The Portal of Geriatrics Online Education

Geriatric Syndromes

Ambulatory Geriatrics Knowledge Examination for Residents

Posted: 
12/31/1969
Updated: 
12/31/1969
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Estimated time to complete: 
1
Date posted: 
Sat, 06/22/2013
Date last updated: 
Wed, 03/06/2013
Suggested Citation:
, and . Ambulatory Geriatrics Knowledge Examination for Residents. POGOe - Portal of Geriatric Online Education; 2013 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

Boomer Care Blue Book Elective Lecture Series

Posted: 
12/31/1969
Updated: 
12/31/1969
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Estimated time to complete: 
1
Abstract: 

This blue book elective course includes six standardized, interactive lectures with survey at course completion. This course is designed primarily for first and second year medical students, although third and fourth year medical students are encouraged to attend as well. The elective course is meant to build the foundation for a generation of physicians with sound clinical knowledge and skills in Geriatrics and Palliative Care.  By sharing patient stories and building awareness of several common issues related to the care of older adults and the seriously ill, the course aims to promote lasting compassion for these populations and encourage recognition of their unique medical needs.  Regardless of students’ career paths, the course will help students to cater their future learning towards quality Geriatrics and Palliative care. This course will help to bridge gaps in education that exist between general patient care and older adult patient care.  

Educational objectives: 
  1. To promote sensitivity, empathy, respect, and compassion for older adults, the seriously ill, and their families.
  2. To introduce students to the complexity, depth, and importance of quality Geriatric and Palliative medicine.
  3. To encourage students to continue learning about Geriatric and Palliative medicine throughout their medical careers.
Additional information/Special implementation requirements or guidelines: 
This product was reviewed by UTHealth.
Suggested Citation:
, , and . Boomer Care Blue Book Elective Lecture Series. POGOe - Portal of Geriatric Online Education; 2012 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

Geri-ConsultWiz 2.0: An Educational Intervention Using “Just-in-Time Learning” in Computer Orders

Posted: 
12/31/1969
Updated: 
12/31/1969
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Abstract: 

Geri-ConsultWiz 2.0 is an educational intervention project based in the Wiz Order Computerized Provider Order Entry program. Geri-ConsultWiz 2.0 introduces an educational intervention providing new “just-in-time” clinical education modules that allow medical learners at all levels to easily access and review consultation-relevant content for common geriatric syndromes. Geriatric syndromes covered include: Delirium, Dementia, Depression, Falls, Failure to Thrive, Fractures/Osteoporosis, and Polypharmacy. The “just-in-time” learning consists of summarized information from the medical literature and from online authoritative guideline sources describing a brief background of the syndrome, pharmacologic treatments, non-pharmacologic treatments, and laboratory tests to order. This will extend the personal teaching in geriatrics that is provided to trainees and to consult referring providers through the Consultation Service.

Educational objectives: 

1. Offer "just-in-time learning" to providers requesting a geriatrics consult using an automated order program.

2. Learning offered covers several geriatric syndromes including  Delirium, Dementia, Depression, Falls, Failure to Thrive, Fractures/Osteoporosis, and Polypharmacy.

3. Provides learners with appropriate laboratory tests related to each syndrome. 

Additional information/Special implementation requirements or guidelines: 

May be programmable in several different computer ordering platforms. 

Date last updated: 
Fri, 10/19/2012
Suggested Citation:
Geri-ConsultWiz 2.0: An Educational Intervention Using “Just-in-Time Learning” in Computer Orders. POGOe - Portal of Geriatric Online Education; 2012 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

Medical Students as Teachers in Extended Care (MedTEC)

Posted: 
12/31/1969
Updated: 
12/31/1969
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Estimated time to complete: 
999
Abstract: 
Medical Students as Teachers in Extended Care (MedTEC) is a program that was designed to train medical students on the different sites and levels of care in the community after discharge from the hospital. Students who participate in this program spend a day at a community facility that includes skilled nursing, assisted living, and long term care. The program consists of educational sessions on levels of care and transitions of care, a tour of the facilities, and opportunities to talk to patients. In addition, students lead, under the guidance of the program preceptor, an in-service for facility staff on topics relating to the care of older adults. Students are asked to complete pre and post program surveys/tests for program assessment.
Educational objectives: 
By the end of the program, the learner will be able to:
  1. List the levels of post-acute and extended care
  2. Differentiate specific levels of care
  3. Define transitions of care
  4. Articulate ways to improve transitions of care
  5. Differentiate
    1. Inpatient (acute) rehab vs. skilled rehab
    2. Long term acute care vs. inpatient rehab
    3. Subacute vs. skilled nursing
    4. Assisted living vs. long term care
  6. Teach geriatric principles and other topics relevant to the care of older adults in post-acute and extended care to interdisciplinary facility staff members.
  7. Identify a learning need of a patient and utilize a patient-centered teaching approach to address that need.
Date last updated: 
Tue, 10/16/2012
Suggested Citation:
Medical Students as Teachers in Extended Care (MedTEC). POGOe - Portal of Geriatric Online Education; 2012 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

