The Portal of Geriatrics Online Education

University of Miami Leonard M. Miller School of Medicine

Is this a Reynold's grantee: 
Yes

The Medication History: A Small Group Session on Interviewing a Patient Regarding Medication Use

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

This 45-60 minute instructional activity is designed for small groups (4-8) of medical trainees to apply basic information learned about taking a medication history. This interactive teaching uses a simulated patient format with the session facilitator playing the role of Mr. Parsec, a patient who is having his medications reviewed at a health fair.

Educational objectives: 
  1. To take a medication history to gather information regarding: a) the patient's understanding of his medications (indications, dosing and side effects) and b) problems and factors influencing adherence.
  2. To outline a plan to the patient with steps that can be taken to reduce medication problems and obstacles to adherence.
Additional information/Special implementation requirements or guidelines: 

The students are required to complete three tasks in 45-60 minutes:

  1. Take a medication history.
  2. Identify problems with the medication use and formulate a plan to improve medication use.
  3. Communicate the plan to the patient.

The simulated patient has a number of medical, functional, psychological, social, and economic issues that are impacting his medication use. Students use a worksheet to record their findings. The facilitator completes a performance checklist with problems students identify and recommendations they make. After the three tasks are completed, the facilitator conducts a formative feedback session with the students.

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

Mintzer M, van Zuilen M, Cordero M, Kaiser R. The Medication History: A Small Group Session on Interviewing a Patient Regarding Medication Use. MedEdPORTAL; 2008. Available from: www.mededportal.org/publication/1112

Date posted: 
Wed, 07/06/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/01/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , and . The Medication History: A Small Group Session on Interviewing a Patient Regarding Medication Use. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/1217

Eliminate Hazards in Your Home: A Safety Checklist with Recommendations

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Product Information
Abstract: 
Each year, many older adults suffer accidental injuries in and around the home or are victims of crime in their home. Falls, fires, or burglaries can result in substantial injury or even death. This checklist is designed as a survey tool to be used during a home safety evaluation. It assesses various aspects of safety in and around the home. For each concern identified, one or more recommendations are provided for improving safety, many of which can be accomplished with little or no cost. A copy of the completed checklist is given to the person whose home has been evaluated.
Educational objectives: 
  1. To identify safety concerns in and around the home that place an older adult at risk for falls and other unintentional injuries and make them more susceptible to becoming victims of crime.
  2. To make targeted recommendations to address safety concerns identified.
Additional information/Special implementation requirements or guidelines: 

This checklist is designed for medical students, primary care residents, and other healthcare trainees and professionals who participate in the evaluation of older adults in the home. It is helpful if the learner has received basic instruction on home safety evaluation as this will help them complete a more in-depth assessment. This checklist can also be used as a patient education tool. Prior to going to an older adult's home to complete the safety assessment, we recommend users review the following online training module: Home Safety Assessment.

Although many schools have an elderly home visit experience in the pre-clinical years, often the only outcome obtained is student or elder satisfaction with the encounter. This checklist allows the student to make specific recommendations regarding improving the safety of their elder volunteer in and around their home. The content of the checklist is clearly linked to that of the home safety assessment training module. As shown above, we have measured an increased awareness of safety factors in students' reports as well as an increased number of recommendations made to the elder volunteers.

At the University of Miami Miller School of Medicine, first year medical students (in pairs) complete three home visits with active older adults residing in the community. During their final visit they complete a home safety assessment using a home safety checklist. Subsequently each student independently completes an online report in which they answer several questions related to their elder's safety. One of the questions asks them to describe their elder's home environment and strategies to reduce fall risk. Students are instructed to include a description of specific environmental observations and modifications useful in reducing fall risk.

