The Portal of Geriatrics Online Education

Lecture

A classroom session (or similar venue) that can be presented in the form of a video or audio recording, slide presentation or a transcript, accompanied by speaker's notes. Should include any materials that would accompany the lecture, such as a handout.

Office - Based Geriatrics Assessment

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Other Sponsors: 
Learning Institute For Elders ( LIFE) at University of Central Florida
Product Information
Estimated time to complete: 
1
Abstract: 

The geriatric assessment is a multidimensional, multidisciplinary assessment designed to evaluate an older person’s functional ability, physical health, cognition and mental health, and socioenvironmental circumstances. It is usually performed when the medical provider identifies a potential problem with the older adult patient. This holistic evaluation includes nutrition, vision, hearing, fecal and urinary continence, and balance. The geriatric assessment model has been studied in the home, inpatient and ambulatory care settings and there is evidence that it aids in the diagnosis of medical conditions; development of treatment and follow-up plans; coordination of management of care; and evaluation of long-term care needs and optimal placement.

Educational objectives: 
›Understand how to assess a new complex older patient in the office
›Understand the importance of overall function, including activities of daily living (ADL and IADL)
›Discuss validated tools for depression and cognitive assessment
›Discuss medication review
Date posted: 
Wed, 08/11/2021
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 05/07/2021
Contact Person/Corresponding Author:



Suggested Citation:
Office - Based Geriatrics Assessment. POGOe - Portal of Geriatrics Online Education; 2021 Available from: https://pogoe.org/taxonomy/term/36

Interprofessional Didactic on Medication Reconciliation for Medical and Pharmacy Students

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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: 

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/36

Advance Care Planning and POLST Conversation Guide

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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Other Sponsors: 
VA National Center for Ethics in Health Care
Product Information
Estimated time to complete: 
3
Abstract: 

This is an educational product to teach health care providers how to conduct goals of care conversations with patients and caregivers

Educational objectives: 

1. Recognize and respond to emotional cues during challening conversations  2. Demonstrate how to elicit patient perception of illness and goals of care 3. make a recommendation about code status based on patient's goals 4. Provided a basic description of CPR avoiding medical jardon 5. Discuss possible outcomes of CPR including survival percentages and possible risks.

 

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Advance Care Planning and POLST Conversation Guide. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/36

Interprofessional Geriatric Education and Training in Texas: Elder Mistreatment

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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: 

Although estimates vary, it is generally believed that 11% of the elderly are abused. According to the National Incidence Study on Elder Abuse, approximately 450,000 elderly experienced abuse each year. If self-neglect is included, the number increases to 551,000. Elder mistreatment is too large of a problem for any one person or one discipline to resolve. Incorporating the expertise of all the members of the interprofessional healthcare team is critical to determine the facts in the situation and the motives of the people involved. Healthcare providers can only see what is presented in the clinical setting. There is so much of the story that may not be manifested in a routine exam and encounter. Having all team members knowledgeable about the sometimes subtle signs of elder mistreatment is helpful for eliciting information and devising a holistic intervention plan.

The University of North Texas Health Science Center (UNTSHC) Reynolds Interprofessional Geriatric Education and Training in Texas (IGET-IT) Program has developed an Elder Mistreatment module as part of the Interprofessional Communication Improvement Modules (ICIM) Elder Safety series. The ICIM Elder Safety modules were created in collaboration with the National Board of Osteopathic Medical Examiners (NBOME) and are supported, in part, by a grant from the Donald W. Reynolds Foundation. The goal of the Elder Safety ICIMs is to provide innovative and sustainable programs to improve the ability of physicians to work with other health disciplines in teams to provide better care for geriatric patients. The care of older adults can be very complex and studies have shown that a team approach can be most effective in leading to quality outcomes.

