The Portal of Geriatrics Online Education

Caring for the Older Adult

Schwartz Communication Curriculum

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

This curriculum is designed to teach first and second year medical students to acquire and to improve their skills in effective communication with patients and family members. The developing curriculum consists of several 3-hour sessions in the 2-year Doctoring Course. The components of each session include the following: 1. Entire class: Introduction of goals of session (e.g., the importance of communication and professionalism); short videos showcasing examples of communication; demonstration of role play of physician-patient consultations 2. Small group session: 2-3 role plays of case by students followed by faculty and student feedback and further discussion of case 3. Entire class reconvenes and discusses case and experience of role play led by expert panel consisting of chaplain, hospital social worker and 1-2 faculty physicians Products associated with this curriculum consist of an introduction and description of the first program and an evaluation form used for that session, as well as a faculty guide that provides goals and guidance for presenting the curriculum. Additional products will be listed as the curriculum develops.

Educational objectives: 

<p>
The overall objective is to teach pre-clinical students the central importance of effective communication between physicians and their patients and family members.</p>

<ol>
<li>
Students learn to develop and maintain empathy through communication skills.</li>
<li>
Students develop professionalism as they learn to utilize basic and necessary components of questioning and listening skills with patients and family members.</li>
<li>
The use of role play provides effective opportunity for practice in a safe small group setting.</li>
</ol>

<p>
The faculty guide explicitly notes the teaching points to be made in the communication session. It lists questions for discussion based on the session's case, readings and videos. It also describes the components of an effective role play: how to coach each student role player to inhabit their role and play their part, and provides guidance for successful critique and discussion.</p>

Additional information/Special implementation requirements or guidelines: 

Students are assigned readings and videos related to communication principles prior to the Doctoring session. Citations for suggested reading and viewing materials:

  • Schwartz, K. B. (1995, July 16). A patient’s story. The Boston Globe.
  • Delbanco, T., & Augello, T. (2006). When things go wrong: Voices of patients and families [DVD]. Cambridge, MA: CRICO/RMF. (Available from http://www.rmf.harvard.edu/education-interventions... or contact Alison O'Brien, aobrien@rmfstrategies.com, 617.679.1500, ext. 1299.)
  • Goldman, J., & Schapira, L. (2001). One story, two voices; A candid conversation between a cancer patient and her oncologist [DVD]. Both DVDs are also available from The Schwartz Center. Contact them at (617) 724-7576 or by email: schwartzcenter@partners.org.
Publications from, presentations from, and/or citations to this product: 

ShieldR, Tong I, Tomas M, Campbell SE, Besdine RW. Compassionate care does matter: Using teachable moments with medical students, American Geriatrics Society Annual Meeting, May, 2010. Journal of the American Geriatrics Society 2010:58 (Supplement); S215.

Shield R, Tong I, Tomas M, Besdine R. Teaching communication and compassionate care skills: An innovative curriculum for pre-clerkship medical students. Medical Teacher 2011;33(8):e408-16. Available online at http://dx.doi.org/10.3109/0142159X.2011.586748

 

Date posted: 
Thu, 10/08/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 07/25/2011
Contact Person/Corresponding Author:



Suggested Citation:
, and . Schwartz Communication Curriculum. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1052

Cadaver Treasure Hunt Faculty Guide

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
3
Abstract: 

This faculty guide is designed to assist medical schools interested in implementing the Cadaver Treasure Hunt anatomy course program. The program consists of 2 components: (1) a lecture at the very beginning of medical school introducing them to geriatrics, using the extreme old age of their cadavers and their death certificate diagnoses as a window to the importance of aging; and (2) a workshop in the anatomy lab in which geriatricians review the gross anatomical findings of the cadavers and provide important clinical perspectives. This low-cost, high-yield geriatrics intervention has been well received by Brown medical students; 82% rated the experience very positively.

Educational objectives: 

Goals of the program: 1. To introduce geriatrics early in the medical education curriculum. 2. To use the demographic information and the gross anatomical findings of the cadavers as teaching points for normal aging and common medical problems in aging. 3. To provide a medical and clinical context for students about how their cadavers may have lived and died. 4. To remind students of the sacrifice and gift that the cadavers had provided to them. 5. To evaluate how this program influenced students’ perceptions of their cadavers.

Additional information/Special implementation requirements or guidelines: 

Collaboration with the anatomy course directors is a key component for scheduling the lecture and anatomy lab session. You will also need to obtain death certificate data.

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

Presented at the May 2009 American Geriatrics Society Conference as a paper session as well as during the education methods swap session. McNicoll L, Nanda A, Besdine RW. Cadaver Treasure Hunt: Introducing Geriatrics Concepts in the Anatomy Class. J Am Geriatr Soc 2009:57 (Supplement); S8.