This home visit has been part of the curriculum for eight years. Prior to 2005 students attended a one-hour lecture on home safety assessment before making the home visit. They used a pre-existing checklist which allowed them to check off problem areas; recommendations were provided on separate pages. For the past two years, students have used the home safety assessment training module as advance preparation for the home visit and this new checklist during their visit. To evaluate the effectiveness of the curricular changes, we compared the written reports of two cohorts: cohort 1 completed the curriculum immediately before revisions and cohort 2 received the new curriculum.

To rate the written submissions, we developed a 33-item checklist containing a broad range of home-safety elements (e.g., handrails, throw rugs, stairs, lighting). We then marked whether one or both student in a pair (cohort 1 N = 75 and cohort 2 N = 86) commented on the presence or absence of the element, and whether they documented specific recommendations. The average number of elements documented in the reports increased from 4.8 to 8.2 and the average number of recommendations mentioned increased from 2.5 to 3.3.
 

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

Rodriguez O, Tunuguntla R, van Zuilen MH, Ruiz JG, Mintzer MJ. Blended-learning improves medical student competency in home safety assessment of older persons. Journal of the American Geriatrics Society 55(Supplement):S10, 2007

Date posted: 
Fri, 09/17/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 09/17/2010
Contact Person/Corresponding Author:



Suggested Citation:
, and . Eliminate Hazards in Your Home: A Safety Checklist with Recommendations. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/1217

The Interactive Confusion Assessment Method (iCAM)

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Other Sponsors: 
Miami VA GRECC; Florida Teaching Nursing Home Program
Product Information
Estimated time to complete: 
1
Abstract: 

This self-learning web module will teach learners to administer, score and interpret the Confusion Assessment Method.

Educational objectives: 

By the end of this product, learners will be able to administer, score and interpret the CAM.

Additional information/Special implementation requirements or guidelines: 

This product was developed through the joint efforts of University of Miami Miller School of Medicine and its affiliated VA Medical Center, Mount Sinai School of Medicine and the Harvard School of Medicine. The Interactive Confusion Assessment Method (iCAM) has been adapted with permission from: Inouye SK et. al, Clarifying Confusion: The Confusion Assessment Method: A New Method for Detecting Delirium. Ann Intern Med. 1990; 113:941-8.

The web module consists of the following components:

  1. Introduction: CAM is a simple, reliable test that has been validated in several populations.
  2. Using the CAM: Because the test can be administered and scored in a few minutes during clinical care, it represents a minimal burden on hospital staff. The CAM algorithm follows 4 steps in determining whether a patient is likely to have delirium. These steps are briefly outlined below and in more detail in the accompanying form titled "CAM shortened version worksheet", which can also be used to record the results.
  3. CAM Steps:
    • Step 1. Acute Change and Fluctuating Course
    • Step 2. Inattention
    • Step 3. Disorganized Thinking
    • Step 4 Altered Level of Consciousness
  4. Scoring CAM: A brief explanation is provided on how to score the CAM in order to determine whether delirium is present.
  5. Interpretation: Using the CAM is just the first step in the assessment of patients who are confused or at high risk of becoming delirious. After scoring the CAM you must interpret the results in light of the patient's H&P examinations as well as any other conditions diagnosed with this patient.
  6. Practice Case: Learners have the chance to apply the knowledge acquired to a case. After reviewing the video and browsing the patient's virtual chart, learners will be able to score the CAM and decide whether the patient is delirious.
  7. Glossary
  8. References
  9. Credits

You will need Adobe Flash Player to view this module. Download it for free at http://get.adobe.com/flashplayer/ .

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

Inouye SK et. al, Clarifying Confusion: The Confusion Assessment Method: A New Method for Detecting Delirium. Ann Intern Med. 1990; 113:941-8.

Date posted: 
Wed, 01/27/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 07/23/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , , and . The Interactive Confusion Assessment Method (iCAM). POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/1217

Guidelines for Developing User Guides and Facilitator's Manuals for Educational Resources

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

When the developer is preparing educational materials for personal use, instructional guidance is clearly not required. However, when an educational resource is meant for widespread use, the developer must provide the information that will allow others to use the resource as intended. Effective sharing of the materials we produce depends on maximizing their utility and usability. A clearly written facilitator’s manual becomes an essential element of sharable educational materials.

