The Portal of Geriatrics Online Education

Medical Student Pre-Clerkship

Decision-making in Multimorbid Patients

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

This workshop is designed to introduce learners (medical students or residents) to the concept of multimorbidity and an approach to decision-making in this patient population based on the American Geriatrics Society’s Guiding Principles for the Care of Older Adults with Multimorbidity. The workshop has been delivered to groups ranging in size from 20-80 participants and can be delivered in a single 60-90 minute session or spread over two 45 minute sessions. The basic format includes a large group didactic lecture as introduction, small group breakout session to work through multimorbid patient cases, and a large group wrap-up to discuss and review key points. It has been successfully implemented with second year medical students about to transition to their clinical clerkships as well as academic and community hospital internal medicine residents.

Educational objectives: 

After completing this workshop, learners will be able to:

  • Describe the impact of multimorbidity on the US health care system
  • Practice a 5 step approach to multimorbid patients
    • Elicit patient preferences
    • Consider evidence-based treatment options
    • Estimate prognosis
    • Determine clinical feasibility
    • Prioritize plan
Additional information/Special implementation requirements or guidelines: 

None

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

None

Date posted: 
Tue, 10/15/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 10/15/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , and . Decision-making in Multimorbid Patients. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/248

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/248

SBARQ Education Module

:  
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/248

Elder Care: A Resource for Interprofessional Providers: Communicating with Patients who have Dementia

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

Communicating with Patients who have Dementia 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. List 3 verbal strategies that can improve communication with patients who have dementia
  2. List 3 non-verbal strategies that can improve communication with patients who have dementia
  3. List 3 things to avoid when talking to patients who have dementia
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: 
Tue, 10/29/2019
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 03/06/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care: A Resource for Interprofessional Providers: Communicating with Patients who have Dementia. POGOe - Portal of Geriatrics Online Education; 2019 Available from: https://pogoe.org/taxonomy/term/248

Elder Care: A Resource for Interprofessional Providers: Not all Dementia is Alzheimer's Disease

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

Not all Dementia is Alzheimer's Disease 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. List the 3 most common causes of dementia, other than Alzheimer’s Disease (AD)
  2. List common characteristics of those 3 non-Alzheimer’s dementias
  3. List 4 features of a dementia-like illness that should raise concern about causes other than AD
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: 
Thu, 08/02/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 05/31/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care: A Resource for Interprofessional Providers: Not all Dementia is Alzheimer's Disease. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/248

Prescription for Safety and Well Being: Home Modifications

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

  This one hour video lecture with accompanying PowerPoint slides decribes possible home modifications for older adults and ways older adults can stay safe in thier homes. The target audience is Interdisciplinary Health Care Professionals.

Educational objectives: 

 List home modifications that promote safety for older adults in the home.

Additional information/Special implementation requirements or guidelines: 

Please note: The speaker was caught in traffic so the first 9 minutes of presentation are Q&A with Dr. James Powers about home and safety modifications from a MD perspective. This material is from the Geriatrics and Gerontology Interest Groups (GGIG) of Vanderbilt University

This video may take a few moments to load based on your connection. Please wait if it does not appear right away.

Date posted: 
Wed, 05/22/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 05/22/2013
Contact Person/Corresponding Author:



Suggested Citation:
Prescription for Safety and Well Being: Home Modifications. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/248

"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/248

Medical Student Curriculum: Cognitive & Behavioral Disorders Domain

:  
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/248

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/248

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/248

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