Gillespie, S. M. and Medina-Walpole, A. (2010, October). Teaching Undergraduate Geriatrics in the Anatomy Laboratory. Journal of the American Geriatrics Society, 58(10), 2000-2002. Also available online.

McNicoll L,Shield R, Ritter D, Besdine RW. Cadaver Treasure Hunt: Introducing Geriatrics Concepts in the Anatomy Class. J Am Ger Soc  2012:60(5);962-6.

 

Date posted: 
Fri, 08/07/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 08/06/2012
Contact Person/Corresponding Author:



Suggested Citation:
, and . Cadaver Treasure Hunt Faculty Guide. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1052

The Patient Encounter: Asking Difficult Questions

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

This resource is a PowerPoint-based interactive lecture. The intended audiences are senior medical students and interns, with special focus on International Medical Graduates. The lecture presents the importance and the components of the doctor-patient relationship. It focuses on areas that doctors (and patients) often find difficult to discuss. These areas are: 1) screening for and discussing sexual orientation, 2) intimate partner violence, 3) mood, 4) memory, 5) substance use/abuse and 6) financial barriers. As an additional focus of this presentation, acknowledgement is made of the particular difficulties International Medical Graduates may face in both establishing relationships with their patients and asking difficult questions. By demonstrating the importance of communication with our patients, and providing handouts on language and tools to use in discussing sensitive topics, we intend to improve the comfort and the performance of participants, and thereby to improve the patient care they provide.

Educational objectives: 

1) Establish the importance of patient-doctor communication. 2) Describe the elements of patient-doctor communication. 3) Explore areas of communication that are difficult or uncomfortable for patients and doctors. 4) Provide language and tools to use in screening for and discussing the "sensitive" topics of sexual orientation, intimate partner violence, mood, memory, substance use/abuse and financial barriers.

Additional information/Special implementation requirements or guidelines: 

Faculty presenter will need to compile recommended handouts, and will need internet access with audio in order to obtain and present the audio clips recommended.

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

MedEd Portal

Date posted: 
Fri, 01/01/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 01/01/2010
Contact Person/Corresponding Author:



Suggested Citation:
The Patient Encounter: Asking Difficult Questions. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/1052

Minimum Geriatric Competencies - Medical Students, Emergency Medicine Residents and IM-FM Residents

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

“Competency-based education prepares trainees to perform tasks occurring within the context of practice. Teaching to competency differs from traditional instruction. It begins by stating the performance we expect of our graduates in the workplace and then designing the medical school curriculum to prepare our learners to achieve that performance through deliberate practice in applying the underlying knowledge, skills, and attitudes.” As the elderly population in America "booms," medical education must address the issue at hand and modify their curriculum and teaching practices to give credence to geriatric principles within medical care. It is imperative for many reasons (socially, financially, etc.) that we ensure competency in the care of older adults for every physician.

To help achieve this lofty goal, the Minimum Geriatric Competencies have been developed for Medical Students and are being developed for multiple residency disciplines. The files within this product showcase the Medical Student Minimum Geriatric Competencies (published in Academic Medicine, May 2009), Internal Medicine – Family Medicine Resident Minimum Geriatric Competencies (published in Journal of Graduate Medical Education, Sept 2010), and Emergency Medicine Resident Minimum Geriatric Competencies (published in Academic Emergency Medicine, 2010).

Additional information/Special implementation requirements or guidelines: 

The "Side-by-Side" document shows the progression from Medical Student Competencies into resident education.

The documents included with this product are:

  • Emergency Medicine Resident Competencies
  • Medical Student Competencies
  • IM-FM Resident Competencies
  • Side-by-Side Competencies Comparison
Publications from, presentations from, and/or citations to this product: 

Leipzig R M, Granville L, Simpson D, Brownell Anderson M, Sauvigne K, and Soriano R P. (2009). Keeping granny safe on July 1: Consensus on minimum geriatric competencies for graduating medical students. Academic Medicine, 84, 604–610. Also available at http://journals.lww.com/academicmedicine/Fulltext/2009/05000/Keeping_Granny_Safe_on_July_1__A_Consensus_on.17.aspx

Hogan T M, Losman E D, Carpenter C R, Sauvigne K, Irmiter C, Emanuel L, and Leipzig R M. (2010). Development of geriatric competencies for emergency medicine residents using an expert consensus process. Academic Emergency Medicine, 17(3), 316-324. Also available at http://dx.doi.org/10.1111/j.1553-2712.2010.00684.x