SAFE: The Safe Admissions For Elders App

Posted: 
12/31/1969
Updated: 
12/31/1969
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Other Learning Resource Type: 
iPhone app
Product Information
Estimated time to complete: 
0
Abstract: 

The SAFE App is an educational app intended for use by medical students and residents on their inpatient rotations.  SAFE App addresses the processes of hospital admission and effective discharge planning for optimal transitions of care for older adult patients.  The app also provides practical, just-in-time instruction in recognizing and managing common geriatric syndromes, symptoms and hazards of hospitalization.

Educational objectives: 

1)  Learners will access and use diagnostic and treatment recommendations for common geriatric symptoms and syndromes

2)  Learners will identify and implement critical components of admission and discharge processes for hospitalized older adults

Date posted: 
Sun, 01/01/2012
Date last updated: 
Fri, 10/12/2012
Suggested Citation:
and . SAFE: The Safe Admissions For Elders App. POGOe - Portal of Geriatric Online Education; 2012 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

Competency-based Outpatient Skills Modules for Internal Medicine Residents

Posted: 
12/31/1969
Updated: 
12/31/1969
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Estimated time to complete: 
1
Abstract: 

This is a collection of brief structured clinical evaluation exercises based on geriatric competencies for internal medicine residents. They are designed to be used as direct observation tools in the ambulatory clinic setting, for faculty to give structured feedback on specific geriatric competencies, including: falls screening and assessment, cognitive assessment, estimating remaining life expectancy, patient education incorporating health literacy, medication review, and urinary incontinence assessment.

Educational objectives: 

The objective for each exercise is for a faculty member to observe and give formative feedback to a resident on a specific geriatric competency area.

Date last updated: 
Mon, 10/08/2012
Suggested Citation:
Competency-based Outpatient Skills Modules for Internal Medicine Residents. POGOe - Portal of Geriatric Online Education; 2012 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

What’s Wrong with Mom (Dad)? Chronic Care Evaluation and Management of the Older Adult (and their Caregivers) with Alzheimer’s Dementia

Posted: 
12/31/1969
Updated: 
12/31/1969
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Abstract: 

Students learn the evaluation and management of the older adult and caregiver with a focus on Alzheimer’s Disease. This module consists of two large group sessions (week 1 & 4) and individualized assignments (weeks 2 & 3). In the first session, students interview a standardized patient and caregiver dyad and discuss initial diagnosis and management of Alzheimer’s Disease. Students receive real time feedback from the standardized dyad and observing faculty.  In weeks 2 & 3, students individually receive questions from the caregiver of the patient they interviewed. These questions reflect real life challenges commonly faced by families of patients with Alzheimer’s as the disease progresses. During week 4, the monthly cohort of medical students participating in the Family Medicine clerkship, spends the final Friday morning of their clerkship month rounding on individual patients with physician providers and interdisciplinary team members, at a long term care facility that cares for patients in the latter stages of Alzheimer’s Disease.  Evaluative components consist of: online post test assessment, Standardized Patient Student Feedback (verbal and written), student email responses to caregivers, final student self assessment.

