The Portal of Geriatrics Online Education

FALLS, BALANCE, GAIT DISORDERS

Interprofessional Geriatric Education and Training in Texas: Seniors Assisting in Geriatric Education - Interprofessional Team-Based Training, Assignments & Grading

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

The Seniors Assisting in Geriatric Education (SAGE) program consists of an educational curriculum and community based outreach program aimed at increasing student opportunities for early exposure to older adults and issues of geriatrics. The program strives to create meaningful relationships for the interprofessional teams of students while gaining knowledge about today’s senior population and their needs. The educational component involves health care profession students interacting with each other and their senior mentor through structured assignments delivered in the home environment.

Student teams are paired in groups of 3-4 healthcare profession students. The student teams are then matched with a community-dwelling senior who receives services from Meals on Wheels or a senior volunteer from the local community. The program includes 6 visits over a 2 year period providing students an opportunity to apply their classroom education in the context and care of an older adult. Students practice and demonstrate basic clinical skills; including taking histories, interviewing, conducting examinations and cognitive assessments, and advising clients on nutrition, home safety, community resources and advance care planning.     

Educational objectives: 
  • Health professions students will develop competency with older adults;
  • Strengthen health care students clinical applications of medical education through an Interprofessional team experience in the SAGE Program;
  • Health professions students learn from each other and appreciate each others professions.
Publications from, presentations from, and/or citations to this product: 

SAGE Presentations

Marquez-Hall, S. (2015). Interprofessional practice: Seniors assisting in geriatric education. A round table presentation at the Interprofessional Practice Symposium, University of North Texas Health Science Center in Fort Worth, TX.

Marquez-Hall, S. Lane, Y. (2014) seniors assisting in geriatric education (SAGE): Reynolds program address the lack of training in geriatrics and provides a model for interprofessional education. Jefferson Center for Interprofessional Education Annual Conference, Jefferson Medical College, Philadelphia, PA.

SAGE Poster Presentations:

Marquez-Hall, S., Pitts-Lane, Y. Knebl, J., (2015). Seniors assisting in geriatric education (SAGE): Reynolds program addresses the lack of training in geriatrics and provides a model for interprofessional education. Poster presentation at Research Appreciation Day, University of North Texas Health Science Center, Fort Worth, TX.

Marquez-Hall, S., Lane, Y., Smith, R. (2014) Survey of medical students in a geriatric training program. Poster presentation at the American Geriatric Society Annual Scientific Meeting, Baltimore, MD.

SAGE Awards:

2013 Mae Cora Peterson Senior Spirit Award in recognition of the Seniors Assisting in Geriatrics Education (SAGE) Program, Senior Citizens of Tarrant County, Texas.

2011 AACOM Excellence in Communications Award. Second Place - Best Community Service Program-Serving Fewer Than 1,000. SAGE Program; University of North Texas Health Science Center at Fort Worth, Texas College of Osteopathic Medicine.  

Date posted: 
Thu, 10/13/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/13/2016
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Geriatric Education and Training in Texas: Seniors Assisting in Geriatric Education - Interprofessional Team-Based Training, Assignments & Grading. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/105

Family Medicine Resident and Geriatric Fellow Longitudinal Home Visit Curriculum

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

With an aging population, the need to train primary care residents and geriatric fellows in home-based care continues to grow. A needs assessment of family medicine residents and geriatric fellows' attitudes and knowledge was performed to guide a novel, longitudinal home care curriculum based out of a Home-Based Primary Care practice within the Family Medicine Center.

Fellows are assigned a panel of two home visit patients from the Family Medicine Center's Home-Based Primary Care practice. Fellows follow these patients monthly and manage their care between visits.  In today’s rapidly changing clinical environment, primary care physicains and geriatricians must be adapt at analyzing systems and processes they work under and making changes to improve patient care. A new home visit program is a natural venue for a specific, achievable quality improvement intervention with support from faculty, the Home Based Primary Care practice team and the Family Medicine Center Patient and Family Advisory Council. 

The longitudinal family medicine resident curriculum is based on graded autonomy and focused objectives for each level with the ultimate goal of residents feeling empowered to include home visits in their future practice. After home visit sessions, residents complete personal, written reflections after each visit to optimize learning and retention, as well as for giving a venue for processing potentially challenging situations. Sample reflections are included. Third-year residents facilitate an interdisciplinary case conference to address various social determinants of health, home safety issues and medication concerns. By residency graduation, residents will complete 10-14 home visits. 

 
Educational objectives: 
  1. Describe challenges and opportunities unique to patient care in the home environment.  
  2. Review medication use and adherence while identifying medications that are no longer effective, are duplicative or carry greater burden than benefit.  Identify medications that you would recommend stopping and create a schedule for stopping these medications.
  3. Develop and implement a safety plan to make the patient’s home environment safer.
  4. Develop a personal plan to integrate home visits into your future practice.

Fellow-specific objectives:

  1. Develop, document and manage patient- and family-centered care plans related to patient’s health conditions and expected trajectory with emphasis on personal goals of care in collaboration with an interprofessional health care team and community service providers.
  2. Implement a process improvement as part of the Home Based Primary Care team.  

