The Portal of Geriatrics Online Education

Physical Diagnosis

Improving Patient Safety: Root Cause Analysis Training for Fourth Year Geriatric Sub-Interns

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

This curriculum was developed to teach students one of the primary tools used for quality improvement in healthcare, root-cause analysis.

Educational objectives: 

By the end of the program, the student will be able to:

  1. The student will be able to complete a root cause analysis of an adverse event.
  2. The student will be able to identify actionable recommendations to decrease the likelihood of recurrence of an event based on a case study.
  3. The student will be able to effectively communicate to colleagues the importance and utility of root cause analyses in patient safety.
  4. The student will be able to relate clinical scenarios to the required AAMC Geriatric Competencies.
  5. The student will choose to use root cause analysis when encountering adverse events amenable to this type of analysis.
Date posted: 
Mon, 02/11/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 02/11/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . Improving Patient Safety: Root Cause Analysis Training for Fourth Year Geriatric Sub-Interns. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/224

Objective Structured Clinical Examination Case: Gina Babkins

:  
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 Gina Babkins is a standardized patient case designed for third and fourth year medical students. Gina Babkins is a 75-year-old woman who presents to the outpatient office with a complaint of lightheadedness. She asked to be seen prior to her scheduled appointment because she is concerned. The examinee's task is to obtain a focused history, perform a focused physical examination, and counsel the patient regarding her situation. Following the encounter, the examinee documents the encounter in a SOAP-style patient note.

Educational objectives: 

On completion, the educator will be able to assess the learner's ability to:

  • Perform a focused history & physical exam on a patient presenting with lightheadedness
  • Recognize dehydration secondary to medications
  • Create an appropriate plan for treatment of dehydration
Additional information/Special implementation requirements or guidelines: 

This product was reviewed by the University of Hawaii John A. Burns School of Medicine.

Date posted: 
Thu, 10/18/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 01/14/2013
Contact Person/Corresponding Author:



Suggested Citation:
, and . Objective Structured Clinical Examination Case: Gina Babkins. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/224

Elder Care: A Resource for Interprofessional Providers: Dealing with Overweight and Obesity in Non-Frail Older Adults

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

Dealing with Overweight and Obesity in Non-Frail Older Adults is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of healthcare settings.

Educational objectives: 

After reading this issue of Elder Care, you should be able to…

  1. Identify the best measurements for assessing overweight and obesity in older adults.
  2. State how much exercise is generally needed by overweight older adults to achieve weight loss
  3. Explain whether or not bariatric surgery is ever appropriate for obese older adults
Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as

  1. content is not changed,
  2. no one is charged a fee to use or read the publication,
  3. authors and their affiliated institutions are noted without change, and
  4. the reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatric Education Center."

For more information on this series, go to http://www.reynolds.med.arizona.edu/EduProducts/El...

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

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Date posted: 
Mon, 01/28/2019
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 03/06/2018
Contact Person/Corresponding Author:



Suggested Citation:
, and . Elder Care: A Resource for Interprofessional Providers: Dealing with Overweight and Obesity in Non-Frail Older Adults. POGOe - Portal of Geriatrics Online Education; 2019 Available from: https://pogoe.org/taxonomy/term/224

Osteoporosis Educational Series

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

This three-part lecture series provides an overview of  topics related to the elderly and osteoporosis. The lectures are designed to be presented in sequence and illustrate learning principles developed for residents but suitable for a variety of learner levels.

Lecture one: A Public Health Problem of Older Age

Lecture two: Pathogenesis and Risk Factors

Lecture three: Treatment and Prevention

Educational objectives: 

Lecture one:

  1. Define osteoporosis
  2. Describe the health impact of osteoporotic fractures from an individual to health care system level.
  3. Identify the generally recommended DEXA site to diagnose osteoporosis.

Lecture two:

  1. Explain normal and abnormal state of bone metabolism
  2. Define bone remodeling
  3. Identify risk factors for bone loss
  4. Calculate risk of facture

Lecture three:

  1. Characterize the pathophysiology of osteoporosis
  2. Identify the clinical diagnosis of osteoporosis
  3. Summarize treatment and prevention options
Additional information/Special implementation requirements or guidelines: 

Speaker notes are embedded within the PowerPoint Presentation.