Educational resources range from preceptor-assisted to computer-assisted materials and can include learning, assessment, and evaluation tools. The user guides for each of these varies depending on content and intended use. For example, this manual was created as a resource guide for instructional designers who are developing materials intended for use by others. It contains a comprehensive list of elements to be considered when developing a user guide.

Educational objectives: 

The user will be able to:

  1. Explain the rationale for developing user's guides/facilitator's manuals for educational resources.
  2. Describe the essential elements to include in a user's guide/facilitator's manual.
Publications from, presentations from, and/or citations to this product: 

van Zuilen MH, Ruiz JG, Mintzer M J. Guidelines for Developing User Guides and Facilitator’s Manuals for Educational Resources. MedEdPortal; 2005. Available from http://www/aamc.ord/mededportal. ID = 169. MedEd Portal

Date posted: 
Sun, 01/07/2007
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 07/17/2012
Contact Person/Corresponding Author:



Suggested Citation:
, and . Guidelines for Developing User Guides and Facilitator's Manuals for Educational Resources. POGOe - Portal of Geriatrics Online Education; 2007 Available from: https://pogoe.org/taxonomy/term/1217

Interactive Gait and Balance Assessment

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

The "Interactive Gait & Balance Training Module" is based on the fall risk assessment tool developed by M. Tinetti. This tool can be used to asses fall risk in a wide variety of settings including outpatient, acute, home and long term care. The computer-based training module was created as a "reusable learning object", and is available in a web-based version as well as a desktop application. To view the module on the web, click on the URL above. To use the desktop version, download the .zip file.

Educational objectives: 
  1. Explain how the Tinetti gait and balance instrument can be used in assessing fall risk.
  2. Describe the components of the balance and gait tests.
  3. To administer and score the Tinetti gait and balance assessment
Additional information/Special implementation requirements or guidelines: 

Windows/PC:

  1. Internet Explorer 6.0 and above, Netscape Navigator 7.0 and above
  2. Flash 6.0 or higher
  3. Intel Pentium processor (Pentium II or higher is recommended)
  4. 256-color monitor capable of 800 x 600 resolution
  5. Windows 95, 98, 2000, XP, Windows NT 4 (Service Pack 3) or Windows ME
  6. 64 MB or more of available RAM or higher is recommended


Macintosh:

  1. Mozilla 1.0 and above (which uses the same engine as Netscape)
  2. Flash 6.0 or higher
  3. Intel Pentium II processor (or higher)
  4. 256-color monitor capable of 800 x 600 resolution
  5. Mac OS 8.5, 8.6, 9.0 and 9.1 (For OS X, we recommend running as Classic)
  6. 64 MB or more of available RAM (with virtual memory on)

For a longer version of this product, view POGOe Product Interactive Performance Oriented Mobility Assessment (iPOMA).

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

Ruiz JG, Granville LJ, Ribera V, Kai T, Smith M, van Zuilen MH, Roos BA. Interactive Gait and Balance Training. MedEdPortal; 2005. Available from http://www/aamc.org/mededportal. ID = 170.

Date posted: 
Thu, 01/01/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 09/26/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . Interactive Gait and Balance Assessment. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1217

Home Safety Assessment

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

The home safety assessment learning object consists of two components:

  1. An interactive multimedia tutorial that introduces the learners to basic concepts and rationale for the use of home safety assessment for older persons with special emphasis in older persons with dementia. The tutorial uses textual content enhanced by multimedia animations and graphics. 
  2. Practice Exercises consisting of simulated home environments where the learner has an opportunity to identify home safety hazards. 
Educational objectives: 

The learner will be able to identify home related fall hazards and safety concerns for patients, including patients with dementia.

