The Portal of Geriatrics Online Education

18 ATYP: Diagnose based on unique presentations of common conditions

18. Generate a differential diagnosis based on recognition of the unique presentations of common conditions in older adults, including acute coronary syndrome, dehydration, urinary tract infection, acute abdomen, and pneumonia.

Iron Deficiency Anemia Across the Lifespan

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

The Iron Deficiency Anemia across the Lifespan module was created for first-year medical students in the Cellular Function in Medical Genetics Course. The purpose of the module is to teach first-year medical students the basic biochemistry of anemia, the metabolism of iron and common clinical presentations of anemia.

Iron deficiency anemia (IDA) is the most common nutritional deficiency; therefore it is likely that most students will care for patients with IDA sometime during their career. While Anemia is one of the most frequent problems encountered in Primary Care, its diagnosis could be easily overlooked, as the clinical presentation is not usually classic/traditional. For example: tiredness, and lack of energy, may be mistakenly attributed to aging instead of that to anemia. Therefore we thought that an important competency that students need to demonstrate early during training is the ability to recognize clinical presentations of iron deficiency anemia in different age groups. Early exposure and thorough understanding of IDA presentation across the lifespan is important to preparing learners to recognize and treat IDA effectively.

This module incorporates interactive case studies related to the profile of three at risk populations. The case studies are provided at the end of the module for learners to apply principles to virtual patient cases. The module is designed to enhance learning by comparing and contrasting between IDA signs, symptoms and treatment throughout the lifespan. The clinical symptoms and presentations of the cases are adequate for first-semester medical students. Students were given an hour to complete the module, which should be sufficient for students in their first year.

Educational objectives: 
  • Identify common conditions that might predispose a patient to iron deficiency anemia (IDA).
  • Interpret the signs, symptoms, and laboratory values that are associated with IDA.
  • Evaluate three case studies resembling groups that are at high risk for IDA.
Date posted: 
Wed, 05/16/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 04/02/2018
Product Viewing Instructions: 
We recommend using Google Chrome. Users will need to ensure that flash is enabled on their browser.
Contact Person/Corresponding Author:



Suggested Citation:
Iron Deficiency Anemia Across the Lifespan. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/139

Geriatric Medicine Consult Curriculum for Orthopedic Surgery

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

Geriatrics/medicine curriculum developed for Orthopedic residents to complete during a required Internal Medicine consult rotation.  Topics include: preoperative assessment, medication reconcilliation and adverse drug events, post-operative complications including delirium, care transitions, and common inpatient medical problems.   Curriculum also includes references to relevant high-yield literature for additional information.

Educational objectives: 

Provide learners (specifically orthopedic surgery interns) with an introduction to common inpatient medical problems and post-operative complications.  At the end of this curriculum, learners should be able to demonstrate an understanding of the work-up and management of  common inpatient problems and post-operative complications, and apply this knowledge to the direct care of patients.  Learners should be able to identify common adverse events in older patients.

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Medicine Consult Curriculum for Orthopedic Surgery. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/139

Interdisciplinary Health Profession Module Videos

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

Care teams often don't know how to effectively and efficiently collaborate when addressing a patient’s health. Depending on a patient’s needs, team leadership can shift at any given moment from one person to another. Because of this constant jockeying and adaptation, educating learners about their own interprofessional relationships is becoming incredibly important. These videos and the corresponding text supplements provide a context for interprofessional team members to discover more about what it takes to become a member of another profession. This knowledge, combined with their own experiences and clinical practice, will assist in preparing learners for the next-generation of team-based healthcare.

Educational objectives: 

After watching these short 2-3 minute videos, interprofessional teams will be able to contextualize their own relationship within the group dynamic, understand the educational requirements that go into other disciplines, and formulate an effective team-based learning approach for future activities.

Date posted: 
Tue, 09/27/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/27/2016
Contact Person/Corresponding Author:



Suggested Citation:
Interdisciplinary Health Profession Module Videos. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/139

VirginiaGeriatrics.Org

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Intended Learner Audiences: 
Product Information
Estimated time to complete: 
2
Abstract: 

The VirginiaGeriatrics.Org website consists of 6 primary resources and a secondary list of resources for further research. These primary resources include a video archive of the geriatric grand round lecture series, interactive pre-clinical basic science geriatric case studies for medical students, more advanced geriatric case studies for clinical residents, a quick consult guide for geriatric consults, an "ask the expert" discussion resource, and various educational materials related to the Virginia Geriatrics Society Conference. Additionally, spread through the website are external educational resources to complement the core material. Finally, there are some resources for patients and families that may be interested in contacting clinics and/or geriatricians.

