The Portal of Geriatrics Online Education

Intro to Clinical Medicine/Clinical Skills/Doctoring

Interprofessional Collaboration with Pharmacists

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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: 

The goals of this educational module are:

1.  To provide the learner with information on how to constructively engage pharmacists as consultants or care providers in the care of older patients with various diseases requiring pharmacotherapy

2.  To provide the learner with information on how to apply selected facts and principles involving medication choice, dosing, and drug regimen hygiene in the care of older patients with various diseases.

Educational objectives: 

Part I: "An Introduction to Interprofessional Collaboration with Pharmacists"

1. Provide an overview of pharmacists in the role of drug therapy consultants

2. Illustrate methods used by pharmacists in identifying and caring for patients with limited health literacy

Part II: "Interprofessional Anticoagulation Management"

1. Describe the different roles and skills that pharmacists have in anticoagulation managment in several different care settings.

2. Determine when pharmacists can be consulted for anticoagulation management

Part III: "Optimizing Drug Therapy in the Elderly"

1. Identify drugs associated with high risk or adverse outcomes in the elderlyl population.

2. Apply strategies to reduce risk of adverse drug events and optimize therapeutic regimens in the elderly population.

3. Develop an understanding and appreciation of the pharmacist's role and responsibility in achieving optimal patient outcomes.

Additional information/Special implementation requirements or guidelines: 

For evaluation purposes, there are pre/post knowledge questions available from the author.

Contact Person/Corresponding Author:



Suggested Citation:
, , , , and . Interprofessional Collaboration with Pharmacists. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/208

How to discuss Code Status and make a recommendation

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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: 

Code status discussions are often rushed events done during a hospital admission by a doctor that the patient has never met.  The content, and therefore the quality, of these discussions varies widely and often contains very incomplete information that fails to meet a person at their individual health literacy level.  Additionally, once a physician decides to make a recommendation for a DNR status, the methods used may be crude and border on coercive.  

The goal of this lecture is to provide the listener with a complete understanding of CPR outcomes that can be presented flexibly at the level of the health literacy of the patient and family.  Second, the lecture provides a framework for making a recommendation of CPR by not viewing it soley as a health literacy problem but as a fit between a patient's stated values and the likely outcomes of CPR.  In this way, there are many reasons why a person may choose to be DNR.  

First, an evidence review of outcomes are discussed by site of care (inpatient, outpatient and nursing home) including immediate failure, prolonged death in a hospital, survival with impaired neurological status and survival with intact neurological status.  Both absolute and relative rates are presented.  An evidence review of the risks are summarized including the trauma of CPR, what happens when a person fails to survive to hospital discharge and surviving with impaired neurological status.  Success rates in studies are analyzed by diagnosis, age, and functional baseline.  Finally, how to translate the outcomes into goals and values is discussed including when being DNR is appropriate for a patient.  Ideally, the learner will have more tools for helping a patient understand why DNR may be appropriate than before this educational session.  

Educational objectives: 

The purpose of this lecture is to allow the listener to have a much more complete understanding of the pros and cons of CPR and its outcomes and have a framework for making recommendations.  The goal is to move beyond simply thinking about the trauma and success rates of a procedure-oriented CPR discussion and move towards a value-based, patient-centered discussion.

Additional information/Special implementation requirements or guidelines: 

The power point lecture is accompanied by a handout that serves as a literature review.  There is also a bibliography.  In a small group setting, the handout could be the starting point of an interactive discussion.  I usually start by asking the housestaff and students when they have felt a patient who was full code should be DNR, why they felt that way, and how they went about trying to change the code status.  I ask what they communicate and how they communicate it. Having learners provide their own vignettes gets them more engaged in the discussion and at the end they can think about what they might have done differently.  

Date posted: 
Mon, 10/07/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/07/2013
Contact Person/Corresponding Author:



Suggested Citation:
How to discuss Code Status and make a recommendation. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/208

SBARQ Education Module

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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: 

Communication errors contribute to adverse patient outcomes. This product is a web-based module teaching SBARQ (Situation, Background, Assessment, Recommendation, Question) Communication with the goal of reducing communication based errors.