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



Suggested Citation:
Osteoporosis Educational Series. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/224

Elder Abuse and Mistreatment: A Two-Part Training Program

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

Although health care practitioners have a legal and ethical duty to identify and intervene in suspected cases of elder abuse and mistreatment, the existing lack of knowledge and perceived barriers to reporting often interferes with this duty. The goal of the elder abuse and mistreatment learning modules is to provide case-based training to health care professionals. The training consists of two presentation modules with embedded speaker notes. Module One: Identifying Elder Abuse, focuses on the descriptions, signs and symptoms of elder abuse and mistreatment. Module Two: Screening and Intervening, concentrates on screening for elder abuse and mistreatment and provides guidance for intervention. Combined, these modules provide a basic understanding of elder abuse and mistreatment to assist health care practitioners in identifying and reporting this prominent public health problem. 

Educational objectives: 

After reviewing these modules, participants will be able to:                      

  1. Describe three types of elder abuse.
  2. List five signs and symptoms that raise suspicion of elder abuse.
  3. Identify three factors for elder abuse and neglect.
  4. Determine the steps to screen for elder abuse.
  5. Describe three interventions for victims of elder abuse.
  6. Discuss three interventions for stressed caregivers.
  7. List common community resources available to elders and their families. 
Additional information/Special implementation requirements or guidelines: 

Many of the slides within these presentations contain animations. It would be advisable to closely review slides prior to presenting to an audience. Embedded speaker notes are an additional feature of the presentations. 

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

Selected Citations:

  1. Dyer CB, Hyman DJ, Festa NA, Pavlik VN:  The Profile of Texas Adult Protective Services Clients with Multiple Reports.  Presented at the Gerontological Society of America Meeting, San Francisco, CA, November 22, 1999.
  2. Dyer CB, Pavlik VN, Festa NA:  Elder Mistreatment:  Analysis of Allegation Types and Variables Associated with Multiple Allegations from a Statewide Database.  Selected for
  3. Presentation at the Presidential Poster Session at the American Geriatrics Society Meeting, Nashville, TN, May 20, 2000.Dyer CB, Toronjo C, Pavlik VN, Keith M, Silverman E:  How do Adult Protective Service
  4. Specialists Recognize Valid Self neglect.  Presented at the Gerontological Society Meeting, Washington D.C., November 19, 2000.
  5. Harrell R, Toronjo C, Dyer CB:  How do Geriatricians Diagnose Elder Abuse and Neglect?  Presented at the American Geriatrics Society Meeting, Chicago, IL, May 10, 2001.
  6. Heath J, Dyer CB, Mosqueda L:  Partnering With Adult Protective Service Agencies for Educational Experiences in Elder Mistreatment.  Presented at the American Geriatrics Society Meeting, Chicago, IL, May 10, 2001.
  7. Pavlik VN, Barth J, Khan F, Phung M, Lo M, Turner R, Hyman DJ, Dyer CB:  Abnormal Nutritional Markers in Elder Mistreatment Patients.  Presented at the Gerontological Society of America Annual Meeting, Chicago, IL, November 17, 2001.
  8. Dyer CB, Pavlik VN, Mitchell B, Hyman DJ, Poythress EL:  Neurospychiatric Testing in Elders with Self-Neglect.  Presented at the American Geriatrics Society Annual Meeting, Washington D.C., May 11, 2002.
  9. Dyer CB:  Outcomes of Interdisciplinary Geriatric Assessment and Intervention in Elder Abuse.  Presented at the Gerontological Society of America’s 55th annual Scientific Meeting, Boston, Ma, November 24, 2002.
  10. Dyer CB:  Outcomes of Interdisciplinary Geriatric Assessment and Intervention in Elder Abuse.  Presented at the Gerontological Society of America’s 55th Annual Scientific Meeting, Boston, MA, November 24, 2002.
  11. R Hariharan, SG Nash, VN Pavlik, J King, CB Dyer: Medical Complexities Among Elderly Abused and Neglected Patients. Presented at the American Geriatrics Society Meeting, Baltimore, MD, May 14th-18th, 2003.
  12. CB Dyer, VN Pavlik, T Regev, M Vogel, DJ Hyman, B Mitchell, EL Poythress: Outcomes of Interdisciplinary Geriatric Assessment and Intervention in Unresolved Elder Mistreatment Cases. Presented at the American Geriatrics Society Meeting, Baltimore, MD, May 14th-18th, 2003.
  13. Poythress E, Tremaine B, Dyer CB: Self-Neglecters Who Live in Squalor. Presented at the Gerontological Society of America's 56th Annual Scientific Meeting, San Diego, CA, November 21st-25th, 2003.
  14. Dyer CB, Pavlik V, Delgado M, Regev C, Vogel B, Tremaine B: Characterizing Victims of Financial Exploitation. Presented at the Gerontological Society of America's 56th Annual Scientific Meeting, San Diego, CA, November 21st-25th, 2003.
  15. Patel A, Fisher CJW, Dyer CB: Characterizing Sexual Abuse in Older Adults. Presented at the  American Geriatrics Society Meeting, Las Vegas, Na, May 20, 2004.
  16. Kim L, Nieves L, Dyer CB:  Do Medical Examines Determine Elder Mistreatment as a Cause of Death?  Presented at the American Geriatric Society Annual Scientific Meeting, Orlando, FL, May 14, 2005.
  17. Dyer CB, Nieves LE, Delossantos O, Barth J, Poythress EL, Vogel M, Tremaine B, Neycheril A, Harlan J, Kim L: The Cognitive, Functional and Social Profiles of 500 Cases of Elder Mistreatment.  Presented at the American Geriatrics Society Annual Scientific Meeting, Orlando, FL, May 11, 2005.
  18. Dyer CB, Kim LC: "Elder Mistreatment: Abuse, Neglect, & Exploitation" Current Geriatric Diagnosis & Treatment, Landefeld, Palmer, Johnson, Johnston, and Lyons eds. McGraw-Hill, 2004.
  19. Dyer CB,Kim LC: “Elder Mistreatment: Abuse, Neglect & Exploitation”, Current Geriatric Diagnosis & Treatment, Landefield, Palmer, Johnson, Johnston and Lyons eds. McGraw-Hill, 2004.
  20. Mehta MM, Dyer CB:  “A Practical Approach to Elder Abuse, Neglect, and Exploitation”, Practice of Geriatrics, 4th Edition, 2007.
  21. Brandl B, Dyer CB, Heisler CJ, Otto J, Stiegel L, Thomas R: Elder Abuse Detection and Intervention: A Collaborative Approach.  2006 Springer.

Selected Presentations:

  1. “ Elder Mistreatment: Identification, Treatment and the Prevention of Premature Death” Principles of Geriatric Care: A Certificate Program for Health Care Professionals,Houston, TX Feb 21, 2012
  2. “The Medical Signs of Abuse and Neglect”. Elder Justice Care Seminar, National Advocacy Center, Columbia, SC, January 5, 2011.
Date posted: 
Fri, 07/19/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 07/19/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Elder Abuse and Mistreatment: A Two-Part Training Program. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/224

Screening Osteopathic Structural Exam for the Geriatric Patient

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

As our geriatric population continues to increase, physicians will evaluate more and more patients with muscoloskeletal complaints. This presentation demonstrates a screening Osteopathic structural examination modified for the geriatric patient. Screening exams allow the physician to efficiently determine the location of a significant somatic dysfunction(s) in a thorough comprehensive manner. The following screening structural exam is divided into two overall parts: a static and a dynamic portion. Dynamic includes range of motion testing as well as evaluation of gait. Once an area has been identified as having possible somatic dysfunction, the Osteopathic physician can perform a more specific palpatory evaluation segmentally or of a specific joint(s). 