Williams B, et al. (2010). Medicine in the 21st century: Recommended essential geriatrics competencies for Internal Medicine and Family Medicine residents. Journal of Graduate Medical Education, 2(3), 373-383. Also available at http://www.jgme.org/doi/abs/10.4300/JGME-D-10-00065.1

Date posted: 
Thu, 01/01/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 06/08/2011
Contact Person/Corresponding Author:



Suggested Citation:
Minimum Geriatric Competencies - Medical Students, Emergency Medicine Residents and IM-FM Residents. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1052

Texas Tech Medcast Reynolds Geriatrics Step1 Prep Series: No. 107--The Case of the BIG Heart

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

The Step1 Test Prep Series was created by second-year students at the Texas Tech School of Medicine in Lubbock as a project of the MS2 Aging Block of Systems Disorders II. It was developed as part of the Reynolds Geriatrics Podcast series, which is supported in part by an Aging and Quality of Life grant from the D.W. Reynolds Foundation. The episodes in this series are based on questions that have geriatrics content and patient vignettes from the 2009 Step1 Sample Exam, available from http://www.ttuhsc.edu/som/fammed/ttmedcast/gerseri....

Educational objectives: 

The second-year medical student studying for the Step1 exam should be able to:

  • List the diagnostic criteria for COPD
  • Describe the link between dilatd cardiomyopathy and doxorubicin use
  • Differentiate between restrictive and dilated cardiomyopathy
Date posted: 
Fri, 08/07/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 01/22/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , , , , , , and . Texas Tech Medcast Reynolds Geriatrics Step1 Prep Series: No. 107--The Case of the BIG Heart. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1052

Physician's Guide to Nursing Home Phone Call Coverage

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

This is intended to be a guide to physicians covering the nursing home on weekends and evenings with suggested responses to common calls.

Educational objectives: 

Act as a quick reference for covering physicians

Additional information/Special implementation requirements or guidelines: 

This was originally designed for a specific institution. It can be used as a template to help develop a guide that fits a particular situation.

Date posted: 
Mon, 06/08/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/19/2009
Contact Person/Corresponding Author:



Suggested Citation:
Physician's Guide to Nursing Home Phone Call Coverage. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1052

Choosing the appropriate assistive device: A card sorting activity

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

This 30-40 minute instructional activity is designed for small groups of medical trainees (6-8) to apply basic information learned about assistive devices. Although this session is intended for learners who have received some preliminary instruction on assistive devices, it can be modified readily to be the primary instructional modality for learners who have had little previous exposure. This interactive teaching activity uses a card sorting format in which participants are given a set of cards, each containing a different patient scenario, and are asked to match each card with one of seven assistive devices displayed on a table. Once the matches are complete, participants discuss the rationale for their matches and with input from the group members, make needed changes. The facilitator encourages further group discussion to clarify any misconceptions or mismatches. Key points about the use of assistive devices and common mistakes in their use are reinforced.

Educational objectives: 
  1. To select the appropriate assistive device and explain the reason for the selection.
  2. To describe the common problems in the use of assistive devices.
Additional information/Special implementation requirements or guidelines: 

The details for implementation are described in the session guide. Actual session materials are included in the appendices. We have conducted this session with second year medical students. At the time of the session, one of our fourth-year students rotating through the nursing home had a background in physical therapy. He volunteered to facilitate some of the sessions and he received very positive feedback from the students. We have found that with a detailed facilitator's guide, advanced medical students and members from other disciplines can successfully conduct this and some of our other teaching sessions. It is helpful if facilitators have a background in working with older adults, as this allows them to draw on their own experience during the group discussions.

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

van Zuilen MH, Rodriguez O, Paniagua M, Mintzer MJ. Choosing the appropriate assistive device: A card sorting activity. MedEdPORTAL; 2008. Available from http://www.aamc.org/mededportal, ID=823.
MedEd Portal

Date posted: 
Thu, 08/27/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 06/06/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Choosing the appropriate assistive device: A card sorting activity. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1052

Geriatric Emergency Medicine Modules

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

This series of interactive internet modules consists of 5 basic and 3 advanced courses in geriatric emergency care. The 5 basic modules consist of a series of case based and Socratic questions. Each module includes approximately ten questions with links to key references and brief discussions of the answers. The basic courses are offered on the following 5 topics: Altered Mental Status, Geriatric Abdominal Pain, Geriatric Trauma and Elder Abuse, Inappropriate Prescribing and Adverse Drug Events, and Pain Management and Procedural Sedation. Advanced courses allow the learner to apply the knowledge gained from the basic modules on a higher level via a case simulation format. Each case has multiple possible outcomes depending on the clinical decisions made by the participant. Advanced courses are offered on the following 3 topics: Geriatric Acute Abdominal Pain; Altered Mental Status; Geriatric Trauma/Falls.

