The Portal of Geriatrics Online Education

Medical Student Pre-Clerkship

Medical Student Synthesis Block - Hazards of Hospitalization

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

As part of the new curriculum at the University of Nebraska Medical School, geriatrics was utilized as “synthesis block”.  This allowed the presentation of geriatric material with the emphasis of review of material previously learned in the core curriculum in preparation for boards.  The cases were developed with this emphasis on review with the design to teach the information through a geriatric lens.  We addressed several of the major geriatric syndromes while reviewing board-pertinent information through discussion of cases.  The cases that follow were presented in the section of the course focused on the hazards associated with hospitalization.

Educational objectives: 

1. Identify potential hazards of hospitalization for all older adult patients.
2. Identify potential prevention strategies for potential hazards of hospitalization in older adults.
 

Date posted: 
Wed, 07/17/2019
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 06/26/2019
Contact Person/Corresponding Author:



Suggested Citation:
Medical Student Synthesis Block - Hazards of Hospitalization. POGOe - Portal of Geriatrics Online Education; 2019 Available from: https://pogoe.org/taxonomy/term/248

Aging and Immunity: The Important Role of Vaccines

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

Immune function wanes in all adults—whether healthy or sick—as they age into their fifth decade and beyond. Their bodies become less adept at recognizing and stopping pathogens, and the ability to develop and maintain immunity declines. Also known as  immunosenescence, age-related decline in immunity significantly contributes to the susceptibility of older adults to serious conditions, including influenza, pneumonia, and shingles.

Patients often believe that by living a healthy lifestyle, they can avoid illness and disease. While exercising, getting recommended screenings, and eating right are important for staying healthy, they alone do not prevent older adults from acquiring vaccine-preventable diseases. For older adults who feel, and generally are, healthy, it can be difficult to recognize that immunosenescence is occurring or what impact it may have. Underappreciation for immunosenescence could at least partially explain why adult vaccines remain significantly underutilized, despite their ability to stimulate and heighten immune response and boost waning immunity in older adults. According to the National Center for Health Statistics, in 2015, only 57% of Americans aged 65 years or older received a tetanus vaccine in the prior 10 years, 64% had received a pneumococcal vaccine, and only 34% had ever received a herpes zoster vaccine. Among adults 50 years and
older, four vaccine-preventable diseases alone—influenza, herpes zoster, pneumococcal disease, and pertussis—cost the United States more than $26 billion annually.

Ensuring that adult patients receive recommended vaccines is an important way to prevent unnecessary infections and reduce health care costs. Health care professionals play a key role in this process, specifically, they should:

  • Assess their adult patient’s immunization status
  • Strongly recommend vaccination at every opportunity using the 4R approach: Recommend, Repeat, Remind, Review
  • Have a program that supports in-practice vaccine administration
  • Refer patients to a health care professional who administers vaccines if you do not
  • Document vaccine administration and submit to the immunization registry

Vaccination is a critical component of protecting the health of individuals as they age. Providing a strong recommendation for vaccination at each encounter increases the likelihood of an individual accepting a vaccine, reducing the risk for debilitating illness, and protecting quality of life.

Educational objectives: 
  • Provide healthcare professionals with an understanding of the biological impact of aging on immunity,
  • Provide information to support the value of vaccination by exploring herpes zoster in depth and the role that age-related decline in immunity plays in this vaccine-preventable illness,
  • Offer practical tips and strategies for supporting aging patients’ health and overcoming barriers that may contribute to low rates of adult vaccination.
Publications from, presentations from, and/or citations to this product: 
Date posted: 
Mon, 08/06/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 07/19/2018
Contact Person/Corresponding Author:



Suggested Citation:
Aging and Immunity: The Important Role of Vaccines. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/248

Where's the Fall Risk?

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

One in four older adults have a fall or fall-related injury every year. “Where’s the Fall Risk?” is an interactive educational game that allows learners to discuss falls prevention in the home environment and think of potential solutions. Learners will be in groups of 2-6 people and use the provided picture to circle the fall risk areas in the given amount of time. The teams will then present the total number of areas by room and propose solutions for each fall risk area. A point will be given for each circled area and solution. The discussion portion of the game provides learners the ability to identify and fix high fall risk areas in the home. 