Educational objectives: 
Biopsychosocial Model (Patient Centered Communication Skills, Psychosocial Awareness, Patient Education, Comprehensive Care, Contextual Care, Coordination/Complexity of Care)
  • Demonstrate active listening skills and empathy for patients.
  • Demonstrate setting a collaborative agenda with the patient for an office visit.
  • Demonstrate the ability to elicit and attend to patients’ specific concerns.
  • Explain history, physical examination, and test results in a manner that the patient can understand.
  • Clarify information obtained by a patient from such sources as popular media, friends and family, or the Internet.
  • Demonstrate validation of the patient’s feelings by naming emotions and expressing empathy.
  • Reflect on personal frustrations, and transform this response into a deeper understanding of the patient’s and one’s own situation, when patients do not adhere to offered recommendations or plans.
  • Discuss the influence of psychosocial factors on a patient’s ability to provide a history and carry out a treatment plan.
  • Provide patient education tools taking into account literacy and cultural factors.
  • Describe the patient education protocols and programs for core chronic illnesses at their assigned clerkship sites.
  • Identify resources in a local practice community that support positive health outcomes for diverse patients and families.
  • Promote the use of support groups and other community resources in the area of mental health.
  • Find and use high-quality Internet sites as resources for use in caring for patients with core conditions.
  • Conduct an encounter that includes patients and families in the development of screening and treatment plans.
  • Demonstrate caring and respect when interacting with patients and their families even when confronted with atypical or emotionally charged behaviors.
  • Demonstrate interpersonal and communication skills that result in effective information exchange between patients of all ages and their families.
  • Demonstrate interpersonal and communication skills that result in effective information exchange between patients of all ages and professionals from other disciplines and other specialties.
  • Describe the value of teamwork in the care of primary care patients.
  • Discuss the roles of multiple members of a health care team (e.g., pharmacy, nursing, social work, and allied health).
  • Participate as an effective member of a clinical care team.
  • Differentiate among common etiologies based on the presenting symptom.
  • Recognize “don’t miss” conditions that may present with a particular symptom.
  • Elicit a focused history and perform a focused physical examination.
  • Discuss the importance of a cost-effective approach to the diagnostic work-up.
Acute Care, Dementia
  • Perform a screening test for cognitive decline (e.g., the clock drawing test or the Mini-Mental Status Examination).
  • Select appropriate initial diagnos­tic tests for a patient presenting with memory loss, focusing on tests that identify treatable causes.
  • Find and apply diagnostic criteria.
  • Find and apply surveillance strategies.
  • Elicit a focused history that includes information about adherence, self-management, and barriers to care.
  • Perform a focused physical examination that includes identification of complications.
  • Assess improvement or progression of the chronic disease.
  • Describe major treatment modalities.
  • Propose an evidence-based management plan that includes pharmacologic and non-pharmacologic treatments and appropriate surveillance and tertiary prevention.
  • Communicate appropriately with other health professionals (eg, physical therapists, nutritionists, counselors).
  • Communicate respectfully with patients who do not fully adhere to their treatment plan.
  • Educate a patient about an aspect of his/her disease respectfully, using language that the patient under­stands. When appropriate, ask the patient to explain any new understanding gained during the discussion.
Additional information/Special implementation requirements or guidelines: 
Structure of clerkship in which curriculum has been used:
This innovative longitudinal teaching curriculum is used in the third year Family Medicine Clerkship. This is a 4-week, required rotation. Approximately 160 students complete this clerkship each year with 12-15 students on the clerkship at a time. While on the clerkship, the students rotate at either a residency, faculty, or community based family medicine site. All students come back to the medical school for Family Medicine didactic sessions every Friday during the clerkship. This geriatrics based curriculum is taught during these weekly sessions.
 