Educational objectives: 

Upon completion of these courses, you will be able to:

ALTERED MENTAL STATUS:

  • Indicate potentially reversible etiologies of dementia
  • Identify features of delirium
  • Recognize pitfalls in the management of older emergency department patients with altered mental status


GERIATRIC ABDOMINAL PAIN:

 

  • Apply a broad differential diagnosis for the older patient with acute abdominal pain
  • Identify short term mortality risk of older emergency department patients with acute abdominal pain
  • Identify difficulties encountered in diagnosing abdominal pain in older patients


GERIATRIC TRAUMA AND ELDER ABUSE

 

 

  • Indicate three events that account from approximately 75% of all trauma-related morbidity and mortality in older patients
  • Identify characteristics of cervical spine injury in the older trauma patient
  • Recognize the differences between outcomes of older patients cared for in trauma centers to those in nontrauma centers
  • Identify pitfalls in the evaluation of older patients with acute hip fracture


INAPPROPRIATE PRESCRIBING AND ADVERSE DRUG EVENTS:

 

 

  • Indicate appropriate and inappropriate medications for elderly patients in the emergency department
  • Identify emergency department diagnoses associated with an increased risk of inappropriate prescribing in older patients
  • Recognize the role of renal function in the selection of medication dosages for older patients


PAIN MANAGEMENT AND PROCEDURAL SEDATION:

 

  • Identify how physiologic changes associated with aging can impact pain management and procedural sedation
  • Recognize commonly prescribed analgesics and sedatives that should generally be avoided in older patients
  • Identify appropriate pharmacologic options for pain management and procedural sedation in older patients in the acute care setting
Additional information/Special implementation requirements or guidelines: 

If you have previously created an account to login to the Basic GEM courses by emailing COMET, please contact COMET again at comet@ccf.org  to have your new login account merged with your prior login account.

Date posted: 
Tue, 09/07/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/07/2010
Contact Person/Corresponding Author:



Suggested Citation:
and . Geriatric Emergency Medicine Modules. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/1052

Top Blade - Geriatric Surgery Program

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

Top Blade-Geriatrics Edition 1.0© is a web-based, interactive program designed for surgical trainees to introduce them to the unique issues faced by geriatric surgical patients. Top Blade allows a very flexible format that can be molded to fit the needs of the program, the instructor or the learner. Top Blade-Geriatrics Edition 1.0 © was developed in response to the awareness raised by the American Geriatrics Society of the issues unique to the older, hospitalized patient and the potential problems or medical errors that can occur in this specific population. Preliminary observation of our surgical trainees awareness of these issues indicated that we had some work to do. The program contains 22 unique geriatric surgical cases, each with their own chart. You will need to register for a username and password. See instructions below.

Educational objectives: 

Introduce surgical trainees to the unique issues faced by geriatric surgical patients. The program can be utilized in a variety of ways to fit the needs of each particular program.

Additional information/Special implementation requirements or guidelines: 

To obtain a username and password, go to the website: http://topblade.med.sc.edu/ and click on "Request a Password". Fill out the form and an email will be sent to you shortly.

Date posted: 
Mon, 08/17/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sun, 09/12/2010
Contact Person/Corresponding Author:



Suggested Citation:
, and . Top Blade - Geriatric Surgery Program. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1052

ACOVE: Assessing Care of Vulnerable Elders

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

A collaboration from Rand Health, The American Geriatrics Society, and Pfizer, the ACOVE program educates physicians on how to assess and care for older patients with cognitive impairment, falls and mobility disorders, and urinary incontinence. Throughout this interactive CD, Dr. David Reuben provides a lecture style presentation with video clips and various other methods of introducing information. Each module contains an introduction, history, examination, diagnosis and treatment, and wrap-up component. Also, printable forms and educational materials for both the physician and patient. By virtue of being an interactive experience, the user is able to choose the module and component they wish to view.

Educational objectives: 

To educate physicians to assess and care for elders with: - Cognitive Impairment - Falls and Mobility Disorders - Urinary Incontinence

Additional information/Special implementation requirements or guidelines: 

Instructions on how to use an ISO file: http://www.pogoe.org/help/iso

Date posted: 
Fri, 08/07/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 06/29/2012
Contact Person/Corresponding Author:



Suggested Citation:
and . ACOVE: Assessing Care of Vulnerable Elders. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/1052

Pages

Subscribe to RSS - Caring for the Older Adult