Additional information/Special implementation requirements or guidelines: 

These computer-based tutorials were created as "reusable learning objects", and are available in CD ROM and web-based versions. 

This product can be used in conjunction with Eliminate Hazards in Your Home: A Safety Checklist with Recommendations, a checklist designed for medical students, primary care residents, and other healthcare trainees and professionals who participate in the evaluation of older adults in the home. It is helpful if the learner has received basic instruction on home safety evaluation as this will help them complete a more in-depth assessment. This checklist can also be used as a patient education tool.

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

Rodriguez O, Ruiz JG, Phancao F. Home Safety Assessment (web-based program). GeriU, the Online Geriatrics University, Stein Gerontological Institute, 2006.

Date posted: 
Mon, 09/21/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 06/21/2012
Contact Person/Corresponding Author:



Suggested Citation:
, and . Home Safety Assessment. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1217

Interactive Dementia Screening

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Other Learning Resource Type: 
Web module
Product Information
Publications from, presentations from, and/or citations to this product: 

Malphurs JE, Smith MW, Mintzer MJ, Juan A, Katz A, Kai T, McEntire A, Ruiz JG, Roos BA. Pilot study of a blended-learning approach for screening for dementia using the MMSE. Proceedings of the American Geriatrics Society, Annual Scientific Meeting, May 17--21, 2004, Las Vegas, NV Katz A, Ruiz JG, Smith M, McEntire A, Juan A, van Zuilen MH, and Mintzer MJ. Online MMSE Assessment (Web-based program). GeriU, the Online Geriatrics University, Stein Gerontological Institute, 2004 MedEd Portal

Date posted: 
Fri, 08/07/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 07/05/2010
Contact Person/Corresponding Author:



Suggested Citation:
and . Interactive Dementia Screening. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1217

Interactive Performance Oriented Mobility Assessment (iPOMA)

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

Based on the falls risk assessment tool developed by M. Tinetti, this computer-based training module was created as a "reusable learning object". This tool has been used to assess fall risk in a wide variety of settings including outpatient, acute, home and long term care. The instrument has been modified over the years in order to measure usual function rather than standard function; the maneuvers included are based on the position changes and gait activities used during daily activity. Hence this particular instrument includes some maneuvers designed to measure the individual's function in the individual's most natural setting, his home, as opposed to the laboratory or the clinical setting.

 

Educational objectives: 

The learner will be able to:

  1. Describe the general characteristics, indications, validity, and reliability of the Performance Oriented Mobility Assessment.
  2. Describe the components of the balance and gait test.
  3. Determine when it is appropriate to perform the POMA on an individual.
  4. Advanced level: To administer and score the Performance Oriented Mobility Assessment safely and accurately.
Additional information/Special implementation requirements or guidelines: 

The inter-rater reliability for this instrument has been determined at around 83%. In a group of community dwelling elderly, the sensitivity and specificity was 70% and 52% respectively. This particular version has a greater number of maneuvers with a wider spectrum of difficulty in order to increase the sensitivity of the instrument. The maximum number of points that can be achieved is 35. The lower the score, the higher the fall risk, but there are no predetermined cut-off points. The score can be used as a baseline prior to implementing a therapeutic intervention for a particular individual. The maneuvers measured are likely to improve with a therapeutic intervention. The individual can be tested again at the end of the intervention to assess response to therapy. The POMA can be administered in 10-15 minutes.

Windows OS: Internet Explorer 6.0 and above, Netscape Navigator 7.0 and above

Macintosh OS: Mozilla 1.0 and above (which uses the same engine as Netscape) Flash 6.0 or higher CD ROM drive

For a shorter version of this product, view POGOe Product Interactive Gait and Balance Assessment.

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

Phancao F, Katz A, Smith M, Rodriguez O, van Zuilen MH, Juan A, Paniagua M, McEntire A, Mintzer MJ, Ruiz JG. Blended Learning for Medical Students in the Performance-Oriented Mobility Assessment. Proceedings of the 58th Gerontological Society of America Annual Meeting, November 18-22, 2005, Orlando, FL.

