Geriatrics Topics for Ambulatory Medical Education- Part 1

Geriatrics Topics for Ambulatory Medical Education- Part 1
University of Cincinnati College of Medicine
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Product ID: 19040

Abstract: 
Five structured, brief, evidenced-based teaching handouts to be used by faculty with residents. Developed to be used during a 15-minute teaching conference prior to the beginning of a half-day clinic session. Topics include: falls, urinary incontinence, hearing loss, altered level of consciousness, and the forgetful patient.

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Educational objectives: 
Falls:
  1. Identify patients that are appropriate for a thorough falls assessment.
  2. List five categories of evidence-based risk factors for non-syncopal falls among older adults and an example of an appropriate intervention for each.
  3. Complete and document the key elements for a fall assessment in four areas – history taking, physical examination, gait and balance assessment, and medical management – as outlined on the attached office visit form.
  4. Counsel patients how to reduce their risk for serious falls.
  5. List three modifications that can be made in the home or environment to reduce fall risk.
Urinary Incontinence:
  1. Identify six causes of transient urinary incontinence.
  2. List and describe four types of established urinary incontinence.
  3. Define the neurologic mechanisms involved in micturition.
  4. Identify applicable treatment methods for each type of established incontinence.
  5. Discuss the physiologic changes in the lower urinary system of the elderly, which contribute to “age-associated” incontinence (other than changes that are gender-specific).
  6. Recognize the emotional impact incontinence can have on a patient.
Hearing Loss:
  1. Describe the aging auditory system and mechanisms of hearing loss
  2. Counsel patients regarding hearing loss and noise exposure
  3. Identify adults with hearing disability
  4. Communicate effectively with hearing impaired individuals
  5. Make effective referrals for audiology and otolaryngology services.
Altered Level of Consciousness 
  1. List 8 possible causes of confusion and other acute changes of consciousness.
  2. Describe three specific elements each of history, physical and laboratory studies needed to identify the causes of such changes.
  3. Justify your choices for in-patient vs out-patient care of patients with confusional state.
The Forgetful Patient 
  1. List five differential diagnoses for adult-onset cognitive impairment.
  2. Describe an effective work-up for a forgetful patient.
  3. Identify abnormal results on the Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT).
  4. Describe a simplified algorithm for the differential diagnosis of dementia.
  5. List two indications for neuropsychological testing.
Additional information/Special implementation requirements or guidelines: 
Used regularly as a teaching tool in the internal medicine ambulatory clinic with University of Cincinnati internal medicine residents. It is helpful to encourage learners to review the material prior to coming to the clinic for a teaching session.
Date posted: 
Mon, 10/22/2007
Date last updated: 
Mon, 10/22/2007
CME credits available: 
No
Has this product been peer reviewed?: 
No
ACGME competency checklist: 
Learning resource types: 
Intended learner audience: 
Contact person/corresponding author: 
Eric Warm (warmej@uc.edu)
Authors: 
Eric Warm
John Kasckow
Tim Lewis
NLM Citation:
Warm, E, Kasckow, J and Lewis, T. Geriatrics Topics for Ambulatory Medical Education- Part 1. POGOe - Portal of Geriatric Online Education; 2007 Available from: http://www.pogoe.org/productid/19040
APA Citation:
Warm, E, Kasckow, J and Lewis, T. (2007). Geriatrics Topics for Ambulatory Medical Education- Part 1. POGOe - Portal of Geriatric Online Education. Retrieved February 10, 2012 from http://www.pogoe.org/productid/19040