Educational objectives: 
  1. Understand how an Osteopathic Structural Examination assists you in evaluating a patient's musculoskeletal complaints.
  2. Recognize which planes of motion are being evaluated by the different anatomical positions: anterior, posterior, lateral.
  3. Identify landmarks on posterior and lateral positions and how to interpret findings.
  4. Develop proper screening palpatory skills to evaluate the ROM in the spine.
  5. Use these tools to perform a more detailed segmental evaluation.
  6. Describe the purpose of Patrick's (FABERE) test.
  7. Recognize various posture and gaits and be familiar with the following types of gait: antalgic, Parkinsonian (shuffling), ataxic (wise-based).

 

Additional information/Special implementation requirements or guidelines: 
Publications from, presentations from, and/or citations to this product: 

References:

  1. Musculoskeletal Exam-Stuart Williams D.O., Year 1 OMM Presentation, UNTHSC, Texas College of Ostepathic Medicine, 2008.
  2. Foundations of Osteopathic Medicine, 3rd Ed., Anthony G. CHila D.O. (editor), P 410-430.
  3. Osteopathic Principles in Practice, M.L.Kuchera & W.A. Kuchera, Greyden Press, 2nd Ed-revised, P 175-185, 499-512, 533-534.
  4. Foundations for Osteopathic Medicine, 2nd Ed, Robert Ward(editor), P 635-649.
Date posted: 
Thu, 05/23/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 05/23/2013
Contact Person/Corresponding Author:



Suggested Citation:
Screening Osteopathic Structural Exam for the Geriatric Patient. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/224

Team Based Geriatrics

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

The End of Rotation Evaluation Instrument assesses knowledge of teamwork skills, ability to apply knowledge of geriatric syndromes to problem-based scenarios, and attitudes toward interdisciplinary education. Attitudes toward interdisciplinary education are measured using a retrospective pre-test form of the Interdisciplinary Education Perception Scale (IEPS).

Additional information/Special implementation requirements or guidelines: 

Scoring Guideline:

  • Section 1. Teamwork Knowledge. Aggregate Score 80% and above: Conclude students are obtaining the exposure to teamwork skills that is intended. Aggregate Score below 80%: Determine if there are any patterns in the missed items and address identified patterns.
  • Section 2. Geriatric Syndromes: Aggregate Score 80% and above: Conclude students are obtaining the knowledge of geriatric syndromes that is intended. Aggregate Score below 80%: Determine if there are any patterns in the missed items and address identified patterns.
  • Section 3. IEPS. For aggregate groups of 25 or more students, expect statistically significant changes in each of the three subscales. If a subscale does not change, look for patterns to be addressed.


We used the Interdisciplinary Education Perception Scale (IEPS) (Luecht, Madsen, Taugher, & Petterson, 1990; McFadyen, Maclaren, & Webster, 2007) to assess attitudes toward interdisciplinary education. We used a retrospective pre-test form of the IEPS. In a retrospective pre-test (RPT) design, participants rate and then compare their knowledge, skills, or behaviors immediately after an activity to the same knowledge, skills, or behaviors that they possessed within a specific time frame before the activity (Howard, 1980). I developed this form of the IEPS because the RPT design minimizes respondent burden, missing data, and response shift bias. Response shift bias is the tendency for an individual to overestimate their knowledge, skills, and behaviors in a pretest because their understanding of these topics is limited prior to the program intervention. By using the RPT design, respondents use the same frame of reference to judge their pretest and posttest attitudes, knowledge, and abilities (Pratt et al., 2000).

 

 

Howard, G. S. (1980). Response-shift bias: A problem in evaluating interventions with pre/post self-reports. Evaluation Review, 4(1), 93-106.
Luecht, R. M., Madsen, M. K., Taugher, M. P., & Petterson, B. J. (1990). Assessing professional perceptions: Design and validation of an interdisciplinary education perception scale. Journal of Allied Health, 19(2), 181-191.
McFadyen, A. K., Maclaren, W. M., & Webster, V. S. (2007). The interdisciplinary education perception scale (IEPS): An alternative remodelled sub-scale structure and its reliability. Journal of Interprofessional Care, 21(4), 433-443.
Pratt, C. C., McGuigan, W. M., & Katzev, A. R. (2000). Measuring program outcomes: Using retrospective pretest methodology. American Journal of Evaluation, 21(3), 341-349.