Educational objectives: 

Listed through 6 primary education sections (Grand Rounds, Med Student Materials, Resident Materials, Quick Consults, Ask the Expert, etc)

Date posted: 
Thu, 09/22/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 09/22/2016
Contact Person/Corresponding Author:



Suggested Citation:
VirginiaGeriatrics.Org. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/139

Geriatric Interprofessional Teaching Clinic (GITC)

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
1
Abstract: 
•Collaborative interprofessional practice and care are essential to the complex healthcare needs of a rapidly growing older adult population.
•Interprofessional collaboration (IPC) occurs when various health care practitioners, clients and/or caregivers work together to improve a client’s overall health.
•Teaching an IPC model continues to be a major gap in every health professionals’ education.
•To address this gap, the Geriatrics Interprofessional Teaching Clinic (GITC) at the University of Kansas Medical Center's Landon Center on Aging was created. It incorporates six professions: Students and faculty from  Physical Therapy, Medicine, Pharmacy, Social Welfare, Dietitics/Nutrition and Occupational Therapy.
•It is scheduled one half day a week with four patients scheduled on a "rolling" basis allowing for interprofessional teams of three to see patients in a staggered fashion. On average, each visit takes approximately 60-90 minutes.
•Logistically, students from 3 professions review the medical record together, discuss what they want to accomplish in the room, and how they will approach the patient encounter as a team. The students then see the patient and report back to the attending physician and other health professions faculty as a team. The assessment and plan for the patient is developed by the team.
•Team members are asked to define their roles by what the patient needs at that particular visit, starting with their own professional training and scope of practice, but then encouraged to allow themselves to participate in new ways. The interprofessional clinic faculty assist the learners by facilitating reflection on their clinical performance as individuals and as a team at the time of the clinic visit, incorporating their reflections into their next clinical encounter and through debriefing.
•To quantify interprofessional collaboration, evaluation tools are being piloted to assess for team dynamics, and surveys are sent out to each individual learner to assess for behavior and attitude changes. These are both done at the "beginning" and "end" of their GITC experience.
 
 
Educational objectives: 
•Create an interprofessional (IP) clinic involving multiple learners, emphasizing the national interprofessional competencies (values/ethics, roles/responsibilities, interprofessional communication and teams/teamwork).
•Train students in IP teams to evaluate their communication with the patient and with other team members following a patient encounter in GITC using a validated rubric. 
•Monitor changes in IP team behavior through individual learner evaluations.
Date posted: 
Mon, 10/10/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/10/2016
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Interprofessional Teaching Clinic (GITC). POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/139

Introduction to the Geriatric History and Physical Exam

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
0
Abstract: 

With a growing number of older adult patients entering the health care system and fewer students and residents pursing geriatric medicine,1,2 it is critical to prepare all medical students, no matter their specialty choice, with the basic knowledge and skills needed to care for the older adult population. 

The Geriatric History and Physical Exam Skills Module was designed to orient pre-clinical medical students to the common screening tools, physical exam maneuvers and common findings relevant to older adult patients.  This highly interactive module also presents pertinent modifications that need to be made when interviewing and examining the population.  The resource is most useful for second year medical students who have been introduced to history and physical exam skills on normal adult patients.  Requiring about 15 minutes to complete, this module incorporates self-assessment questions, radiographic images and high yield concepts for an early medical student.

 

References

  1. Golden, A. G., Silverman, M. A., & Mintzer, M. J. (2012). Is geriatric medicine terminally ill?. Annals of internal medicine, 156(9), 654-656.
  2. Golden, A. G., Silverman, M. A., & Issenberg, S. B. (2015). Addressing the shortage of geriatricians: What medical educators can learn from the nurse practitioner training model. Academic Medicine, 90(9), 1236-1240.