 

Educational objectives: 

Upon completion of this activity, participants will be able to:

  • Define “elder mistreatment”
  • Describe the prevalence of elder mistreatment in the US
  • Define the multiple forms of elder mistreatment
  • Identify risk factors for elder mistreatment
  • List indicators of elder mistreatment
  • Prioritize the steps of elder mistreatment assessment
  • Determine the approach for including an elder mistreatment assessment in an IP team model of geriatric assessment
Publications from, presentations from, and/or citations to this product: 

Marquez Hall, S. (2016, May). Assessment Tool for Elder Safety on the Topics of Falls Risk and Elder Mistreatment. Presented at American Geriatrics Society Annual Scientific Meeting Education Product Showcase, Long Beach, CA.

Date posted: 
Wed, 10/05/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/05/2016
Product Viewing Instructions: 
Select your activities and add them to your cart. In the cart, click Proceed to Checkout. You will be prompted to create a new account or log in to your existing one. Once your account is created, you will be directed back to complete your registration.
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Geriatric Education and Training in Texas: Elder Mistreatment. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/36

Interprofessional Geriatric Education and Training in Texas: Fall Risk Education & Assessment

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

Each year, one in every three adults ages 65 or older falls and 2 million are treated in emergency departments for fall-related injuries. The risk of falling increases with each decade of life. The long-term consequences of fall injuries, such as hip fractures and traumatic brain injuries (TBI), can impact the health and independence of older adults. However, falls are not necessarily an inevitable part of aging. In fact, many falls can be prevented. All healthcare professionals can take actions to protect older adults.

The University of North Texas Health Science Center (UNTSHC) Reynolds Interprofessional Geriatric Education and Training in Texas (IGET-IT) Program has developed a Fall Risk Assessment and Education module as part of the Interprofessional Communication Improvement Modules (ICIM) Elder Safety series. The ICIM Elder Safety modules were created in collaboration with the National Board of Osteopathic Medical Examiners (NBOME) and are supported, in part, by a grant from the Donald W. Reynolds Foundation. The goal of the Elder Safety ICIMs is to provide innovative and sustainable programs to improve the ability of physicians to work with other health disciplines in teams to provide better care for geriatric patients. The care of older adults can be very complex and studies have shown that a team approach can be most effective in leading to quality outcomes.

Educational objectives: 

Upon completion of this activity, participants will be able to:

  • Describe risk factors associated with falls in older adults using a comprehensive fall risk assessment.
  • Identify examination components to assess for fall risk.
  • Describe how neurocognitive features can contribute to the risk of falls.
  • Identify four essential tests to assess neurocognitive features.
  • Describe how sensory factors impact the risk of falls.
  • Identify exams to assess sensory factors.
  • Identify the prescription, nonprescription, nutritional supplements, and food/drug interactions that are most frequently associated with an increased fall risk.
  • Discuss polypharmacy and its impact on fall risk.
  • Examine the evidence behind nutritional supplements that may help reduce fractures from falls.
Publications from, presentations from, and/or citations to this product: 

Gimpel, J., & Dowling, D.J. (2014, August). Watch Your Step: An Osteopathic Approach to Patient Fall Prevention and Intervention. Presented at the Pennsylvania Osteopathic Family Physicians Society Annual Convention, Hershey, PA.

Marquez Hall, S. (2016, May). Assessment Tool for Elder Safety on the Topics of Falls Risk and Elder Mistreatment. Presented at American Geriatrics Society Annual Scientific Meeting Education Product Showcase, Long Beach, CA.

Date posted: 
Wed, 10/05/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/05/2016
Product Viewing Instructions: 
Select your activities and add them to your cart. In the cart, click Proceed to Checkout. You will be prompted to create a new account or log in to your existing one. Once your account is created, you will be directed back to complete your registration.
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Geriatric Education and Training in Texas: Fall Risk Education & Assessment. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/36

Goals of Care Conversation Curriculum (GOCCC) Training

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

We developed a 3-part curriculum for teaching the basics of communication about goals of care (GOC) in older persons targeted towards medical students, residents, fellows, and faculty. There are 3 modules: 

1. Communicating Serious News - identifies strategies for effective communication and especially communicating serious news to patients or family members and improving our ability to transmit this news in an empathic and effective manner.