 

 

Contact Person/Corresponding Author:



Suggested Citation:
and . Team Based Geriatrics. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/224

Elder Abuse and Neglect Mandated Reporter Card - California

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

Template for a half-page card including: Elder abuse and neglect types and definitions in California, Mandated reporter requirement under CA WIC Code, Instructions on how to make a report of suspected abuse or neglect and Sample of reporting agencies.

Educational objectives: 
  • Recognize that anyone with full or intermittent responsibility for care or custody of an elder or dependent adult is mandated to report suspected Elder and Dependent Adult Abuse in California
  • Identify the types of abuse and neglect that require a mandated report in CA
  • Identify and compare Adult Protective Services and Long-term Care Ombudsman as agencies that will help consult about a situation, accept reports, and investigate alleged mistreatment

 

Additional information/Special implementation requirements or guidelines: 

For additional training materials on abuse and neglect, visit the Training Institute section of the website of the Center of Excellence on Elder Abuse & Neglect at UC Irvine http://www.centeronelderabuse.org

Date posted: 
Mon, 05/13/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 05/13/2013
Contact Person/Corresponding Author:



Suggested Citation:
Elder Abuse and Neglect Mandated Reporter Card - California. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/224

Texas Tech Medcast Reynolds Geriatric Step 2CK Test Prep Series 10-11: No. 100--I'm Healthy But My Bloodwork Says Otherwise

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

The Step2CK Test Prep Series was created by fourth-year students at the Texas Tech School of Medicine in Lubbock as a project of the fourth-year geriatrics rotation. It was developed as part of the Reynolds Geriatrics Podcast series, which is supported by an Aging and Quality of Life grant from the D.W. Reynolds Foundation. The episodes in this series are based on questions that have geriatrics content and patient vignettes from the 2010 Step 2CK Sample Exam.

Educational objectives: 

This episode is based on Question 100 on page 61 of the 2010 Step2CK Sample Exam.

Learning Objectives:  the third-year medical student studying for the Step 2CK exam should be able to:

  • Understand what leukemia is and the cells affected
  • Differentiate between an acute and a chronic leukemia
  • Differentiate between a lymphocytic and myeloid leukemia
  • Know the main ages affected by the different types of leukemias
  • Understand what a leukemoid reaction is and how it is different from a leukemia
Additional information/Special implementation requirements or guidelines: 
Date posted: 
Fri, 08/05/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 01/22/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Texas Tech Medcast Reynolds Geriatric Step 2CK Test Prep Series 10-11: No. 100--I'm Healthy But My Bloodwork Says Otherwise. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/224

Texas Tech Medcast Reynolds Geriatric Step 1 Prep Series 2011: No. 115--The Short-Tempered Patient

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

The Step1 Test Prep Series was created by second-year students at the Texas Tech School of Medicine in Lubbock as a project of the MS2 Aging Block of Systems Disorders II. It was developed as part of the Reynolds Geriatrics Podcast series, which is supported in part by an Aging and Quality of Life grant from the D.W. Reynolds Foundation. The episodes in this series are based on questions that have geriatrics content and patient vignettes from the 2011 Step1 Sample Exam, available from http://www.ttuhsc.edu/som/fammed/ttmedcast/gerseries/gerstep1prep.aspx.

Educational objectives: 

The second-year medical student studying for the Step 1 exam should be able to:

  • Describe the basic pathophysiology of hyperthyroidism.
  • Describe the signs and symptoms of hyperthyroidism.
  • List the laboratory values associated with hyperthyroidism.
  • Distinguish the difference in labl values for primary vs. secondary hyperthyroidism.
Date posted: 
Fri, 08/05/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 01/22/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , , , , , and . Texas Tech Medcast Reynolds Geriatric Step 1 Prep Series 2011: No. 115--The Short-Tempered Patient. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/224

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