Ruiz JG, Morel G, Phancao F, Smith M, Rodriguez O, McEntire A, Hernandez S, Juan A, van Zuilen MH, and Mintzer MJ. Interactive Performance Oriented Mobility Assessment {iPOMA} (CD-ROM program). GeriU, the Online Geriatrics University, Stein Gerontological Institute, 2004.

MedEd Portal

Date posted: 
Fri, 08/07/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 08/07/2009
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , , , and . Interactive Performance Oriented Mobility Assessment (iPOMA). POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1217

Delirium Trigger Videos

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

The delirium trigger videos are one to two minute video clips produced by GeriU. The videos contain a visual scenario regarding delirium that the learners must address. There is often an emotional appeal to the video. Ask students, working in small groups, to view the situation, identify the problem, identify different courses of action, and then make recommendations. These videos deliver the information in an interactive way, step-by-step, through written text, animations, graphics and video clip demonstrations.

Educational objectives: 

The learner will be able to:

  1. Appreciate that delirium is a serious medical/surgical problem.
  2. Recognize potential risk factors for developing delirium.
  3. In a given patient, recognize characteristic findings of delirium.
Publications from, presentations from, and/or citations to this product: 

Ruiz JG, Paniagua M, Milanez M, Juan A, Phancao F, McEntire A, Picardo R. Delirium Trigger Videos (Digital videos). GeriU, the Online Geriatrics University, Stein Gerontological Institute, 2005

Ruiz J. Delirium Trigger Videos. MedEdPORTAL; 2006. Available from: www.mededportal.org/publication/229

Date posted: 
Fri, 08/01/2008
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 08/01/2008
Contact Person/Corresponding Author:



Suggested Citation:
Delirium Trigger Videos. POGOe - Portal of Geriatrics Online Education; 2008 Available from: https://pogoe.org/taxonomy/term/1217

Geriatrics Assessment Lite

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

Geriatrics Assessment Lite is a CD based series of short 5 e-learning interactive tutorials or learning objects. These learning objects teach physicians and trainees how to perform the basic components of geriatric assessment in a fraction of the time that it would take to perform a comprehensive geriatric assessment. These learning object tutorials deliver the information in an interactive way, step-by-step, through written text, animations, graphics and video clip demonstrations.

Educational objectives: 

The learner will be able to:

  1. Perform an assessment on the functional ability of an elderly patient using ADL and IADL scales.
  2. Perform a depression assessment on an elderly patient using the Geriatric Depression Scale and SIGECAPS, and interpret the results.
  3. Describe the key components of the geriatric review of systems.
  4. Administer, score, and interpret the results of a Mini-Cog Test.
  5. Administer, score, and interpret the results of the Timed "Up and Go" Test
Additional information/Special implementation requirements or guidelines: 

GeriU, the Online Geriatrics University, at the Stein Gerontological Institute, originally created this module in January 2005. Expertise was provided by faculty members from the University of Miami Miller School of Medicine, and the Miami VA, including Drs. J. Ruiz and A. Katz (geriatricians). 

System Requirements (viewing on web)

  1. Windows OS: Internet Explorer 6.0 and above, Netscape Navigator 7.0 and above.
  2. Macintosh OS: Mozilla 1.0 and above (which uses the same engine as Netscape).
  3. Flash 6.0 or higher
Publications from, presentations from, and/or citations to this product: 

Katz A, and Ruiz JG. Geriatric Assessment Lite (CD-ROM program). GeriU, the Online Geriatrics University, Stein Gerontological Institute, 2005

Date posted: 
Tue, 02/12/2008
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sun, 10/18/2009
Contact Person/Corresponding Author:



Suggested Citation:
Geriatrics Assessment Lite. POGOe - Portal of Geriatrics Online Education; 2008 Available from: https://pogoe.org/taxonomy/term/1217

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