2. Goals of Care Discussion -focuses on the essential components of a GOC discussion; initiation, understanding the patient and family perspective, surrogate decision making, and concluding remarks clarifying and summarizing key discussion points and areas of understanding.

3. Managing conflict with patients and families - focuses on how to address frustrated and perhaps angry patients or family members who sometimes don’t feel that they are being listened to.  As providers, we are often put in this situation with few resources or skills to help guide us on how to deal with the patient’s and family’s emotions as well as our own. 

Each module contains a didactic lecture (45-60 minutes), examples of faculty role play (10-15 minutes), and instructions for participant role play activities. Each module is focused around a clinical case scenario done in dyads (30 minutes), and a sample evaluation form. Each module is best done in 2-hour sessions and in small groups (10-20 participants) but can be modified for 1-hour sessions. The content is applicable to a range of learners although the participant role play will likely be more meaningful for the more advanced learners.

Educational objectives: 

At the end of Module 1: Discussing Serious News, students, residents, and faculty will be able to:        

a.      Use curiosity and good listening skills to understand patient coping styles

b.      Describe empathic and effective approaches to discussing serious news

c.       Identify strategies for discussing prognosis

At the end of Module 2: Basic GOC, students, residents, and faculty will be able to:

a.       Be comfortable and effective in talking with patients and families about goals of care for patients with serious life-threatening, or chronic conditions

b.      Describe goals of care discussions as an essential component of the practice of medicine accepted within the mainstream of legal, moral, and ethical principles

c.       Articulate the complexity and subtleties of surrogate decision-making,  and the concept of substituted judgment

d.      Practice the key components of goals of care discussions in a simulation as a means of gaining competence and confidence in conducting GOC conversations

At the end of Module 3: Managing Conflict, students, residents, and faculty will be able to:

a.       Manage conflict in an effective and empathic manner to de-escalate anger and frustration experienced by patients and families during serious illness

b.      Recognize that in life-threatening situations, anger is a common response

c.       Describe communication techniques for diffusing anger

d.      Apply recommended skills to manage conflict and guide patients, families, and other clinicians through difficult decisions

Date posted: 
Mon, 06/20/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 08/08/2019
Contact Person/Corresponding Author:



Suggested Citation:
Goals of Care Conversation Curriculum (GOCCC) Training. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/36

Transitions of Care Workshop- Preparing 4th year Medical Students for Internship

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

Care Transitions are complicated and ineffective transitions result in poor patient outcomes and readmissions. The Association for American Medical Colleges (AAMC) has recently developed Entrustable Professional Activities (EPA) required for graduating medical students and two of the thirteen focus on transition of care issues. Residency programs are formalizing curricula around this topic as it is one of six focus areas within the Clinical Learning Environment Review (CLER) program, however graduating medical students have no formalized training in Care Transitions as of this time. This product provides a framework for practical training for graduating medical students and interns. A case based workshop on care transitions was created and utilized to instruct 4th yeard medical students and  Interns.  This included a small group didactic and a team based problem-solving session focused on a discharge case of a geriatric patient with multimorbidity. This curriculum was initially designed for medical students and interns on Internal Medicine, but can also be utilized to instruct learners in other fields and interprofessional learners.