Educational objectives: 

After completing the SBARQ module, the student will be able to:

  • Demonstrate SBARQ Communication

 

Date posted: 
Wed, 07/17/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 07/17/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , and . SBARQ Education Module. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/208

"The Case of Sherman Davis: An Interprofessional Analysis of Geriatric Medical Problems"

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
999
Abstract: 

This case demonstrates the evaluation and care of an elderly gentleman who has fallen.  The complexity of caring for the geriatric patient becomes evident early in the case.  The following points are emphasized:

(1) medical problems common in elderly patients include falls, fluid and nutrition problems;

(2) the elderly often present with common problems in an atypical way;

(3) the morphologic, microbiologic, and epidemiologic aspects of tuberculosis;

(4) interprofessional teams are needed to provide optimal care.

Educational objectives: 

The students will be able to formulate a broad differential diagnosis for an elderly patient after receiving physical and history information. It is important to stress the difficulties in formulating a differential diagnosis when patient history is lacking, but also to discuss strategies to overcome these barriers (e.g. multi-professional evaluation, collateral source history). The students will then be given additional laboratory and x-ray results and more history from the patient's nephew. This will allow the students to narrow  differential diagnoses down. There is much happening with this patient. Students will understand that patients, especially the elderly, do not always present with one problem. By the end of the session, the students will be able to review the care of the patient and have a good understanding of most learning objectives in the case, including those for tuberculosis and community acquired pneumonia.

Additional information/Special implementation requirements or guidelines: 

This case will be used with second-year medical students as part of  the Introduction to Disease Processes Core. This Interprofessional Problem-Based Learning Case will be used as a small group activity (10-12 students) with 1-2 faculty leaders.

Date posted: 
Sun, 01/01/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 07/31/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , , , , , and . "The Case of Sherman Davis: An Interprofessional Analysis of Geriatric Medical Problems". POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/208

Objective Structured Clinical Examination Case: Mary Smith

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

The case of Mary Smith is a standardized patient case designed for third and fourth year medical students. Mary Smith is a 70-year-old African American woman with a history of diabetes and hypertension who presents to the outpatient office with a complaint of tiredness and increased frequency and amount of urination. Mrs. Smith is non-compliant with checking her blood sugars and taking her blood pressure medication. The examinee's task is to take a focused history and counsel the patient.

Educational objectives: 
  • To assess students' ability to recognize and manage non-compliance (patient does not take medications as prescribed or at all, etc.)
  • To assess students' ability to effectively counsel patient on diabetes self-management, including exercise and preventive care
  • To assess students' ability to make appropriate referrals for diabetes management, including eye exam and foot care
Date posted: 
Fri, 03/28/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 03/28/2014
Contact Person/Corresponding Author:



Suggested Citation:
, and . Objective Structured Clinical Examination Case: Mary Smith. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/208

Medical Student Curriculum: Cognitive & Behavioral Disorders Domain

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
999
Abstract: 

The curriculum module was developed for faculty use in teaching medical students the fundamental knowledge and skills required to build competence in the AAMC Cognitive and Behavioral Disorders Domain. The module can be offered as a stand-alone unit or as part of a course. The formal content is taught in the context of clinical scenarios and includes a range of instructional strategies to reinforce learning and skill acquisition.

Standardized patients have also been developed for this domain; they are available on POGOe, as well (Items 21301 and 21302).

Educational objectives: 

The module includes instruction that is designed to build student knowledge and skill in each of the five cognitive and behavior disorders domain competencies. The specific learning objectives are to:

  1. Distinguish normal and abnormal physiologic changes in the aging brain
  2. Utilize a systematic approach to assessing a patient presenting with memory loss
  3. Distinguish between the unique clinical signs and symptoms of dementia, delirium and depression
  4. Describe the etiology, diagnosis and management of dementia, delirium and depression
  5. Administer four common cognitive and affective assessment instruments (MMSE, Clock Draw, Sweet 16, Geriatric Depression Scale) and interpret the results
  6. Recommend appropriate pharmacologic and non-pharmacologic interventions for a patient presenting with dementia, delirium or depression
Publications from, presentations from, and/or citations to this product: 

Overbeck KJ.  “Innovative Competency-based Curricular Models for Undergraduate Osteopathic Medical Education – Competency-based MS II Geriatrics Block Module,” presented at the American Association of Colleges of Osteopathic Medicine (AACOM) 2011 Annual Meeting, Baltimore, MD, April 2011.