 

Educational objectives: 
  1. Understand what aspects of the home environment are considered fall risks
  2. Think of creative solutions to fix these fall risk areas
  3. At the end of the game, be able to have an active discussion with patients regarding falls prevention in the home environment
Additional information/Special implementation requirements or guidelines: 
Materials:
The game is best played in a group setting with teams composed of about 2-6 people.
  • Diagram of the home environment (PowerPoint provided)
  • Pen/Marker to circle fall risk areas
  • Timer
  • White board to keep track of points
Instructions:
Please print the provided diagram of the home environment. Groups of 2-6 people with a minimum of 2 groups.
Identification Phase:
  1. Set timer for 2 minutes and provide groups with the home diagram
  2. Start timer and have groups circle areas in the home that are considered fall risks. Suggestion to groups: it is easier to go room by room
  3. Once time is up, set pens to the side.
Solution Phase:
  1. Set timer for 2 minutes and provide groups with a sheet of paper.
  2. Start timer and have groups discuss why they circled the area as a fall risk and think of a solution for the fall risk area (of note, groups may not use “get rid of the item” as a solution).
  3. Once time is up, set pens to the side.
Discussion Phase:
  1. On white board, create a grid with group names at the top and rooms on the side (“Outside”, “Living Room”, “Kitchen”, “Dining”, “Bedroom”, “Bathroom”)
    1. Depending on how much time you have, it may be faster to discuss some rooms together: Outside & Living Room, Kitchen & Dining, Bedroom & Bathroom
  2. Start the discussion by going from room to room. Each team will get 1 point if they can identify a fall risk area and provide a solution. Of note, this is a key opportunity to discuss and talk about these high fall risk areas. You may propose other solutions and open it up to discussion with other groups as well.
  3. The winning team has the most points at the end of the game. 
Date posted: 
Wed, 07/25/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sat, 05/26/2018
Contact Person/Corresponding Author:



Suggested Citation:
Where's the Fall Risk?. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/248

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/248

Interprofessional Didactic on Medication Reconciliation for Medical and Pharmacy Students

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

Introduction
Medical schools are now required to include interprofessional training in which students collaborate with other healthcare professionals. This interprofessional didactic session was created by a pharmacist and physicians to teach a group of medical and pharmacy students about medication reconciliation.
Methods
A physician and pharmacist collaborated to deliver this 50-minute PowerPoint didactic during second-year medical students’ clinical skills course. Participating students included second-year medical students at the author’s institution, plus all pharmacy students rotating at the institution on the day of the didactic, since the author’s institution does not have its own pharmacy school. The didactic consists of lecturing, interprofessional small group work on cases, and large group discussion. Students were surveyed after the didactic to assess their attitudes about the session.
Results
A total of 63 students (54 medical and 9 pharmacy students) attended this didactic. Survey response rate was 58/63 (92%). On a 5-point Likert scale (1=Strongly Disagree, 5=Strongly Agree), students generally agreed that the lecture was valuable (mean +/- SD 4.7 +/- 0.5), provided new information (4.4 +/- 0.7), and should be continued for future students (4.7 +/- 0.5). Students also agreed that their school should have more interprofessional didactics (4.6 +/- 0.6).
Discussion
This 50-minute interprofessional didactic for medical and pharmacy students was highly valued by students, and provides a valuable setting for interprofessional education. This interprofessional didactic can be replicated at other institutions, including medical schools that do not have an on-site pharmacy school.

Educational objectives: 

By the end of this activity, learners will be able to:
1. Appreciate the difficulties many patients have with taking medications appropriately.
2. Describe how to approach patients in a collaborative, nonthreatening manner about their medications.
3. Identify how to appropriately obtain and document a patient’s complete medication list.
4. Appreciate the importance of maintaining an accurate medication list during times of transitions of care.
5. Appreciate the value of interprofessional learning.

Date posted: 
Thu, 02/15/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 02/15/2018
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Didactic on Medication Reconciliation for Medical and Pharmacy Students. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/248

Compendium of Five Case Studies: Lessons for Interprofessional Teamwork in Education and Workplace Learning Environments

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

The VA Centers of Excellence in Primary Care Education began educational activities in Academic Year 2011-2012 to improve primary care education, particularly to harmonize the education of clinician trainees with the emerging and future practice of primary care exemplified by patient centered care such as VA’s Patient Aligned Care Team model for primary care delivery. This volume shares examples of educational strategies that have
emerged from the first four academic years of the project, with each chapter being a case study from a participating site. Each case study reports on the implementation of a curricular element within their unique Center of Excellence. These case studies are intended to be of use to those interested in introducing curricular activities in accredited programs for health profession trainees that will lead to
the advancement of interprofessional, Veteran/patient-centered primary care. These case studies also represent one component of the project’s evaluation plan, designed by Annette Gardner, Ph.D. We have attempted to inform readers about the context of the institutions and readiness for change, the steps each program completed to design and develop strategies, gain leadership commitments,
implement, and evaluate these interventions in the spirit of continuous improvement. Additional reports about the project have been published, are in press, or are in the pipeline. Further, many of the references in this document have full-text available online. We have provided live links for ease of access to these additional resources.