 

Date posted: 
Wed, 10/19/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/19/2016
Contact Person/Corresponding Author:



Suggested Citation:
Family Medicine Resident and Geriatric Fellow Longitudinal Home Visit Curriculum. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/105

VirginiaGeriatrics.Org

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

The VirginiaGeriatrics.Org website consists of 6 primary resources and a secondary list of resources for further research. These primary resources include a video archive of the geriatric grand round lecture series, interactive pre-clinical basic science geriatric case studies for medical students, more advanced geriatric case studies for clinical residents, a quick consult guide for geriatric consults, an "ask the expert" discussion resource, and various educational materials related to the Virginia Geriatrics Society Conference. Additionally, spread through the website are external educational resources to complement the core material. Finally, there are some resources for patients and families that may be interested in contacting clinics and/or geriatricians.

Educational objectives: 

Listed through 6 primary education sections (Grand Rounds, Med Student Materials, Resident Materials, Quick Consults, Ask the Expert, etc)

Date posted: 
Thu, 09/22/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 09/22/2016
Contact Person/Corresponding Author:



Suggested Citation:
VirginiaGeriatrics.Org. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/105

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

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
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/105

Geriatric Interprofessional Teaching Clinic (GITC)

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
1
Abstract: 
•Collaborative interprofessional practice and care are essential to the complex healthcare needs of a rapidly growing older adult population.
•Interprofessional collaboration (IPC) occurs when various health care practitioners, clients and/or caregivers work together to improve a client’s overall health.
•Teaching an IPC model continues to be a major gap in every health professionals’ education.
•To address this gap, the Geriatrics Interprofessional Teaching Clinic (GITC) at the University of Kansas Medical Center's Landon Center on Aging was created. It incorporates six professions: Students and faculty from  Physical Therapy, Medicine, Pharmacy, Social Welfare, Dietitics/Nutrition and Occupational Therapy.
•It is scheduled one half day a week with four patients scheduled on a "rolling" basis allowing for interprofessional teams of three to see patients in a staggered fashion. On average, each visit takes approximately 60-90 minutes.
•Logistically, students from 3 professions review the medical record together, discuss what they want to accomplish in the room, and how they will approach the patient encounter as a team. The students then see the patient and report back to the attending physician and other health professions faculty as a team. The assessment and plan for the patient is developed by the team.
•Team members are asked to define their roles by what the patient needs at that particular visit, starting with their own professional training and scope of practice, but then encouraged to allow themselves to participate in new ways. The interprofessional clinic faculty assist the learners by facilitating reflection on their clinical performance as individuals and as a team at the time of the clinic visit, incorporating their reflections into their next clinical encounter and through debriefing.
•To quantify interprofessional collaboration, evaluation tools are being piloted to assess for team dynamics, and surveys are sent out to each individual learner to assess for behavior and attitude changes. These are both done at the "beginning" and "end" of their GITC experience.
 
 
Educational objectives: 
•Create an interprofessional (IP) clinic involving multiple learners, emphasizing the national interprofessional competencies (values/ethics, roles/responsibilities, interprofessional communication and teams/teamwork).
•Train students in IP teams to evaluate their communication with the patient and with other team members following a patient encounter in GITC using a validated rubric. 
•Monitor changes in IP team behavior through individual learner evaluations.
Date posted: 
Mon, 10/10/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/10/2016
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Interprofessional Teaching Clinic (GITC). POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/105

Introduction to the Geriatric History and Physical Exam

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
0
Abstract: 

With a growing number of older adult patients entering the health care system and fewer students and residents pursing geriatric medicine,1,2 it is critical to prepare all medical students, no matter their specialty choice, with the basic knowledge and skills needed to care for the older adult population. 

The Geriatric History and Physical Exam Skills Module was designed to orient pre-clinical medical students to the common screening tools, physical exam maneuvers and common findings relevant to older adult patients.  This highly interactive module also presents pertinent modifications that need to be made when interviewing and examining the population.  The resource is most useful for second year medical students who have been introduced to history and physical exam skills on normal adult patients.  Requiring about 15 minutes to complete, this module incorporates self-assessment questions, radiographic images and high yield concepts for an early medical student.

 

References

  1. Golden, A. G., Silverman, M. A., & Mintzer, M. J. (2012). Is geriatric medicine terminally ill?. Annals of internal medicine, 156(9), 654-656.
  2. Golden, A. G., Silverman, M. A., & Issenberg, S. B. (2015). Addressing the shortage of geriatricians: What medical educators can learn from the nurse practitioner training model. Academic Medicine, 90(9), 1236-1240.

 

Educational objectives: 

By the end of the module, a learner will be able to:

  1. Recognize pertinent modifications for the interview and clinical exam of older adults
  2. Practice functional assessment and physical exam maneuvers of older adults by responding to questions
  3. Identify common findings in the geriatric exam
  4. Utilize screening tools to identify common geriatric syndromes
Date posted: 
Thu, 02/04/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 02/04/2016
Contact Person/Corresponding Author:



Suggested Citation:
Introduction to the Geriatric History and Physical Exam. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/105

Falls: A Geriatric Syndrome (Mrs. Pierce)

Posted:  
Fri, 10/09/2015 - 4:56pm
Date Updated:  
Fri, 10/09/2015 - 4:56pm

You are in the Geriatric Clinic with Dr. Green, a geriatrician. Dr. Green says, "Why don't you go see Mrs. Lurlene Pierce? She is a 78 year old woman I have been following for over 13 years. She is complaining of being slightly dizzy when she stands, which is new for her. She has never had any trouble with falls in the past, but be sure to ask if she has had any recent falls."