 

Educational objectives: 

By the end of the module, a learner will be able to:

  1. Recognize pertinent modifications for the interview and clinical exam of older adults
  2. Practice functional assessment and physical exam maneuvers of older adults by responding to questions
  3. Identify common findings in the geriatric exam
  4. Utilize screening tools to identify common geriatric syndromes
Date posted: 
Thu, 02/04/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 02/04/2016
Contact Person/Corresponding Author:



Suggested Citation:
Introduction to the Geriatric History and Physical Exam. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/139

2015 Quick Reference App: Internal Medicine and Family Medicine Resident Geriatric Competencies

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Intended Learner Audiences: 
Product Information
Abstract: 

In 2010, the essential geriatric competencies for Internal Medicine (IM) and Family Medicine (FM) residents were published. To reinforce and disseminate these critical skills, we created a quick reference mobile application for IM and FM residents that addresses competencies in each of the seven key competency domains: Medication Management; Cognitive, Affective and Behavioral Health; Complex or Chronic Illness; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care.

This application can be used as a comprehensive reference by learners of multiple levels and disciplines while caring for patients in a variety of settings, including inpatient wards, outpatient clinic, nursing homes and home visits. Various screening tools, criteria, mnemonics and guidelines supporting each competency are included in this concise guide to caring for aging adults.

To access the free app:

  1. Go to Geriatrics Quick Reference App on AgileMD
  2. Create a free AgileMD account  
  3. Download the free AgileMD application using your smartphone app store 
  4. Open the AgileMD app and login with the username and password you created
Educational objectives: 
After using this quick reference tool, learners will be able to:
1.) Select and apply evidence-based tools to screen for or assess geriatric syndromes.
2.) Asses for and manage issues affecting older adult health across seven key competency domains: Medication Management; Cognitive, Affective and Behavioral Health; Complex or Chronic Illness; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care.
Publications from, presentations from, and/or citations to this product: 

AGS 2015 Educational Showcase Product Swap

Date posted: 
Mon, 09/28/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 04/03/2018
Contact Person/Corresponding Author:



Suggested Citation:
2015 Quick Reference App: Internal Medicine and Family Medicine Resident Geriatric Competencies. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/139

Degenerative Aortic Stenosis

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
1
Abstract: 

The UT Southwestern SAGE Aortic Stenosis module is self-directed learning of degenerative aortic stenosis in the elderly. After completion of the program, medical students will have reviewed the disease, patient presentation, physical exam and treatment of aortic stenosis.

Educational objectives: 

After completion of the aortic stenosis module, learners will be able to describe:

  • anatomy and physiology of aortic stenosis
  • patient symptoms of aortic stenosis
  • diagnosis of aortic stenosis
  • treatment of aortic stenosis
Additional information/Special implementation requirements or guidelines: 

Quicktime is needed to view this material.

Author:  Melane Sulistio, MD

Geriatrician:  Kathryn Eubank, MD

Medical Illustrator: Lindsay Oksenberg, MA

Date posted: 
Tue, 12/02/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 12/02/2014
Contact Person/Corresponding Author:



Suggested Citation:
Degenerative Aortic Stenosis. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/139

Lower Urinary Tract Symptoms in the Aging Male

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

This PowerPoint presentation reviews an extremely common quality of life issue in the elderly male population.  The target audience is healthcare providers, particularly primary care providers, but could be informative for any practitioner seeing elderly patients, or for the patients themselves.  For this audience we intend to define the key terms and diagnoses involved, and outline the prevalence and impact.

Educational objectives: 

Upon completion of this lesson, the audience will have the basic knowledge to evaluate lower urinary tract symptoms, and have an improved understanding of the pathology to better analyze symptoms to select for appropriate treatment, or proceed with specialist consultation.

Date posted: 
Thu, 09/04/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 09/04/2014
Contact Person/Corresponding Author:



Suggested Citation:
Lower Urinary Tract Symptoms in the Aging Male. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/139

Precise Evaluation of the Geriatric Patient in the Emergency Department

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
2
Abstract: 

Background: The number of Emergency Department (ED) visits by patients over age 65 is increasing rapidly. Common chief complaints, such as abdominal pain, often are associated with atypical presentations and significant morbidity and mortality. Hence, it is important for Emergency Medicine (EM) physicians to have both a high suspicion for disease and an in-depth knowledge base when treating these patients. However, the unique presentations of disease in older patients are rarely focused on during EM residency training. The authors created an innovative, interactive small group activity with five cases of older patients presenting to the ED, focusing on fundamental disease processes and presentations, for training EM residents.