Educational objectives: 

Shared Decision-Making: Care is aligned with the values, preferences and cultural perspectives of the patient. Curricula focus is on communication skills necessary to promote patient’s self-efficacy.


Sustained Relationships: Care is designated to promote continuity of care; curricula focus on longitudinal learning relationships.


Interprofessional Collaboration: Care is team based, efficient and coordinated, curricula focus is on developing trustful, collaborative relationships.


Performance Improvement: Care is designed to optimize the health of populations; curricula focus on using the methodology of continuous improvement in redesigning care to achieve quality outcomes.

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

Centers of Excellence in Primary Care Education (2017). Compendium of Five Case Studies: Lessons for Interprofessional Teamwork in Education and Workplace Learning Environments 2011-2016 (S. Gilman & L. Traylor Eds.): United States Department of Veterans Affairs, Office of Academic Affiliations. ISBN: 978-0-16-094202-0

Date posted: 
Wed, 05/16/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 05/16/2018
Product Viewing Instructions: 
Download Adobe pfd file
Contact Person/Corresponding Author:



Suggested Citation:
Compendium of Five Case Studies: Lessons for Interprofessional Teamwork in Education and Workplace Learning Environments. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/248

Elder Care - A Resource for Interprofessional Providers: Hearing Loss

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

Hearing Loss 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 health care settings.

Educational objectives: 

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

  1. Identify the most common cause of hearing loss in older adults
  2. State whether or not most people who could benefit from a hearing aid have one
  3. Identify relative advantages and disadvantages of methods of screening for hearing loss
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 Geriatrics Workforce Enhancement Program”. 
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.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.

Date posted: 
Fri, 06/30/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 03/01/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care - A Resource for Interprofessional Providers: Hearing Loss. POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/248

Advance Directives

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

Advance Care Planning (ACP) is more than documenting life-sustaining treatment choices or identifying a surrogate decision-maker; it is a comprehensive, continuing communication and ‘shared decision-making’ process between the patient, family, and medical providers designed to document patient values and goals for treatment.

This interactive self- learning module is designed for undergraduate medical students with the goal of introducing learners to ACP while building their confidence in facilitating difficult conversations with patients. At the beginning of the module, we provide background on ACP including the challenges and benefits associated with the process. We showcase an elderly couple discussing how important it is to have advance directives in place. The second portion of the module reviews the common forms that are used to document advance directives and two patient case scenarios where the students can interact and reflect on the acquired content.

Educational objectives: 
  • Recognize the relevance in conducting and documenting advance directive discussions with patients.
  • List commonly used advance directives documents.
  • Develop the skills necessary to engage patients in a discussion about advance directives through the use of realistic patient case scenarios.
     
Date posted: 
Wed, 07/19/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sun, 07/19/2020
Product Viewing Instructions: 
Interactive self learning module
Contact Person/Corresponding Author:



Suggested Citation:
Advance Directives. POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/248

Elder Care A Resource for Interprofessional Providers: Presbyphonia: The Aging Voice

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

Presbyphonia: The Aging Voice  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 health care settings.

Educational objectives: 
  1. Explain what presbyphonia is and why it occurs
  2. Identify a diagnostic test used to confirm the diagnosis of presbyphonia
  3. Explain how presbyphonia is treated
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 Geriatrics Workforce Enhancement Program”. 
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.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.               

Date posted: 
Wed, 04/19/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 04/19/2017
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Presbyphonia: The Aging Voice. POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/248

Mini-Cog Clinical Evaluation Exercise (Mini-CEX)

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

This Mini-Cog Clinical Evaluation Exercise (Mini-CEX) is a revision of the Ehrlich and Freeman's (2011) Clinical Evaluation Exercise (Mini CEX) Mini-Cog with the addition of assessing if there was time in communication of the test with patients and families. It is designed to use with a learner during an actual patient encounter. The teacher observes the learner during the patient encounter and completes the form. The teacher then reviews the form with the learner and provides feedback of what skills were observed, partially observed, not observed, not applicable and comments about the encounter.

Educational objectives: 

The learner who is administered this Mini-Cog Mini-CEX will:

1)be observed performing a Mini-Cog with a patient.

2)receive feedback about their Mini-Cog clinical skills and communcation skill with patients.

3)obtain a record of their clinical skill in performing a cognitive sceening using Mini-Cog.

Date posted: 
Mon, 01/23/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 01/23/2017
Contact Person/Corresponding Author:



Suggested Citation:
Mini-Cog Clinical Evaluation Exercise (Mini-CEX). POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/248

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