 

 

 

 

 

Notice ⚠️

 

Web-GEMs will no longer be available via POGOe after August 31, 2017. The web-GEMS modules will be moved to Med-U and are now available via subscription

If your institution created web-GEMs assignments before September, 2016, you are “grandfathered” into web-GEMs on Med-U and your institution will have one year free access to web-GEMs through June, 2018. MedU has already notified users who are ‘grandfathered’ about the process and has sent information on initiating your free access to the course through their new learning management system. If your institution is grandfathered and you haven't already done so, please complete the MedU onboarding form here so you can begin the process of onboarding onto the MedU platform.

If you have not received notification that you are will have free access for the 2017-18 subscription year and would like a quote to purchase a license for access to web-GEMs starting in July, please contact MedU Subscriptions for a quote. If you have any questions about this transition please reach out to Elvy Ickowicz at AGS. If you are currently using web-GEMs modules, you and your trainees will have until August 31, 2017 to complete the module via POGOe at no cost.

 
Link to Case:
Suggested Citation:
, , and . Falls: A Geriatric Syndrome (Mrs. Pierce). POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/105

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Gait Velocity Assessment Toolkit

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

Gait Velocity is a marker of functional and cognitive status in older adults.  Slow gait speed has been associated with poor clinical outcomes such as cognitive decline, falls and hospitalization. This toolkit provides  instructions on how to perform a gait speed or gait velocity assessment.  It includes START and STOP labels, labels for the Timed Zone, and instructions on how to interprete and apply the results.  The examiner will need to measure and mark a walkway, and supply a stopwatch or watch with a second hand. By following these simple steps, gait velocity assessment can become a routine practice for clinicians who care for older adults.

Educational objectives: 

1. Describe how to perform and interpret gait velocity assessment in older adults.

2. Discuss the clinical implications of slow gait speed

Date posted: 
Fri, 10/09/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 04/13/2018
Contact Person/Corresponding Author:



Suggested Citation:
Gait Velocity Assessment Toolkit. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/105

Geriatric Fast Facts Quizzes

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
0
Abstract: 

Geriatric Fast Facts (GFFs) [www.geriatricfastfacts.com] is a mobile enabled website which contains 1-2 page concise, peer-reviewed evidence-based educational summaries on key geriatrics topics to increase medical knowledge.

GFF Quizzes are quick, online assessment tools paired with GFF content, to be used by learners at the point of care to assess knowledge of geriatric content aligned with ACGME Milestones.  Design elements include quiz content searchable by topic, links to corresponding GFFs, MCQ/ short answer question formats and ability to include images. Learners enter brief demographic information to start (institution, email of self and up to 1 other) allowing annotated score results, displayed immediately after quiz completion, to be sent to themselves and one other individual (faculty, program director). These quick quizzes, available on hand held mobile devices at the point of care, linked to GFF content provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Educational objectives: 

The Geriatric Fast Fact (GFF) quizzes, available on hand held mobile devices at the point of care, linked to GFF content will provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Additional information/Special implementation requirements or guidelines: 

The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed and accessed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app".

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

Quick Quizzes:  Geriatrics Right in Your Hand & at the Point of Care.  Denson K, Simpson D, Padua K, and the GET Collaboratives at the Medical College of Wisconsin & Aurora Health Care, American Geriatrics Society Annual Meeting, Baltimore, MD, 05/2015

Date posted: 
Thu, 10/08/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/08/2015
Product Viewing Instructions: 
The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app"
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Fast Facts Quizzes. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/105

Error Disclosure: An Interprofessional Clinical Skills Session

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

The goal of this clinical skills session is for students to gain skills in working in teams during a particularly difficult situation: the team disclosure of medical errors.  There will be an encounter with a standardized patient (SP) acting as a family member, followed by feedback from the SP and for some students, a review of the recorded interview in a meeting with their mentors and mentor group.

Educational objectives: 

At completion of this case, the student will demonstrate effective team communication behaviors when:

  1. Discussing a medical error (by demonstrating four important principles),
  2. Planning for the disclosure (by demonstrating three important principles), and
  3. Conducting the disclosure (by demonstrating eight important principles).

The principles mentioned above are described in the online module.

Date posted: 
Mon, 10/12/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/12/2015
Product Viewing Instructions: 
Video can be accessed via geriSAGE.com>Educational Modules "Interprofessional web-GEM on Values & Ethics". Handout can be accessed on geriSAGE.com>Resources link>"IP Error Disclosure Handout"
Contact Person/Corresponding Author:



Suggested Citation:
Error Disclosure: An Interprofessional Clinical Skills Session. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/105

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