Methods: EM residents are divided into teams and challenged to provide the most efficient, cost-effective care in five cases. Using play money, the residents are given limited funds to perform specific exam components and order laboratory studies and imaging. After teams complete the cases, a debriefing is performed in a large group to discuss learning points, highlighting diagnoses and treatments specific to geriatric patients. This activity was developed for EM residents but has since been adapted for use with medical students and residents and faculty from other specialties, including Internal Medicine and Surgery.

Results: EM residents were very receptive to this exercise. On evaluations, they appreciated the interactive learning and case-based teaching. On a scale from 1-5, with 5 being the highest score, residents rated the overall quality of the session and teaching effectiveness as 4.6 and 4.3, respectively. Comments included: “awesome case format” and “very clinically applicable”.

Conclusions: A case-based, interactive small group exercise is an innovative way to educate EM residents about emergencies and atypical presentations in geriatric patients. These cases also can be adapted for residents in other specialties as well as for faculty and medical students.

Educational objectives: 

On completion, the learner will:

  • Understand Geriatric Emergency Medicine as its own subspecialty, with unique and evolving knowledge base and skills

  • Be wary of "under-triaging" geriatric patients, especially trauma patients

  • Identify acute abdominal pain in geriatric patients as often life threatening

  • Utilize the Mini Cog and ICU CAM

  • Identify delirium and understand that it requires further evaluation for an underlying cause

  • Treat pain appropriately in older patients

  • Treat agitation appropriately in older patients

  • Prepare for care transitions
Additional information/Special implementation requirements or guidelines: 

This is an interactive, case-based didactic on the evaluation of older patients in the Emergency Department (ED). This product consists of five cases of common chief complaints in the ED, as well as a lecture to describe the importance of Geriatric Emergency Medicine (EM) and highlight the keypoints of each case. The didactic is intended to begin with the Power Point lecture as a large group. Then, learners will break out in smaller teams to complete the "Precise Evaluation of Older Patients in the ED Game." Each team is provided with the packet of cases and play money, which can better demonstrate cost. The teams will work through the differential diagnoses on each case and selectively order tests to identify the correct diagnosis. Teams must keep track of the tests ordered on each case as well as total money spent. Either facilitators or one member of each team can provide results to the team from the appropriate answer key for each case. Teams then return to the large group to debrief and discuss each case. The lecture provides key learning points on each case specifically related to Geriatric EM, including atypical presentations and management. The winning team can be rewarded for spending the least while arriving at the correct diagnoses. The workshop in its entirety takes about 2 hours; however, less cases can be used for a shorter didactic. In addition, more cases can easily be added to this exercise to discuss other dieases processes. This curriculum has been used with EM residents as well as residents and faculty from other specialties and medical students.

Publications from, presentations from, and/or citations to this product: 

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Geriatric Abdominal Pain Game.”  Society of Academic Emergency Medicine 2013. Atlanta, Geargia. May 16, 2013. (Poster, Solicited).

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Material and Methods Swap: Geriatric Abdominal Pain Game.” American Geriatrics Society 2013. Grapevine, Texas. May 5, 2013. (Oral Presentation, Invited).

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Geriatric Abdominal Pain Game.”  American Geriatrics Society 2013. Grapevine, Texas. Denver, Colorado. May 3, 2013. (Poster, Solicited).

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Educational Soundbites: Geriatric Abdominal Pain Game.” Council on Emergency Medicine Residency Directors Academic Assembly 2013. Denver, Colorado. March 7, 2013. (Oral Presentation, Invited). (1 hour, 200 faculty members)

Waller N, Biese K, Barrio K, Howarth C, Roberts E, Busby-Whitehead J. “Geriatric Abdominal Pain Game.” Council on Emergency Medicine Residency Directors Academic Assembly 2013. Denver, Colorado. March 7, 2013. (Poster, Solicited).

Date posted: 
Thu, 09/05/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 09/05/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . Precise Evaluation of the Geriatric Patient in the Emergency Department. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/139

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