Date posted: 
Tue, 07/15/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 07/15/2014
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Medical Student Curriculum: Cognitive & Behavioral Disorders Domain. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/208

Standardized Patient: Mike O'Halloran - Falls

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

The case of Mike O'Halloran is a skills-based standardized patient case designed for second year medical students. Mike O'Halloran is a 75-year-old man who presents to the outpatient clinic with a recent history of falls, having fallen three times in the last month. The examinee's task is to demonstrate competence in functional assessment, using the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living Scale, and in testing gait with the Timed Get-Up-And-Go Test.

Educational objectives: 

To assess student competence in:

  1. Performing a functional assessment, including use of the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living Scale
  2. Assessing gait and balance with the Timed Get-Up-And-Go Test
  3. Documenting results of testing using SOAP note format
Additional information/Special implementation requirements or guidelines: 

Students will need the Katz Index of Independence in Activities of Daily Living and the Lawton Instrumental Activities of Daily Living Scale checklist documents.

Date posted: 
Thu, 08/08/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 08/08/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Standardized Patient: Mike O'Halloran - Falls. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/208

Standardized Patient: Margaret Pelli

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

The case of Margaret Pelli is a skills-based standardized patient case designed for second year medical students. Margaret Pelli is a 74-year-old female who presents to an outpatient clinic with a history of forgetfulness and memory loss for approximately one year. The examinee's task is to demonstrate competence in administering the Mini Mental Status Exam (MMSE) and the Clock Drawing Test.

Educational objectives: 

To assess student competence in:

  • Conducting cognitive screening of an older adult
  • Demonstrating competence with administration of Mini Mental Status Exam (MMSE) and Clock Drawing Test
  • Documenting (in SOAP note format) and interpreting MMSE and Clock Drawing scores

 

 

Additional information/Special implementation requirements or guidelines: 

Students will need a copy of the Mini Mental Status Exam and paper and pencil for the Clock Draw Test.

Date posted: 
Fri, 03/28/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 03/28/2014
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Standardized Patient: Margaret Pelli. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/208

Objective Structured Clinical Examination Case: Henry Corbett

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

The case of Henry Corbett is a standardized patient designed for third and fourth year medical students. Henry Corbett is a 75-year-old man who presents to the outpatient office with a complaint of dizziness, fatigue, low energy, and loss of appetite. The examinee's task is to review the medical chart before seeing the patient, take a medical history, perform a physical examination, present a diagnosis, and lay out a treatment work-up plan. Following the encounter, the examinee documents the encounter in a SOAP-style patient note.

Educational objectives: 
  • To measure students' ability to do a focused history & physical exam on a patient presenting with lightheadedness
  • To assess students' ability to identify causes of lightheadedness
  • To assess students' ability to recognize orthostatic hypotension secondary to medications
Date posted: 
Wed, 07/17/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 07/17/2013
Contact Person/Corresponding Author:



Suggested Citation:
, and . Objective Structured Clinical Examination Case: Henry Corbett. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/208

Choose Your Own Differential Diagnosis: A Mrs. Porter Activity

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

This activity, resembling a “Choose Your Own Adventure” book is a clinical reasoning/critical thinking exercise for students interested to learn more about identifying the potential differential diagnoses of a geriatric patient. The activity provides the learner with the social and medical history of Mrs. Porter and her chief complaint during a routine visit to her physician, Dr. Pat, to obtain a medication refill. The learner is then asked to determine three potential differential diagnoses for Mrs. Porter's chief complaint. The three potential differential diagnoses are explored, with a preferred and an unfavorable plan of care presented for each diagnosis. The overall goal of the activity is to provide the learner with an understanding of a thorough examination of a geriatric patient in order to provide quality health care. 

Educational objectives: 

On completion, the learner will be able to:

  1. Identify differential diagnoses for a unique presentation of a common older adult patient condition.
  2. Identify a geriatric patient's social and medical history to develop a comprehensive treatment plan.
  3. Generate a preferred plan of care for each differential diagnosis.
Additional information/Special implementation requirements or guidelines: 

This activity is formatted as a fillable PDF file.

 

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

Presented as part of "Write Your Own Medical Adventure: Infusing Critical Thnking into Medical Education Curriculum" at the 2012 Reynolds Grantee 10th Annual Meeting, October 22, 2012.

Date posted: 
Tue, 04/23/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 04/23/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Choose Your Own Differential Diagnosis: A Mrs. Porter Activity. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/208

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