VIII: Program Content and Instructional Strategies
Week 1:
  1. Background content information is reviewed by medical students using asynchronous learning with students reading material and watching and scoring a video of a geriatrics faculty member giving the Montreal Cognitive Assessment (MoCA) to a patient.
  2. Students take an online quiz (utilizing Blackboard) on the background material by Thursday morning of the first week. This is a graded assignment.
  3. Standardized patient session take place on the first Friday of the Clerkship.
    1. Overview of the geriatrics curriculum and associated assigned tasks that are due throughout the clerkship month, done in a large group.
    2. Discussion with clerkship students (done in a large group) of their review of the background content information. Students submit their questions about this content via Blackboard prior to the first geriatrics curriculum session.  These questions are reviewed by both the Family Medicine and Geriatrics faculty who moderate this session.
    3. Review of the standardized patient (SP) chart as a large group.
    4. Dyads of students interview the SPs (a dyad consisting of a mother/father as a patient and daughter/son as the caregiver) and give the diagnosis of Alzheimer’s disease.
    5. After interviewing the SPs, students, in their dyads, formulate a problem list and write out an assessment and plan for this patient encounter.
    6. Each student dyad then meets with their SPs to get feedback on their interaction.
    7. In a large group, students collectively discuss their SP feedback and review their assessment and plan. This session is moderated by faculty from Family Medicine and Geriatrics.
Week 2
  1. Following the SP session, students receive a unique, 12 month follow up vignette on their patient and are emailed a question from the family regarding a problem. Students must research the answer to the question and email their response to the family by the second Thursday of the rotation. This assignment is graded and the students receive written feedback on content and writing style.
  2. On the second Friday of the clerkship, the students receive a unique, 36 month follow up vignette and again receive another question emailed from the family.  Once again the student researches the answer to the question and writes another emailed response back to the family. This is due by the third Thursday of the rotation. This assignment is graded and the students receive written feedback on content and writing style.
Week 3
  1. On the third Friday of the clerkship, we have a panel discussion to review the answers to the emailed questions. Panel members include clerkship faculty, members of the Alzheimer’s Association, geriatrics faculty, and a geriatric pharmacist.
Week 4
  1. The monthly cohort of medical students participating in the Family Medicine clerkship, spends the final Friday morning of their clerkship month rounding on individual patients with physician providers and interdisciplinary team members, at a long term care facility that cares for patients in the latter stages of Alzheimer’s Disease.  
  2. Students complete a post self assessment following this session.

“What’s wrong with Mom?” is an innovative Family Medicine Clerkship longitudinal teaching module developed by the University of Cincinnati (UC) Department of Family and Community Medicine in collaboration with the UC Division of Geriatrics, UC College of Pharmacy and the Alzheimer’s Association of Southwestern Ohio.

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

Sehgal, M, Ellis, R and Tobias B. What’s Wrong with Mom (Dad)? Chronic Care Evaluation and Management of the Older Adult (and their Caregivers) with Alzheimer’s Dementia. Family Medicine Clerkship Best Practices, Society of Teachers of Family Medicine. Published online 2012. http://www.fmdrl.org/index.cfm?event=c.beginBrowseD&selectedOptions=&currentGroups=1000078&page=1&perpage=25&sortby=LAST

Date posted: 
Sun, 01/01/2012
Date last updated: 
Tue, 09/25/2012
Suggested Citation:
, and . What’s Wrong with Mom (Dad)? Chronic Care Evaluation and Management of the Older Adult (and their Caregivers) with Alzheimer’s Dementia. POGOe - Portal of Geriatric Online Education; 2012 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

Elder Care: A Resource for Interprofessional Providers: Nocturia in Older Adults

Posted: 
12/31/1969
Updated: 
12/31/1969
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Estimated time to complete: 
1
Abstract: 
Nocturia in Older Adults is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.
Educational objectives: 
After reading this issue of Elder Care, you should be able to…
  1. State how many episodes of voiding per night are considered abnormal (ie, diagnostic of nocturia).
  2. Describe the non-pharmacologic approaches to treatment that are recommended for patients with nocturia.
  3. List medications that can be used for treating nocturia.
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."
Elder Care Provider Sheets can also be accessed at http://www.reynolds.med.arizona.edu/EduProducts/ElderCareProviderSheets.cfm.
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: 
Fri, 09/21/2012
Date last updated: 
Fri, 09/21/2012
Suggested Citation:
and . Elder Care: A Resource for Interprofessional Providers: Nocturia in Older Adults. POGOe - Portal of Geriatric Online Education; 2012 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

Peripheral Neuropathies

Posted: 
12/31/1969
Updated: 
12/31/1969
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Abstract: 

This presentation will familiarize learners to the symptoms and signs of peripheral neuropathy, review common causes and outline the approach to evaluation and treatment. Information about autonomic neuropathies and review evaluation and treatment of these disorders is also included.

Date last updated: 
Wed, 10/17/2012
Suggested Citation:
Peripheral Neuropathies. POGOe - Portal of Geriatric Online Education; 2012 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

Anesthesiology and the Geriatric Patient

Posted: 
12/31/1969
Updated: 
12/31/1969
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Date posted: 
Sat, 06/22/2013
Date last updated: 
Wed, 09/19/2012
Suggested Citation:
Anesthesiology and the Geriatric Patient. POGOe - Portal of Geriatric Online Education; 2012 Available from: http://www.pogoe.org/category/geriatrics-topic-areas/geriatric-syndromes

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