical clinical info gets missed",
    "Patients notice when teams are fractured – it undermines confidence in the service",
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    "The nurse speaking up led to the dose being checked – a near-miss prevented",
    "Incident review led to a new double-check protocol for elderly patients",
    "Junior staff gain confidence to speak up when they see it's safe to do so",
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 14 – Q4: POOR GROUP DYNAMICS
// ═══════════════════════════════════════════════════════════════════════════
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    ["No Shared Goals", "When each profession pushes its own agenda rather than a shared goal, the patient loses out"],
    ["Poor Leadership", "A leader who's either too passive or too controlling tends to shut conversation down"],
    ["Role Ambiguity", "If nobody knows who owns what, tasks get done twice – or not at all"],
    ["Low Psychological Safety", "Staff who feel they can't speak up just stay quiet – and that clinical information never reaches the team"],
    ["Ineffective Communication", "One person talking over everyone else, not sharing information, not actually listening"],
    ["Hierarchy & Power Imbalance", "When seniority silences valid clinical concerns – like a nurse flagging a medication dose – patient safety suffers"],
  ];

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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 15 – Q4: TUCKMAN'S MODEL
// ═══════════════════════════════════════════════════════════════════════════
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 16 – Q4: BELBIN + IMPROVEMENT STRATEGIES
// ═══════════════════════════════════════════════════════════════════════════
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    "Regular team meetings with an actual agenda – not just a catch-up",
    "Time spent learning together across professions (inter-professional education)",
    "An environment where people feel safe enough to say when something's wrong",
    "Formal medication safety protocols – double-check systems for high-risk drugs in vulnerable patients",
    "Leadership that reads the room and responds to how the team is feeling",
    "Debriefing after near-miss incidents rather than just moving on",
  ];

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    s.addText("✓", { x: x, y: y + 0.12, w: 0.22, h: 0.22, fontSize: 7, bold: true, color: C.white, fontFace: "Calibri", align: "center", valign: "middle" });
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  citationLine(s, "Belbin (1981); Aranzabal et al. (2022); RNAO (2012); Kivunja et al. (2019)");
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 17 – Q5: SKILLS TO OVERCOME CONFLICT
// ═══════════════════════════════════════════════════════════════════════════
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  const skills = [
    ["Communication", "Actually listening, confirming understanding, and being direct without getting aggressive. In our scenario, SBAR framing could have structured the nurse's concern clearly (Suarez et al., 2022)"],
    ["Emotional Intelligence", "Goleman's (1998) five domains – self-awareness, self-regulation, empathy, motivation and social skill – all matter here. Staying calm when dismissed is hard but essential"],
    ["Assertiveness & Compromise", "Finding a solution everyone can live with, not just 'winning' the argument. The nurse had a professional duty to persist (CMN, 2022; NMC, 2018)"],
    ["Respect for Diversity", "Recognising that doctors and nurses have different training frames and that's okay – neither side is automatically right"],
    ["Problem-Solving", "Staying focused on the problem (patient safety) rather than pointing fingers at who was right"],
    ["Professionalism", "Staying professional even when it's tense – and always keeping the patient at the centre (CNM, 2023)"],
  ];

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  citationLine(s, "Goleman (1998); RNAO (2012); CMN (2022); Suarez et al. (2022); NMC (2018)");
  footerBar(s);
}

// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 18 – Q6: STRATEGIES TABLE
// ═══════════════════════════════════════════════════════════════════════════
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    ["Formal Escalation", "Used when informal attempts have already failed", "Creates a formal record; more transparent", "Can seriously harm working relationships"],
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 19 – Q6: BEST STRATEGY
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 20 – PROFESSIONAL STANDARDS
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 21 – PATIENT-CENTRED CARE
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    ["Football & Sport", "The exercise physiologist and DSN work together so Liam can play football safely – adjusting food and insulin around training"],
    ["School Integration", "The school nurse goes in, trains the staff and sets up a personal care plan with the school. Glucagon kit provided."],
    ["Family Education", "Before leaving hospital, parents are taught by the DSN and dietitian – injections, hypo signs, carb counting. All of it."],
    ["Emotional Wellbeing", "The psychologist and nurse help the family process the diagnosis. Support groups for kids with T1DM are flagged too (ISPAD, 2022)"],
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 22 – INTERPROFESSIONAL COMMUNICATION
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    ["Closed-Loop Communication", "Sender → Receiver confirms understanding → Sender verifies", "Especially important when prescribing doses – a misheard instruction can cause real harm, as our scenario shows"],
    ["Safety Huddles", "Quick daily team check-ins – usually five to ten minutes", "Spots risks early and keeps everyone on the same page – a daily huddle may have caught the dose issue before it became a conflict"],
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 23 – ETHICAL DIMENSIONS
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    ["N", "Non-maleficence", "This means taking the needle fear seriously, not discharging until parents are genuinely confident, and making sure education is thorough enough to prevent hypos at home (RNAO, 2012)", C.red],
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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 24 – REFERENCES
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    "Aranzabal, A. et al. (2022) Belbin team roles and healthcare teams. Nurse Education Today, 110, p.105249.",
    "Cerqueira, P., Pessoa, G. & Costa, R. (2024) Unlocking team potential: examining communication in palliative care. Cureus, 16(11).",
    "CNM (2023) Code of Professional Conduct for Nurses and Midwives. Malta: CNM.",
    "Compton, J. & Collins, A. (2012) Having Shared Decision-Making in Practice. London: King's Fund.",
    "Danne/man, D. (2006) Type 1 Diabetes in Children: ISPAD Clinical Practice Consensus Guidelines 2006.",
    "Elberzhagen, C. et al. (2022) Barriers & enablers to interprofessional teamwork. PLoS ONE, 16(4).",
    "Goleman, D. (1998) Working with Emotional Intelligence. New York: Bantam Books.",
    "He, H. et al. (2022) Effectiveness of MDT working in healthcare. British Journal of Nursing, 31(5).",
    "ISPAD (2022) Clinical Practice Consensus Guidelines 2022. Available: ispad.org.",
    "Jennings, G. & Evans, A. (2020) MDT working: a structured approach. Nursing in Practice. London.",
    "Kivunja, C. & Kivunja, B.M. (2019) Understanding and applying Tuckman's model. Creative Education, 10(7).",
    "NMC (2018) The Code: Professional Standards of Practice and Behaviour for Nurses and Midwives. London: NMC.",
    "NHS (2023) Framework on Integrated, People-centred Health Services. Geneva: WHO.",
    "Proessl, D. et al. (2021) Interprofessional collaboration in chronic disease. Health Policy, 125(2).",
    "RNAO (2012) Managing & Mitigating Conflict in Healthcare Teams. Toronto: RNAO.",
    "Suarez, K. et al. (2022) MDT barriers and approaches. Journal of Patient Safety, 18(3).",
    "Tuckman, B.W. (1965) Developmental sequence in small groups. Psychological Bulletin, 63(6).",
    "WHO (2024) Framework on Integrated, People-centred Health Services. Geneva: WHO.",
    "WHO (2022) Medication Without Harm – WHO Global Patient Safety Challenge. Geneva: WHO.",
    "CDC (2024) The Multidisciplinary DSMES Team. Available: www.cdc.gov.",
  ];

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// ═══════════════════════════════════════════════════════════════════════════
// SLIDE 25 – THANK YOU
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    ["1", "Liam needs a big team – around 10 professionals – because his needs go far beyond insulin alone"],
    ["2", "Good MDT working comes down to clear communication, knowing your role and sharing the load"],
    ["3", "Conflict happens in every team. A nurse raising a medication concern is a patient safety act, not an attack"],
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