Educational objectives: 
Define a care transition
Identify those at high risk for a complicated care transition
Apply specific risk assessment tools including the 8P’s, to estimate risk
Appraise the consequences resulting from ineffective transitions of care
Formulate a  safe care transition and discharge plan
Identify the important components of  successful transitional care
Additional information/Special implementation requirements or guidelines: 
Transitions of Care curriculum for 4th year medical students and Medical Interns
Interactive case based workshop to provide practical training on Transitions of Care
Small group classroom session with power point presentation and with a team based problem-solving component focusing on a discharge case of a geriatric patient with multimorbidit
Faculty Guide designed to guide active learning while students worked through the case in their teams
Publications from, presentations from, and/or citations to this product: 

Kranz, Kimberly, Strano-Paul, Lisa.  Preparing Graduating 4th year Medical Students for Internship- Implementing a Transitions of Care Workshop. Model Geriatric Programs: Geriatric Education Materials and Methods Swap. Presented at American Geriatric Society Annual Meeting Long Beach CA May 2016   

Kranz, K, Strano-Paul L, Go, R. Preparing graduating 4th year medical students for internship: Implementing a Transitions of Care Workshop. American Geriatric Society Annual Meeting, Long Beach CA, May 2016.

Kranz, K, Strano-Paul L, Go, R. Preparing graduating 4th year medical students for internship: Implementing a Transitions of Care Workshop. Women in Medicine Research Day. Stony Brook School of Medicine, Stony Brook, NY March 2016.

Kranz, K, Strano-Paul L, Go, R. Preparing graduating 4th year medical students for internship: Implementing a Transitions of Care Workshop. Clerkship Directors of Internal Medicine, Academic Internal Medicine Week, Atlanta, GA. October 2015.

                               

Date posted: 
Mon, 06/20/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 06/20/2016
Contact Person/Corresponding Author:



Suggested Citation:
Transitions of Care Workshop- Preparing 4th year Medical Students for Internship. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/36

3D (dementia, depression, delirium) Flipped Classroom Didactic for Medical Students

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

Background: Dementia, delirium, and depression are core minimum competencies outlined by the AAMC (Association of American Medical Colleges) for medical students by graduation. Focus groups with Hopkins’ medical students found that they had variable clinical experiences with 3Ds during neurology and psychiatry rotations and found it challenging to take a history from a patient with cognitive impairment.
Methods: A joint curriculum was established with psychiatry and neurology core clerkship directors for third and fourth year medical students. Pre-session: PowerPoint with information on 3Ds, mini-cog, 4AT, and PHQ-9. Using pre-recorded simulated videos, students completed worksheets and discussed in class. Additionally we incorporated an in person caregiver interview. We assessed students’ knowledge with in-class audience response questions, pre and post evaluations on how well learning objectives were addressed, and three month post didactic to assess behavior change. This curriculum will be repeated 4 more times during 2015-2016 academic year.
Results: In the first 3 quarters, 64 students completed didactic. Students scored 44-78% correct on 3/6 knowledge test questions (other 3 questions scored >90% correct). Students demonstrated most improvement in use and interpret mini-cog for dementia screen and 4AT for delirium screen as well as communication skills with patients and caregivers. No self-reported change pre and post didactic for students’ ability to differentiating between dementia and depression, or between dementia and delirium. Most importantly, a majority of students identified the importance of communicating with caregivers and providing support not only for the patient, but also for the caregiver. At three months follow up survey (75% completion rate), students identified communication techniques and understanding caregiver’s challenges as the most useful “take home” points from didactic.
Conclusions: Overall the 3D didactic was well received by medical students. They improved in identifying when to use screening tools for 3Ds, which may translate from knowledge to behavior at their next rotations. They also overwhelmingly identified the importance of communicating and assessing caregivers’ needs. More data will be collected during additional sessions this academic year. This curriculum could be easily disseminated without much additional resources.

Educational objectives: 

Knowledge & Skills objectives:
1. Recognize, compare and contrast  delirium, dementia, and depression in various clinical presentations.
2. Formulate a differential diagnosis and implement initial evaluation in a patient who exhibits delirium, dementia, or depression by evaluating video interviews among patient, caregiver, and provider triad communication skills.
3.  Assess an older patient with delirium, initiate a diagnostic work-up to determine the root cause (etiology), by identifying predisposing factors and differential diagnosis of delirium, by utilizing  non pharmacologic strategies for delirium.
4. Perform and interpret a cognitive assessment in older patients for whom there are concerns regarding memory or function by demonstrating the ability to differentiate the result of 4AT (rapid assessment test of delirium) based on video interview of delirious patient.  Proficiency to use Mini-Mental Status Exam (MMSE)and mini-cog to determine cognitive impairment.

Program/process Objectives:
• ≥ 95% of medical students in neurology and psychiatry rotation will attend the dementia day.
• Of students who attended didactic in person, 100% of the medical students will have demonstrated the ability to distinguish dementia, delirium, and depression using worksheets based on video interviews.

 

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

AGS poster presentation 2016

AGS Educational Showcase 2016

Date posted: 
Tue, 07/26/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 07/26/2016
Contact Person/Corresponding Author:



Suggested Citation:
3D (dementia, depression, delirium) Flipped Classroom Didactic for Medical Students. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/36

Ambulatory Geriatrics Curriculum for Internal Medicine Residents Module on BPSD: Agitation and Behavioral Problems in Dementia

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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: 

In 2012, 5.4 million Americans are diagnosed with Alzheimer’s Disease.  Lifetime risk of experiencing BPSD (Behavioral and Psychological Symptoms of Dementia) is nearly 100%.  BPSD is associated with increased morbidity and nursing home placement and is potentially treatable.  The information in this curriculum has been created to help the general internal medicine residents have a structured approach to the evaluation and management of BPSD.  This is the 3rd topic covered in a four part ambulatory geriatric curriculum that was developed for internal medicine residents.  To learn more about the successful ambulatory curriculum developed, please  check out  manuscript by Chang C1, Callahan EH, Hung WW, Thomas DC, Leipzig RM, DeCherrie LV. A Model for Integrating the Assessment and Management of Geriatric Syndromes Into Internal Medicine Continuity Practice: 5-Year Report. Gerontol Geriatr Educ. 2015 Jul 9:1-15.

Educational objectives: 

At the conclusion of this module, learners will be able to:

  1. Define BPSD
  2. Evaluate BPSD
  3. Discuss the Guidelines for Management of BPSD
    • Nonpharmacologic Interventions
    • Pharmacologic Interventions
Publications from, presentations from, and/or citations to this product: 

Christine Changab*, Eileen H. Callahanab, William W. Hungc, David C. Thomasb, Rosanne M. Leipzigab & Linda V. DeCherrieab A Model for Integrating the Assessment and Management of Geriatric Syndromes Into Internal Medicine Continuity Practice: 5-Year Report Gerontology & Geriatrics Education. Published online: 09 Jul 2015. DOI:10.1080/02701960.2015.1031897.

Date posted: 
Mon, 09/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 09/12/2016
Contact Person/Corresponding Author:



Suggested Citation:
Ambulatory Geriatrics Curriculum for Internal Medicine Residents Module on BPSD: Agitation and Behavioral Problems in Dementia. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/36

Nonpharmacologic Management of BPSD: Behavioral and Psychological Symptoms of Dementia

:  
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: 

In 2012, 5.4 million Americans were diagnosed with Alzheimer’s Disease.  Lifetime risk of experiencing BPSD (Behavioral and Psychological Symptoms of Dementia) is nearly 100%.  BPSD is associated with increased morbidity and nursing home placement and is potentially treatable.  The information in this curriculum has been created to help the general internist have a structured approach to the evaluation and management of BPSD. 

Educational objectives: 

Participants will be able to:

  1. Define BPSD
  2. Evaluate BPSD
  3. Discuss the Guidelines for Management of BPSD
Date posted: 
Mon, 09/12/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 09/12/2016
Contact Person/Corresponding Author:



Suggested Citation:
Nonpharmacologic Management of BPSD: Behavioral and Psychological Symptoms of Dementia. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/36

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